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How Income Affects Medicare Costs (IRMAA)

  • Writer: Cassidy Clark
    Cassidy Clark
  • 1 minute ago
  • 2 min read

Some people pay more for Medicare based on having a higher income. This extra amount is called IRMAA, which stands for Income-Related Monthly Adjustment Amount. 


Let’s break down each aspect of IRMAA, how it is calculation, and how to know if you are impacted by IRMAA. 


  1. What Is the Standard Cost?


In 2026: 


  • The standard Part B premium is $202.90 per month. 

  • Part D premiums vary by plan. 


Most people pay the standard amount. 


IRMAA only applies if your income is above specific limits. 


  1. How Does Medicare Know Your Income?


IRMAA is based on your Modified Adjusted Gross Income (MAGI) from your federal tax return two years ago.  


  • For 2026 Medicare premiums, Social Security looks at your 2024 tax return. 


  1. When Does IRMAA Apply?


For 2026, IRMAA begins if your 2024 income was: 


  • More than $109,000 (individual tax return), or 

  • More than $218,000 (married filing jointly) 


If your income was below those amounts, you pay the standard premium of $202.90. 


If your income was above those amounts, you pay more. See the chart below for an idea of what your premium may be. 


  1. How Much More Could You Pay?


Here is a simplified breakdown of Part B premiums based on Individual income, please note that married couples filing jointly have higher income thresholds: 

2024 Income (Individual) 

2024 Income (Married Filing Joint) 

2026 Part B Premium 

$109,000 or less 

$218,000 or less 

$202.90 

$109,001 – $136,000 

$218,001 - $272,000 

$283.00 

$136,001 – $170,000 

$272,001 - $340,000 

$364.20 

$170,001 – $204,000 

$340,001 - $408,000 

$445.40 

$204,001 – $500,000 

$408,001 - $750,000 

$526.60 

Above $500,000 

Above $750,000 

$689.90 

If IRMAA applies, you will also pay an additional surcharge for Part D, this amount is added to the premium that your Part D plan charges. 

2024 Income (Individual) 

2024 Income (Married Filing Joint) 

2026 Part D Surcharge 

$109,000 or less 

$218,000 or less 

$0 

$109,001 – $136,000 

$218,001 - $272,000 

$14.50 

$136,001 – $170,000 

$272,001 - $340,000 

$37.50 

$170,001 – $204,000 

$340,001 - $408,000 

$60.40 

$204,001 – $500,000 

$408,001 - $750,000 

$83.30 

Above $500,000 

Above $750,000 

$91.00 


  1. What If Your Income Has Dropped?


IRMAA is not always permanent. 


You may request a review if you have experienced a major life event such as: 


  • Retirement 

  • Divorce 

  • Death of a spouse 

  • Loss of income-producing property 

  • Significant reduction in work hours 


You would file an appeal through the Social Security Administration. If approved, your premium can be adjusted. 


Important Things to Remember 


  • IRMAA does not affect your Medicare coverage, only what you pay. 

  • It is reviewed each year and can change. 

  • About 8% of Medicare beneficiaries pay IRMAA. 

  • It is based on tax returns from two years prior. 


Why This Matters 


If you are retiring soon, selling property, or taking large withdrawals from retirement accounts, it’s important to understand how those decisions may affect your Medicare premiums. Planning ahead can help you avoid unexpected premium increases. 


The SGIA Benefit Consultants are here to help you understand if IRMAA applies to you and how this may impact the costs you are responsible for. 



 
 
 
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