IRMAA 2026 Income Limits and Brackets

Your 2026 Medicare Part B and Part D premiums are set by your 2024 MAGI. If your income exceeded $109,000 (single) or $218,000 (married filing jointly) in 2024, you owe IRMAA surcharges on top of the standard $202.90/month Part B premium. Here is the complete 2026 bracket table, verified against SSA.gov and CMS.¹

2026 IRMAA brackets — single filers

Filing status: single, head of household, or qualifying surviving spouse with dependent child. Threshold based on 2024 MAGI.

Annual extra = (Part B surcharge + Part D surcharge) × 12. Part B surcharge = total premium minus base $202.90/mo. Per person; Medicare does not offer a family plan.

2026 IRMAA brackets — married filing jointly

Thresholds are exactly double the single thresholds for Tiers 1–4. Both spouses pay IRMAA independently based on the same joint MAGI.

Both spouses pay IRMAA on their individual Part B and Part D premiums based on the joint return MAGI. A couple both in Tier 2 pays $2,885 × 2 = $5,770/yr in combined IRMAA surcharges.

The married-filing-separately trap

Married couples who file separate returns face a nearly punitive IRMAA structure. The IRS sends SSA the MFS filing status, which triggers a compressed bracket:²

A married individual with $130,000 in MAGI who files jointly would pay zero IRMAA (well under the $218,000 MFJ threshold). The same person filing separately with $130,000 of their own MAGI jumps immediately to Tier 4 — an extra $6,355/year. Tiers 1 through 3 do not exist for married-filing-separately filers: the bracket skips from zero to Tier 4 at $109,001.

There are legitimate reasons couples file separately (e.g., income-driven student loan repayment, Medicaid planning). But if IRMAA avoidance is the goal, separate filing is almost always counterproductive.

How the two-year look-back works

SSA uses the most recent tax return the IRS has processed when it sets your premiums for a given year. The practical result:¹

This lag has two important consequences. First, a one-time income spike in 2024 — a Roth conversion, home sale gain above the §121 exclusion, large RMD, or business sale — raises your 2026 premiums even if your 2025 and 2026 income are much lower. Second, if you retired in 2025 and your 2024 income was high, you will pay elevated 2026 premiums based on that last working year — unless you file an SSA Form SSA-44 to request use of your current (lower) income.

What counts as MAGI for IRMAA

IRMAA MAGI = your AGI (Form 1040, Line 11) plus tax-exempt interest (Line 2a). Some income that escapes federal income tax still counts:³

The muni bond interest inclusion is one of the most overlooked IRMAA traps. You pay no federal income tax on it, but it still counts toward the MAGI that sets your Medicare premiums. A retiree holding $500,000 in municipal bonds earning 3% generates $15,000 in tax-exempt interest that pushes MAGI up — potentially by enough to cross a bracket threshold.

Annual perspective: what each tier actually costs

These numbers are per person. Medicare does not have a family plan; each Medicare beneficiary is billed individually.

Part B annual = monthly total × 12. Couple cost assumes both spouses are in the same tier. Does not include Part A, Medigap/MA, or Part D plan premium.

Bracket cliff risk: $1 matters

IRMAA is not a marginal system — it is a cliff. A single filer at $136,999 MAGI owes the Tier 1 surcharge ($1,148/yr). At $137,001, they owe the Tier 2 surcharge ($2,885/yr): $1,737 more per year for $2 of additional MAGI. The practical implication:

• Staying just under a threshold is worth real money. A $5,000 Roth conversion that pushes you from $136,000 to $141,000 costs $1,737/year in IRMAA — before considering the Roth's tax benefit.
• One-year income spikes (sales, conversions, large distributions) get locked into premiums for two years before normalizing.
• Tax-exempt interest and 0%-rate capital gains count. You can have a low effective tax rate and still owe IRMAA.

The Tier 5 bracket is frozen

Tiers 1–4 are adjusted for inflation annually, tracking the Consumer Price Index (CPI-U). Tier 5 is different: the $500,000 single / $750,000 MFJ threshold is frozen at its 2017 TCJA level through at least 2027, when it first becomes eligible for inflation adjustment. In practice, Tier 5 will gradually capture more beneficiaries over time without requiring any income change on their part.

If your 2024 income was a one-time spike: SSA-44

SSA Form SSA-44 allows Medicare beneficiaries to request a reduction in IRMAA when a qualifying life-changing event caused income to fall in a more recent year. The seven qualifying events include:⁴

• Marriage, divorce, or annulment
• Death of spouse
• Work stoppage or reduction (including retirement)
• Loss of income-producing property (involuntary — foreclosure, disaster, fraud)
• Loss or reduction of pension income
• Receipt of a settlement from an employer

The SSA-44 only applies to a qualifying life-changing event — not to deliberate income decisions such as a Roth conversion you chose to execute, a business sale, or a voluntary IRA distribution. If you took a large distribution in 2024 to fund retirement expenses and now your MAGI is lower, SSA-44 likely does not help. An advisor can assess whether your specific income pattern qualifies.

Five strategies to reduce IRMAA exposure

1. Qualified Charitable Distributions (QCDs). Direct IRA distributions to charity up to $111,000/person per year (2026) satisfy RMDs without adding to AGI. The QCD never appears in gross income — zero MAGI impact, unlike a regular distribution followed by a charitable deduction.⁵
2. Pre-65 Roth conversion window. The two-year look-back means conversions completed by age 63 do not affect Medicare premiums at age 65. Converting in lower-income years before Medicare enrollment, when income is still manageable, is the cleanest IRMAA lever for most people.
3. Capital gain and Roth harvest sequencing. If MAGI is already near a threshold, avoid compressing large gains or conversions into years when other income (RMDs, SS, pension) is also high. Spreading gains across years often keeps each year below the next tier.
4. Income smoothing across the bracket. Instead of irregular large distributions, annual systematic withdrawals calibrated to stay $3,000–$5,000 below a tier threshold are worth modeling explicitly. Even modest adjustments compound significantly over a 10–20-year retirement.
5. SSA-44 appeal after retirement year. If you retired in 2025 and your final W-2 year (2024) was high, file SSA-44 with documentation showing your expected 2025 or 2026 income. If approved, SSA adjusts your premiums to reflect the lower current year.

Sources

1. SSA POMS HI 01101.020: IRMAA Sliding Scale Tables — authoritative 2026 IRMAA bracket thresholds and Part B/D surcharge amounts for all filing statuses, updated December 2025. All bracket values on this page verified here.
2. CMS: 2026 Medicare Parts A & B Premiums and Deductibles — official CMS fact sheet confirming $202.90 standard Part B premium, IRMAA surcharge tiers, and the married-filing-separately bracket structure. Verified November 2025.
3. IRS Publication 590-B: Distributions from Individual Retirement Arrangements — MAGI definition and what income types count toward IRMAA MAGI calculation; QCD exclusion from AGI per IRC §408(d)(8).
4. SSA Form SSA-44: Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event — seven qualifying life-changing events, documentation requirements, and how to request IRMAA recalculation using a more recent year's income.
5. IRS IR-2025-244: 2026 Retirement Contribution Limits — QCD limit $111,000 per person for 2026 (indexed under SECURE 2.0 § 307). QCDs exclude the transferred amount from gross income, reducing MAGI dollar for dollar.

Bracket values verified against SSA POMS and CMS fact sheet, May 2026. IRMAA brackets are reset annually by CMS each November. Consult a licensed advisor for guidance specific to your income and tax situation.