You may think that once you qualify for Medicare, your premiums are set. But if you’re a higher-income earner, you might be surprised to learn that you’ll pay more for your Medicare Part B and Part D coverage. That extra amount is called IRMAA, and in 2026, it could add hundreds of dollars to your monthly costs.
Let’s walk through what IRMAA is, how it works, and what steps you can take to reduce or avoid it.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an extra charge added to your Medicare Part B (medical insurance) and Part D (prescription drug coverage) premiums if your income is above a certain level.
The Social Security Administration determines your IRMAA based on your modified adjusted gross income (MAGI) from two years prior. That means your 2024 tax return is used to calculate your 2026 IRMAA.
2026 IRMAA Thresholds and Premiums
In 2026, the standard monthly premium for Part B is $202.90, and you may pay more if your income in 2024 exceeds these thresholds:
Single filers:
- $109,000 or more
Married filing jointly:
- $218,000 or more
Once you cross those thresholds, your premiums rise based on which of six IRMAA brackets you fall into.
Here are the highest IRMAA amounts in 2026:
- Part B: $689.90 per month
- Part D: Your plan premium + up to $91.00/month in IRMAA charges
Can You Avoid or Reduce IRMAA?
Yes—and it starts with planning ahead.
If your income dropped due to a life-changing event, such as:
- Retirement
- Death of a spouse
- Divorce
- Loss of income-producing property
- Work reduction
...you can file an IRMAA appeal with the Social Security Administration. Use Form SSA-44 and include documentation to explain the change.
Why It Matters
Paying more for Medicare might be manageable—but it shouldn’t catch you off guard. Many retirees are surprised to learn that their income from investments, required minimum distributions (RMDs), or capital gains can push them into a higher IRMAA bracket.
Even if you’re not in that situation yet, understanding IRMAA now helps you plan better for the future.
If you're a higher-income earner—or expect to be when you retire—start planning today. Talk to your financial advisor or tax professional to understand how your income affects your Medicare costs. Ask them how to reduce your MAGI and potentially avoid or lower your IRMAA in future years.
Want to learn more? Join a Medicare class at GetSetUp’s Medicare Hub.