Medicare’s Income-Related Monthly Adjustment Amount (IRMAA) for 2026 keys off the income you reported on your 2024 tax return, under the standard two-year lookback. CMS released the 2026 brackets and surcharges on November 14, 2025, and a one-time income event, such as a property sale or a Roth conversion, can lift a household into a higher tier for a single year.
IRMAA touches a minority of beneficiaries. Roughly 8% of people with Medicare Part B pay any surcharge, and a similar share pay the Part D adjustment. If your modified adjusted gross income (MAGI) sits comfortably below the first threshold, none of this applies. For everyone else, the 2026 brackets reset where the cliffs sit and what one extra dollar of income costs.
The 2026 Part B Income Brackets
MAGI for IRMAA is adjusted gross income (Form 1040, line 11) plus tax-exempt interest (line 2a). Municipal bond income that feels tax-free still counts, which is the most common reason a household near a threshold misjudges its bracket.
The 2026 Part B figures below come from CMS and use your 2024 return as the income reference under the standard two-year lookback.
| Single MAGI (2024) | Joint MAGI (2024) | Monthly Part B surcharge (per person) | Total monthly Part B premium (per person) |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $0.00 | $202.90 |
| $109,001 to $137,000 | $218,001 to $274,000 | $81.20 | $284.10 |
| $137,001 to $171,000 | $274,001 to $342,000 | $202.90 | $405.80 |
| $171,001 to $205,000 | $342,001 to $410,000 | $324.60 | $527.50 |
| $205,001 to under $500,000 | $410,001 to under $750,000 | $446.30 | $649.20 |
| ≥ $500,000 | ≥ $750,000 | $487.00 | $689.90 |
The first single-filer threshold rose from $106,000 to $109,000 between 2025 and 2026, and the joint threshold sits at twice that. The remaining breakpoints moved by similar proportions, except the top tier at $500,000 single and $750,000 joint, which carries no inflation indexing and stayed put.
The 2026 Part D Surcharges
Part D uses the same income brackets but adds its own monthly amount on top of whatever your drug plan charges. A household in the first surcharge tier pays an extra $14.50 per person a month in 2026 for Part D, on top of the $81.20 Part B add-on.
The Part D adjustment climbs through the same five tiers as Part B, and Medicare either deducts it from your Social Security check or bills it directly, no matter how you pay the underlying Part D premium.
The Cliff: What One Dollar Over Costs
IRMAA works as a cliff at each threshold. A single filer with 2024 MAGI of $109,000 pays the standard $202.90 Part B premium in 2026. A single filer at $109,001 pays $284.10, an extra $81.20 a month for the full year. Add the $14.50 Part D surcharge, and one dollar of MAGI triggers roughly $1,148 in added Medicare costs over 12 months for a single filer, or about twice that for a married couple where both spouses are on Medicare.
The same cliff repeats at every tier. Moving from the first surcharge tier to the second adds another $121.70 a month in Part B alone ($202.90 versus $81.20), and the dollar-over example plays out the same way at the $137,000, $171,000, $205,000, and $500,000 single breakpoints.
The Two-Year Lookback
Your 2024 return set your 2026 surcharge. Your 2025 income will set 2027, and your 2026 income will set 2028. Closed years are locked: a Roth conversion you completed in 2024 already sits inside the 2026 bracket calculation, and you cannot unwind it for IRMAA.
That lag is also why one-time events drive most surprise surcharges. A home sale, a Required Minimum Distribution in the year you turn 73, a severance payment, or a large Roth conversion can push your household one tier higher, or several, for a single year, then drop it back the next.
The Survivor Trap
The joint thresholds sit at exactly twice the single thresholds. When one spouse dies and the survivor starts filing single the following year, the same household income that rested comfortably under the $218,000 joint threshold can clear the $109,000 single threshold and climb several tiers. The bracket shifted while the income held constant.
What SSA-44 Does and Does Not Do
The Social Security Administration’s Form SSA-44 lets you request a recalculation when income drops because of a qualifying life-changing event: marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, or an employer settlement.
SSA-44 will not reverse a voluntary income event. A Roth conversion, a home sale, or an RMD that pushed your MAGI over a threshold does not qualify, however large the resulting surcharge. The form addresses income declines only.
Practical Considerations
- Add Form 1040 line 11 and line 2a from your 2024 return, then find your household in the table above; that determines the 2026 surcharge.
- If your household sits within roughly $20,000 of any 2026 bracket edge, model your 2025 and 2026 income before year-end. You can size a planned Roth conversion or RMD to land just under the next cliff, since the brackets that set your 2027 and 2028 premiums are still in play.
- If you are a surviving spouse filing single for the first time, your income runs against the single column, not the joint one. That transition year is when survivor IRMAA surprises usually show up.
- When a qualifying life-changing event reduces your income, file SSA-44 with supporting documentation (a retirement letter, death certificate, divorce decree, or employer notice) rather than waiting for the next annual recalculation.
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