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

2026 Part B and Part D premiums at a glance

The standard Medicare Part B premium for 2026 is $202.90 per month with an annual deductible of $283. That is a 9.7% increase from the 2025 base of $185.00. Part D premiums vary by plan, but the IRMAA surcharge on Part D is a flat add-on per tier — it stacks on top of whatever your plan charges.

If your 2024 MAGI is at or below $109,000 (single) or $218,000 (married filing jointly), you pay the base rate with no surcharge. Cross those lines by even $1, and IRMAA kicks in. Source: CMS 2026 Medicare Parts B Premiums & Deductibles fact sheet; Federal Register 2025-20251.

Full 2026 IRMAA bracket table: single filers

Your 2024 MAGI determines your 2026 premium. Every dollar figure below is your monthly cost (Part B) and monthly surcharge (Part D) at that tier. The “annual extra cost” column is the combined Part B increase plus Part D surcharge above the base, annualized.

Full 2026 IRMAA bracket table: married filing jointly

Same mechanics, different thresholds. For a married couple where both spouses are on Medicare, every surcharge below applies per person — multiply the annual extra cost by two.

A married couple both on Medicare at Tier 1 ($218,001–$274,000 MFJ) pays $2,296 extra per year combined. At Tier 5 ($750,000+), that jumps to $13,872 per year for the couple.

The two-year lookback: which income year sets your 2026 premium

SSA uses your most recently filed federal tax return to set IRMAA. For 2026 premiums, that is your 2024 return (filed by April 2025). This two-year lag is the mechanic most retirees miss — and the source of most IRMAA sticker shock.

The lookback creates two problems. First, your 2026 IRMAA is already locked: the income decisions you made in 2024 are set in stone. Second, it means someone who earned $160,000 in 2024 but retired in March 2025 with current income of $50,000 is paying a surcharge based on stale data. SSA knows this happens, which is why Form SSA-44 exists.

The forward planning implication: the income decisions you make this year (2026) determine your 2028 Medicare bill. Roth conversions, capital gains, RMD amounts — all must be planned two years ahead.

The cliff mechanic: why IRMAA is not a marginal rate

Federal income tax brackets are marginal — only the dollars inside a bracket get taxed at that rate. IRMAA is a cliff. Cross the threshold by $1 and your premium jumps to the full next tier for all 12 months of the year.

For a married couple both on Medicare, every cliff cost doubles. The Tier 1 cliff at $218,001 MFJ costs $2,296 per year. One unexpected capital-gains distribution from a mutual fund, one poorly sized Roth conversion, or one extra consulting payment can push you over.

Decision tree: find your situation, then your move

There is no single answer to “how do I manage my Medicare premium?” Your strategy depends on your age, income sources, and how far above or below the nearest cliff you sit. Start with the branch that matches you.

Branch 1: Your 2024 MAGI is safely below $109K / $218K

You pay the base $202.90/month. Your risk is future creep: RMDs growing as your IRA balance compounds, Social Security COLA increases pushing taxable SS income higher, or a one-time event (property sale, inheritance distribution) spiking a single year. Plan two years ahead. If your 2026 income will push your 2028 MAGI near a cliff, act now — harvest losses in taxable accounts, route charitable giving through QCDs ($111,000 per person limit in 2026 per IRC § 408(d)(8)), and size any Roth conversions to stay below the line.

Branch 2: Your 2024 MAGI is between $109K–$137K (single) or $218K–$274K (MFJ)

You are in Tier 1, paying an extra $1,148 per person per year. The question is whether you can get below the cliff for future years. Calculate your controllable MAGI: total MAGI minus income you cannot change (Social Security, pensions, required minimum distributions). The remainder — capital gains, Roth conversions, consulting income — is your lever.

If your controllable income is small (most of your MAGI comes from SS + RMDs), focus on QCDs to offset RMDs and tax-loss harvesting to offset gains. If your controllable income is large (you are still working or have significant investment income), consider deferring income or splitting it across tax years.

Branch 3: Your 2024 MAGI is well above $137K / $274K

You are in Tier 2 or higher, paying $2,885 to $6,936 per person per year in surcharges. At these levels, IRMAA is a real cost — but it is also less likely you can drop below the first cliff without a major structural change (retirement, a down year in capital gains, a life event). Your move: model each tier boundary against your projected income for the next three years. It may be rational to accept a higher IRMAA tier now if aggressive Roth conversions this year reduce future RMDs enough to drop you one or two tiers in five years.

Branch 4: Your income dropped since the lookback year — file SSA-44

This is the branch most retirees do not know exists. If a qualifying life-changing event — retirement, work reduction, marriage, divorce, death of a spouse, loss of income-producing property, or loss of pension — has materially lowered your income since the year SSA is using, you can appeal with Form SSA-44.

Worked example: the SSA-44 appeal that saves $1,148/yr

Here is the gap-angle scenario no top-ranking page walks through with dollar-level specificity.

The situation: A Denver single filer, age 66, earned $160,000 in 2024 (final year of full-time employment: salary plus a year-end bonus). She retired in March 2025. Her 2025 income is projected at $48,000: $24,000 from a part-time consulting contract winding down, plus $24,000 from her brokerage dividends. She has not yet started Social Security.

Without the appeal: SSA uses her 2024 MAGI of $160,000. That puts her in Tier 2 ($137,001–$171,000), paying $405.80/month Part B plus $37.50 Part D surcharge. Annual extra cost: $2,885 above the base.

With the appeal: She files Form SSA-44, documenting the work stoppage (retirement) with her final pay stub, a letter from her employer, and a projected 2025 income statement. SSA recalculates using her 2025 projected income of $48,000 — well below the $109,000 Tier 1 threshold. Her Part B premium resets to the base $202.90/month with no Part D surcharge. Annual savings: $2,885.

What to file: Form SSA-44 (available at ssa.gov), plus proof of the life-changing event (termination letter, retirement letter, divorce decree, or death certificate) and proof of reduced income (tax return, pay stubs, or a signed estimate of expected income). Bring the form to your local SSA office or mail it. Processing typically takes 2–8 weeks; retroactive adjustments are applied once approved.

The income sources that count toward IRMAA — and the ones that do not

IRMAA is based on modified adjusted gross income, which is your AGI (line 11 on Form 1040) plus tax-exempt interest income. Here is what counts and what does not:

The surprise on that list: tax-exempt municipal bond interest counts toward IRMAA even though it does not appear on your tax return as taxable income. MAGI for IRMAA purposes adds tax-exempt interest back to AGI. Retirees holding large muni-bond portfolios for “tax-free income” are often blindsided when that income pushes them into a higher IRMAA tier.

Year-over-year context: 2025 vs 2026 premiums

The 2026 increase is not trivial. Here is how the base premium and IRMAA thresholds shifted:

The threshold increase means some beneficiaries who were in Tier 1 in 2025 may drop back to the base rate in 2026 — if their income stayed flat. But the premium increase means even the base rate costs more than last year.

Three MAGI-reduction levers you control

1. Qualified Charitable Distributions (QCDs)

Available at age 70½+ from Traditional IRAs. A QCD satisfies your RMD but is excluded from gross income and does not appear in MAGI. The 2026 limit is $111,000 per person ($222,000 for a married couple where each spouse owns an IRA). A one-time QCD to a charitable remainder trust or gift annuity of up to $55,000 is permitted under SECURE 2.0 § 307. This is the single most efficient IRMAA lever for retirees who give to charity.

2. Tax-loss harvesting in taxable accounts

Net capital losses offset realized gains dollar-for-dollar, plus up to $3,000 per year in net losses against ordinary income. Harvest losses in the tax year whose MAGI will set your premiums two years later. Losses harvested in 2026 help with 2028 premiums, not 2026.

3. Roth conversions sized below the cliff

A Roth conversion adds to MAGI in the year of conversion — but every dollar converted to Roth is invisible to IRMAA in all future years (no RMDs, no MAGI impact on withdrawal). The key is sizing: calculate your non-conversion MAGI, subtract from the IRMAA cliff you want to stay below, and convert only up to that amount. A married couple with $93,000 of baseline MAGI (SS + pension + investment income) and a $218,000 MFJ Tier 0 ceiling has $125,000 of Roth-conversion headroom before triggering Tier 1.

Your next step depends on which branch matched you

If you are at the base rate and want to stay there: map your projected income for the next two tax years. Flag any events (property sales, large Roth conversions, RMD increases) that could push MAGI over $109,000 single or $218,000 MFJ. Act in the year the income hits, not the year the premium rises.

If you are in Tier 1 and close to the line: run the QCD and tax-loss-harvesting math. A $10,000 QCD that drops you from $113,000 to $103,000 MAGI saves $1,148/yr in surcharges — that is a guaranteed return on $10,000 of giving you were likely already planning.

If you are in Tier 2+ and the income is structural: model a multi-year Roth-conversion plan that accepts short-term IRMAA pain for long-term RMD and premium reduction. The math usually favors converting aggressively if you have 5+ years of Medicare ahead.

If your income dropped and you are overpaying: file Form SSA-44 this week. Every month you delay is a month of surcharges you may not owe.