IRMAA 2026 Brackets by Income: Find Your Medicare Surcharge (Single and Married)

The full 2026 IRMAA bracket table — Part B and Part D, single and married

Your 2026 Medicare premium is determined by your 2024 modified adjusted gross income (MAGI). IRMAA is a cliff, not a gradient: one dollar over a threshold means you pay the full surcharge for all twelve months. Here is every tier, with the exact dollar cost over the base premium.

Annual extra = (Part B increase + Part D surcharge) × 12 vs base tier. Couple assumes both spouses on Medicare. Source: CMS 2026 Medicare Premiums & Cost Sharing; IRMAA determination based on 2024 MAGI per IRC § 1839(i).

The part most people miss: these are cliffs, not brackets. Federal income tax is graduated — you pay 22% only on the income inside the 22% bracket. IRMAA is not graduated. Cross the $103,000 line by a single dollar and you pay the $259/month premium on every dollar of Part B coverage for the entire year. There is no proportional scaling.

The two-year lookback: your 2024 tax return sets your 2026 premium

Social Security determines your IRMAA tier using a two-year lag. Your 2026 Medicare premiums are based on the MAGI reported on your 2024 federal tax return (Form 1040, line 11, plus any tax-exempt interest from line 2a). By the time you receive the IRMAA determination letter, the income that triggered it is already filed.

This matters for three scenarios in particular:

• You retired in 2025 but earned a full salary in 2024. Your 2026 premium reflects the high-income 2024 return, not your retirement-year income. You are paying a surcharge based on earnings you no longer have.
• You did a large Roth conversion in 2024. Every dollar converted is included in 2024 MAGI. A $60,000 conversion stacked on $70,000 of other income puts a single filer at $130,000 — into the second IRMAA tier, paying $370/month instead of $185.
• You sold a rental property or exercised stock options in 2024. Capital gains and the bargain element on nonqualified stock options are both MAGI. A one-time event in 2024 can spike your 2026 premium for twelve months even if your income returned to normal in 2025.

The planning upshot: every income decision you make in 2026 will set your 2028 IRMAA. If you are sizing a Roth conversion, selling an investment, or timing a distribution, the IRMAA impact lands 28 months later.

Worked example: a recently retired couple at the IRMAA cliff

This is the scenario none of the top-ranking pages walk through — the retiree whose 2024 tax return no longer reflects reality, and the appeal that can fix it.

The setup: A married couple in Atlanta. He earned $140,000 through September 2024, then retired October 1. She earned $55,000 part-time. Their 2024 MAGI: $195,000 in wages plus $12,000 in interest and dividends = $207,000. That is $1,000 over the $206,000 MFJ cliff.

The cost: Both spouses are on Medicare. At the first IRMAA tier, each pays $259/month for Part B (instead of $185) plus a $13.70/month Part D surcharge. Extra annual cost: $2,105 for the couple — triggered by $1,000 of income above the line.

The fix: He retired — that is a qualifying life-changing event (“work stoppage”). In 2025, his income dropped to $36,000 (Social Security at 67, started January 2025) and her part-time work fell to $30,000. Their 2025 MAGI: roughly $66,000 — well below the $206,000 cliff.

They file Form SSA-44 with Social Security, requesting that SSA use 2025 income instead of 2024. They include his retirement letter, final pay stub, and a signed estimate of 2025 household income. If SSA approves (and the facts here clearly qualify), both premiums drop to the $185/month base. The $2,105/year surcharge disappears.

Decision tree: which IRMAA path applies to you

Your situation falls into one of four branches. Each has a different set of levers.

Branch A — You are under the first cliff and want to stay there

Your 2024 MAGI is below $103,000 (single) or $206,000 (MFJ). You pay the $185/month base premium. The goal is to keep future determination-year MAGI below the same line.

Your levers:

• Size Roth conversions to the cliff. If your non-conversion MAGI is $70,000 (single), you have $33,000 of conversion headroom before crossing $103,000. Convert up to that line each year. After the standard deduction of $15,750 (single, 2026), that $103,000 MAGI means roughly $87,250 of taxable income — inside the 22% federal bracket (tops at $103,350 single). You are paying 12–22% now to avoid 24%+ later when RMDs start.
• Harvest capital losses before year-end. If gains from a brokerage sale would push you over, offset them with realized losses from other positions. Up to $3,000 of net losses reduces ordinary income under IRC § 1211(b).
• Time income events. If you plan to sell a rental property or exercise options, model the MAGI impact before executing. Shifting the event to a year when you are already over a cliff costs less than triggering a new one in a clean year.

Branch B — You are already in a surcharge tier and RMDs are the driver

You are 73+ (born 1951–1959, per SECURE 2.0 § 107) and your required minimum distribution pushes you over a cliff involuntarily. At age 73, the Uniform Lifetime Table divisor is 26.5. On a $1,800,000 Traditional IRA, that is a $67,924 RMD (per IRS Pub. 590-B, Table III). Add $72,000 in Social Security and $15,000 in dividends: MAGI hits $154,924 single — deep in the second IRMAA tier.

Your levers:

• QCDs — the cleanest cut. A Qualified Charitable Distribution (up to $111,000 per person in 2026, IRC § 408(d)(8)) satisfies your RMD but is excluded from gross income entirely. If you were going to donate $20,000 to charity anyway, doing it as a QCD instead of writing a check removes $20,000 from your MAGI. That $20,000 might be the difference between Tier 2 ($370/month) and Tier 1 ($259/month) — saving you $1,752/year.
• Prior-year Roth conversions (if still available). The window for this was ages 60–72. If you did not convert pre-RMD, the ship has partially sailed — but RMDs only require the minimum. You can still convert amounts above the RMD to reduce the balance for future years, accepting the IRMAA hit now if the bracket arbitrage is strong enough.

Branch C — You had a one-time income spike (property sale, options exercise, severance)

A one-time event in 2024 inflated your MAGI for that year only. Your 2026 premium is based on that spike. In 2025 and beyond, your income is back to normal.

Your lever: the SSA-44 appeal. If the spike resulted from a qualifying life-changing event (work stoppage, property loss, settlement payment), file Form SSA-44 asking SSA to use 2025 income instead. If the event does not fit the SSA-44 categories — for example, you simply chose to sell a stock position — the appeal is not available. In that case, you absorb the surcharge for 2026 and plan to keep 2025 MAGI (which sets 2027 premiums) below the cliff.

Branch D — You are pre-Medicare (under 65) and planning ahead

You are not yet on Medicare, so IRMAA does not apply yet. But your income in the two years before enrollment sets the surcharge for your first year of coverage. If you turn 65 in 2028, your 2026 income determines your first IRMAA tier.

Your levers:

• Front-load Roth conversions to ages 60–63. This is the widest conversion window: you are likely retired or semi-retired, not yet on Social Security (if delaying to 70), and IRMAA does not apply. Convert aggressively into the 12% ($23,851–$96,950 MFJ) and 22% ($96,951–$206,700 MFJ) federal brackets. After the MFJ standard deduction of $31,500, $206,000 of MAGI means ~$174,500 of taxable income — well inside the 22% bracket. You are paying 10–22% now to shrink the Traditional balance that would generate RMDs at 24%+ later.
• Model the 2-year lookback calendar. If you turn 65 in January 2028, your IRMAA is based on your 2026 return. Every conversion, gain, or distribution you take in 2026 sets the Medicare premium you pay starting in 2028.

The SSA-44 appeal: step-by-step dollar walkthrough

Most retirees do not know this form exists. Here is exactly how it works, using the Atlanta couple from the scenario above.

1. Confirm you have a qualifying life-changing event. The seven qualifying events: marriage, divorce, death of a spouse, work stoppage or reduction, loss of income-producing property, loss of pension income, receipt of an employer settlement. The Atlanta couple qualifies under “work stoppage” (he retired in October 2024).
2. Gather documentation. Retirement letter or employer confirmation of last day worked, final pay stub, W-2 for the partial year (if available), and an estimate of the more recent year’s income. If you are asking SSA to use 2025 income and the return is not yet filed, a signed statement with projected income sources suffices.
3. Complete Form SSA-44. The form asks for the type of event, the date it occurred, and your estimated MAGI for the year you want SSA to use. For the Atlanta couple: event = “work stoppage,” date = October 1 2024, requested year = 2025, estimated 2025 MAGI = $66,000.
4. Submit to your local SSA office. You can walk it in, mail it, or (in some districts) fax it. Processing typically takes 2–8 weeks. If approved, SSA retroactively adjusts the premium back to the correct tier for all months in the determination year.
5. Check the result. SSA sends a revised determination letter. For the Atlanta couple, the premium drops from $259/month to $185/month — $74/month per person, $148/month for the couple, $1,776/year recovered (Part B alone) plus Part D surcharge relief.

The savings at higher tiers are even larger. A single filer with a 2024 MAGI of $400,000 (from a one-time stock option exercise) who retired and earned $50,000 in 2025 would move from $591.90/month to $185/month — saving $4,882.80/year in Part B alone.

The Social Security taxation multiplier most retirees overlook

IRMAA does not exist in isolation. Social Security benefits are taxable above $25,000 (single) or $32,000 (combined income, MFJ) — with up to 85% of benefits taxable above $34,000 (single) or $44,000 (MFJ). These thresholds have not been inflation-adjusted since 1983. Virtually every retiree with a pre-tax IRA and Social Security benefits is in the 85% taxable zone.

Here is where it stacks: taxable Social Security is included in MAGI. A Roth conversion or large RMD does not just add its own amount to MAGI — it can also push more of your Social Security into the taxable bucket, which further inflates MAGI, which can push you over an IRMAA cliff you thought you were safely under. The effective marginal rate in the SS-taxation phase-in zone can exceed 40% when you combine the federal bracket, the SS inclusion bump, and the IRMAA cliff.

This is exactly why the gap-year Roth conversion strategy (Branch D above) is so powerful. Converting before Social Security starts means the conversion amount does not trigger the SS-taxation multiplier. Once SS is flowing, every dollar of conversion pushes harder against both the bracket and the IRMAA cliff.

Your next step depends on which branch matched you

1. Branch A (under the cliff, staying there): Pull your 2024 tax return. Find line 11 (adjusted gross income) and add line 2a (tax-exempt interest). That is your MAGI. Calculate the distance between that number and $103,000 (single) or $206,000 (MFJ). That distance is your annual conversion or income headroom — do not exceed it.
2. Branch B (RMDs pushing you over): Calculate your next RMD using the Uniform Lifetime Table divisor (26.5 at age 73, per IRS Pub. 590-B). If RMD + SS + other income crosses a cliff, determine how much of the RMD you can redirect as a QCD (up to $111,000). Switch your charitable giving from cash to QCDs immediately.
3. Branch C (one-time spike): Check the SSA-44 qualifying events list. If your spike was caused by one of the seven events, file the form this month — there is no benefit to waiting, and retroactive adjustments apply to the full determination year.
4. Branch D (pre-Medicare planning): Build a 5-year MAGI projection with and without Roth conversions. Map each year’s conversion target to the IRMAA cliff that applies two years later. Your widest conversion window is now, before SS and Medicare start.