IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge tacked onto Medicare Part B and Part D premiums when your Modified Adjusted Gross Income (MAGI) from two years ago tops $109,000 (single) or $218,000 (married filing jointly). If you're new to Medicare, start planning ahead—because today's income shows up on your Medicare bill two years from now.
What Exactly is IRMAA? • IRMAA Brackets & Costs • The Sneaky IRMAA Trigger • 5 Ways to Dodge or Reduce IRMAA • How to Appeal an IRMAA Surcharge • Guide to IRMAA Deep Dive • IRMAA FAQs • Key Takeaway
What exactly is IRMAA...and why should you care?
Just getting started with Medicare? Meet IRMAA—the “success tax.” Every fall, the Social Security Administration reviews the Modified Adjusted Gross Income (MAGI) on the tax return you filed two years earlier. If that income tops the inflation-indexed thresholds below, SSA tacks an extra charge onto your Part B premium, and your Part D drug premium if you enroll, for the entire upcoming calendar year. So even first-time enrollees can feel IRMAA’s bite right out of the gate.
2026 IRMAA brackets & monthly premiums
| 2024 MAGI* | Filing status | 2026 Part B premium | 2026 Part D surcharge** | Nickname |
|
≤ $109,000 |
Single |
$202.90 |
$0 |
Standard |
|
≤ $218,000 |
Married-Joint |
$202.90 |
$0 |
Standard |
|
$109,001 – $137,000 |
Single |
$284.10 |
$14.50 |
Tier 1 |
|
$218,001 – $274,000 |
Married-Joint |
$284.10 |
$14.50 |
Tier 1 |
|
$137,001 – $171,000 |
Single |
$405.80 |
$37.50 |
Tier 2 |
|
$274,001 – $342,000 |
Married-Joint |
$405.80 |
$37.50 |
Tier 2 |
|
$171,001 – $205,000 |
Single |
$527.50 |
$60.40 |
Tier 3 |
|
$342,001 – $410,000 |
Married-Joint |
$527.50 |
$60.40 |
Tier 3 |
|
$205,001 – $500,000 |
Single |
$649.20 |
$83.80 |
Tier 4 |
|
$410,001 – $750,000 |
Married-Joint |
$649.20 |
$83.80 |
Tier 4 |
|
> $500,000 |
Single |
$689.90 |
$91.00 |
Tier 5 |
|
> $750,000] |
Married-Joint |
$689.90 |
$91.00 |
Tier 5 |
* SSA uses your 2024 return for 2026 premiums.
** Added to whatever your plan charges for Part D coverage.
Side-gig income: The sneaky IRMAA trigger
That fun Etsy shop or “just one more” consulting project might net only a few grand—but if it nudges your MAGI across a bracket line, the IRMAA surcharge can quickly wipe out the profit (and then some). Keep a running tally of year-to-date income and time new invoices or sales to stay beneath the next cliff.
Five proven ways to dodge or reduce IRMAA
1. Play the two-year chess game. Split large Roth conversions or capital gains sales across two calendar years to keep each year's MAGI under the threshold.
2. Tap Roth of HSA money first. Withdrawals from Roth IRAs and tax-free HSA reimbursements don't count toward MAGI.
3. Harvest losses to offset gains. Realize losing positions to balance big winners.
4. Go charitable with RMDs. Use Qualified Charitable Distributions (QCDs) to satisfy Required Minimum Distributions (RMDs) without boosting MAGI. Alphabet soup translation: QCDs feed RMDs without fattening your MAGI.
5. Shift income into January. A client happy to pay on December 31 is usually just as happy to pay on January 2.
These moves don't just cut taxes—they can save hundreds or even thousands per year in Medicare premiums.
Hit with IRMAA anyway? Here's how to appeal
If retirement, job loss, divorce, death of a spouse, or another “life-changing event” slashed your income after the tax year SSA used, file SSA-44 with documentation (retirement letter, pay stubs, amended return, etc.). Many appeals succeed, and adjustments start the month after SSA approves you.
Want more than the IRMAA CliffsNotes?
Get it decoded, without the headache
Looking for the full story? Grab our IRMAA Guide—the plain-English deep dive that's less alphabet soup and more "I've got this."
Inside you’ll find:
- IRMAA in one page: How the two-year look-back really works, and why last year’s income shows up on next year’s bill.
- Bracket breakdowns: Read the tiers like a pro and spot the cliffs before you tumble over one.
- Timing playbook: Split Roth conversions, offset gains, and time invoices so MAGI stays beneath the line.
- Appeal walk-through: Step-by-step SSA-44 checklist, what counts as a life-changing event, and the docs to bring.
- Side-gig sanity check: Etsy/consulting income traps—and how to keep hobbies from hiking premiums.
- Quick calculators & checklists: Turn “uh-oh” into action with simple worksheets you can actually use.
IRMAA FAQs
What does IRMAA stand for?
Income-Related Monthly Adjustment Amount = extra charges on Part B and/or Part D premiums for higher earners.
When does IRMAA apply?
If your 2024 MAGI exceeded $109,000 (single) or $218,000 (married-joint), IRMAA applies to your 2026 premiums. It’s recalculated every year.
How big is the surcharge?
Anywhere from $81.10 to $486.50 extra on Part B and $14.50 to $91.00 extra on Part D each month, depending on your bracket.
Can IRMAA go away?
Yes. If your income falls below the threshold, your premium resets the following year. You can also appeal immediately after a qualifying life event
Does IRMAA affect Medicare Advantage?
Yes. IRMAA is added to your Part B premium (and Part D, if included) and you pay it on top of your Medicare Advantage plan premium—even $0 plans.
Key takeaway
New to Medicare? Remember, IRMAA isn’t a penalty; it’s a predictable surcharge based on income. By strategically timing your retirement and choosing where your retirement dollars come from, you can keep more cash in your pocket and send less to Uncle Sam. Stay proactive and IRMAA won’t crash your retirement party—or any that follow.
Ready to see your full plan costs—premiums, copays, max out of pocket, IRMAA—and skip surprises?
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