Educational only. I am not an actuary, attorney, tax advisor, or SSA claims representative. This article reports CMS and SSA figures for the Income-Related Monthly Adjustment Amount (IRMAA) on Medicare Part B and Part D. Confirm your notice with Social Security. Official pages: CMS fact sheet, SSA Medicare premiums, lower IRMAA.
When the IRMAA notice lands
If Social Security sends an initial IRMAA determination, read the tax year it used, compare it to the published bracket table for the premium year, and decide whether you need (1) an IRS correction, (2) an SSA-44 life-changing-event request, or (3) a reconsideration because the data is wrong. Do not ignore the notice. IRMAA is billed monthly on top of the standard Part B premium and on top of your Part D plan premium.
IRMAA surprises people because it looks like a Medicare premium problem when it is really a two-year-lagged tax-income problem.
What IRMAA is
Since 2007, Part B premiums have been income-related for higher earners. Since 2011, Part D has carried its own income-related monthly adjustment amount. CMS states these adjustments affect roughly 8% of people with Part B and about 8% of people with Part D.
You cannot shop IRMAA away by changing Advantage plans. It is set from modified adjusted gross income (MAGI) reported to SSA by the IRS, generally from your tax return two years earlier. For 2026 premiums, that is typically tax year 2024.
MAGI for this purpose is adjusted gross income plus certain tax-exempt interest, as SSA describes on its Medicare premiums page. Filing status matters: individual returns, joint returns, and married filing separately have different tables.
2026 standard Part B premium, then the add-ons
CMS’s November 14, 2025 fact sheet: the 2026 standard Part B premium is $202.90 a month. The annual Part B deductible is $283.
2026 Part B IRMAA (full Part B coverage)
Figures below are from the CMS 2026 fact sheet (and restated on SSA’s Medicare premiums page). Amounts are monthly.
| 2024 MAGI (individual) | 2024 MAGI (joint) | Part B IRMAA | Total Part B premium |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $0.00 | $202.90 |
| > $109,000 to $137,000 | > $218,000 to $274,000 | $81.20 | $284.10 |
| > $137,000 to $171,000 | > $274,000 to $342,000 | $202.90 | $405.80 |
| > $171,000 to $205,000 | > $342,000 to $410,000 | $324.60 | $527.50 |
| > $205,000 and < $500,000 | > $410,000 and < $750,000 | $446.30 | $649.20 |
| ≥ $500,000 | ≥ $750,000 | $487.00 | $689.90 |
Married beneficiaries who lived with a spouse during the tax year but file separately use a compressed CMS table: ≤ $109,000 pays the standard $202.90; above $109,000 and under $391,000 pays total $649.20; $391,000 or more pays $689.90.
2026 Part D IRMAA
Part D IRMAA is in addition to whatever your drug plan charges. CMS:
| 2024 MAGI (individual) | 2024 MAGI (joint) | Part D IRMAA |
|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $0.00 |
| > $109,000 to $137,000 | > $218,000 to $274,000 | $14.50 |
| > $137,000 to $171,000 | > $274,000 to $342,000 | $37.50 |
| > $171,000 to $205,000 | > $342,000 to $410,000 | $60.40 |
| > $205,000 and < $500,000 | > $410,000 and < $750,000 | $83.30 |
| ≥ $500,000 | ≥ $750,000 | $91.00 |
Married filing separately: ≤ $109,000 pays $0; above $109,000 and under $391,000 pays $83.30; $391,000 or more pays $91.00.
SSA notes that Part D IRMAA is paid to Medicare (often deducted from Social Security benefits or billed by CMS), not to your drug plan, even when you pay the plan premium separately.
Why one dollar can jump a whole tier
A dollar of MAGI over a threshold moves you into the next tier for the whole premium year. Capital gains, Roth conversions, and large retirement distributions in a single tax year can push MAGI into IRMAA two years later, long after the cash is spent or reinvested. The two-year lookback is how the law works, so plan for that lag when you can.
How to lower or correct IRMAA
SSA’s “Request to lower an IRMAA” page and Form SSA-44 cover qualifying life-changing events that significantly reduce MAGI. SSA’s list (also reflected in POMS and the SSA-44 instructions) includes:
- Marriage
- Divorce or annulment
- Death of a spouse
- Work stoppage
- Work reduction
- Loss of income-producing property
- Loss of employer pension income
- Employer settlement payment
A bad investment year by itself is not on that list. You generally submit proof of the event and proof of the lower income for the more recent tax year you want SSA to use. You can complete SSA-44 online through a my Social Security path SSA provides, or fax/mail the PDF to a local office, or call 1-800-772-1213 (TTY 1-800-325-0778).
If the IRS data itself is wrong, correct it with the IRS; SSA uses IRS information. If you filed an amended return, SSA’s page directs you to contact Social Security to request a new determination based on the amended figures. If you disagree with SSA’s determination for other reasons, SSA’s notice explains reconsideration rights and deadlines (commonly within 60 days of receiving the notice). Follow the notice in your hand; do not rely on a blog’s summary of appeal timing.
What stays the same when IRMAA applies
IRMAA does not change your Part B deductible, your Advantage plan’s medical deductible, or whether you need Medigap. It does not replace Extra Help (the Part D Low-Income Subsidy) or Medicare Savings Programs, which help people with limited income and resources. If your income is high enough for IRMAA, those assistance programs usually do not apply; they are separate frameworks.
Paying IRMAA also does not mean you should drop Part B. Going without Part B can create late enrollment penalties and gaps that last far longer than a one-year surcharge. Evaluate the surcharge, appeal if the facts support it, and keep coverage continuous.
Practical checklist when the notice arrives
- Confirm the premium year (for example, 2026) and the tax year used (often 2024).
- Match your MAGI and filing status to the CMS/SSA table for that year.
- If a qualifying life-changing event reduced income, file SSA-44 with documentation.
- If the tax data is wrong, fix it with the IRS, then ask SSA to update.
- If you still disagree, use the reconsideration path printed on the notice before the deadline.
Numbers to keep
For 2026, IRMAA on Part B ranges from $81.20 to $487.00 a month above the $202.90 standard premium, and Part D IRMAA ranges from $14.50 to $91.00, using CMS’s published MAGI brackets. The income is usually two years old. That lag is why a one-time spike can raise premiums later, and why SSA-44 exists for defined life-changing events. Use CMS and SSA tables, not insurer marketing, as the source of truth.
Sources
- CMS, 2026 Medicare Parts A & B Premiums and Deductibles (includes Part B and Part D IRMAA tables) (Nov. 14, 2025)
- SSA, Medicare premiums (IRMAA charts)
- SSA, Request to lower an IRMAA
- SSA, Form SSA-44 (PDF)
- Medicare.gov, 2026 Medicare Costs (Publication 11579)
