Medicare IRMAA, the income brackets explained

IRMAA stands for Income-Related Monthly Adjustment Amount, an extra charge added to your Part B (medical) and Part D (drug) premiums if your income is above a set level.

Most people pay only the standard premiums, but higher earners pay the standard amount plus the IRMAA surcharge. The surcharge is based on your tax return from two years earlier, so your 2026 IRMAA is based on your 2024 income. The first income tier begins above $109,000 for a single filer and above $218,000 for a married couple filing jointly in 2026. If your income later drops or a life event changed it, you can ask Social Security to review your case. To understand how IRMAA might affect your premiums, reach out to a licensed Goodsurance advisor at 1-888-301-8091 (TTY 711), Mon to Fri 8 am to 5 pm PT.

IRMAA, the Income-Related Monthly Adjustment Amount, is triggered when your income rises above the first tier: more than $109,000 for a single filer or more than $218,000 for a married couple filing jointly in 2026.

Below those amounts, you pay only the standard Part B and Part D premiums with no surcharge. The income used is your modified adjusted gross income from your tax return two years earlier, so 2026 IRMAA is based on your 2024 income. There are several higher tiers above the first one, and the surcharge grows as income rises. Because it uses a two-year lookback, a year with a one-time income spike, like selling a home, can affect you later. To see how your income lines up, reach out to a licensed Goodsurance advisor at 1-888-301-8091 (TTY 711), Mon to Fri 8 am to 5 pm PT.

You appeal IRMAA, the Income-Related Monthly Adjustment Amount, by asking Social Security to reconsider the income they used.

Because IRMAA is based on your tax return from two years earlier, the figure can be outdated if your income has dropped. You can request a new decision if you had a qualifying life-changing event, such as marriage, divorce, the death of a spouse, retirement, or a reduction in work hours, that lowered your income. You file a form with Social Security explaining the change and provide documentation, like a tax return or proof of the event. If approved, your surcharge is recalculated using your more current, lower income. There are deadlines, so acting promptly helps. To understand whether your situation qualifies for an appeal, reach out to a licensed Goodsurance advisor at 1-888-301-8091 (TTY 711), Mon to Fri 8 am to 5 pm PT.

No, IRMAA does not use last year's income; it uses your income from two years earlier.

IRMAA, the Income-Related Monthly Adjustment Amount, is a surcharge on Part B and Part D premiums for higher earners, and Social Security calculates it using your most recent tax return on file, which is generally from two years back. That means your 2026 IRMAA is based on your 2024 income. This two-year lookback is why a one-time income event, such as selling property or a large withdrawal, can raise your premium a couple of years later. If your income has since dropped because of a life-changing event, you can ask Social Security to use more current figures. To understand the timing for your situation, reach out to a licensed Goodsurance advisor at 1-888-301-8091 (TTY 711), Mon to Fri 8 am to 5 pm PT.

Medicare costs in 2026 depend on which parts you have, but here are the standard figures.

Part A (hospital coverage) is premium-free for most people who worked at least 40 quarters; using it carries an inpatient deductible of $1,736 per benefit period in 2026. Part B (doctor and outpatient coverage) has a standard premium, meaning a monthly amount you pay, of $202.90 in 2026, plus a yearly deductible of $283. Part D (prescription drug coverage) varies by plan, with a national base premium of $38.99 in 2026, deductibles up to $615, and a yearly out-of-pocket cap of $2,100. Higher earners pay more for Part B and Part D through IRMAA, an income-based surcharge. Your total depends on the parts and plans you choose.

Your Medicare premium can go up for a few common reasons.

First, the standard Part B premium, the monthly amount for doctor and outpatient coverage, is set each year and is $202.90 in 2026, so a yearly adjustment may be part of it. Second, your premium may have risen because of IRMAA, the Income-Related Monthly Adjustment Amount, an extra charge added when your reported income is above a certain level. In 2026, IRMAA begins for single filers with income above $109,000 and joint filers above $218,000. Because IRMAA uses tax information from a prior year, a higher-income year can raise your premium later. If you added Part D drug coverage or a new plan, that can change your total too.

IRMAA stands for Income-Related Monthly Adjustment Amount, an extra charge some people pay on top of their standard Medicare premiums.

It applies to Part B (doctor and outpatient coverage) and Part D (prescription drug coverage) when your reported income is above a set threshold. In 2026, IRMAA begins for single filers with income above $109,000 and for joint filers with income above $218,000. The amount added increases at higher income levels. IRMAA is based on your tax return from a prior year, so a higher-income year can affect your premiums later on. If your income has dropped due to a major life change, you can ask Social Security to reconsider. In short, IRMAA means higher earners pay more for the same coverage.

No, Medicare is not free at age 65 for most people.

Many people pay no premium for Part A (hospital coverage) at 65 because they worked at least 40 quarters and paid Medicare taxes, but that does not make all of Medicare free. Part B (doctor and outpatient coverage) has a standard premium, the monthly amount you pay, of $202.90 in 2026, along with a yearly deductible of $283. If you add Part D for prescription drugs, that has its own cost too. Even premium-free Part A has a $1,736 inpatient deductible per benefit period in 2026 when you use it. So turning 65 does not mean coverage with no cost; most people pay monthly premiums and out-of-pocket amounts.