Medicare IRMAA uses income tiers, and the income it uses is from your federal tax return two years before the premium year. So your premium today is set by the return you filed two years ago. The brackets change each year, and crossing a threshold by even a small amount moves you into the next tier for the entire year.
This guide walks through how the IRMAA bracket structure works, what counts as MAGI, how the two-year lookback affects timing, and how filing status changes the math. For the current-year dollar amounts, see Medicare.gov and SSA.gov.
Last updated: June 2026.
Key takeaways
- IRMAA brackets are income tiers. Each tier adds a larger surcharge to both Part B and Part D premiums.
- The income SSA uses is your MAGI from your federal tax return two years before the premium year.
- Crossing a threshold by even $1 puts you in the next tier for the entire year.
- Married filing jointly thresholds are roughly double the single thresholds. Married filing separately uses a much narrower three-tier schedule.
- The dollar amounts change every year. Check Medicare.gov and SSA.gov for the current figures.
Most people on Medicare do not pay IRMAA. Only about 8% of beneficiaries owe the surcharge (Medicare Trustees Report; KFF).
2026 IRMAA Brackets (Based on 2024 Income)
The tables below show the 2026 monthly Part B premium, the Part B IRMAA surcharge, and the Part D IRMAA surcharge by income tier. IRMAA is based on your 2024 federal tax return.
2026 IRMAA brackets (based on 2024 income), single filers
| MAGI (single, 2024) | Total Part B (monthly) | Part B IRMAA | Part D IRMAA |
|---|---|---|---|
| $109,000 or less | $202.90 | $0 | $0 |
| $109,001 to $137,000 | $284.10 | $81.20 | $14.50 |
| $137,001 to $171,000 | $405.80 | $202.90 | $37.50 |
| $171,001 to $205,000 | $527.50 | $324.60 | $60.40 |
| $205,001 to $500,000 | $649.20 | $446.30 | $83.30 |
| $500,000 or more | $689.90 | $487.00 | $91.00 |
IRMAA resets every year. For the current-year figures, see SSA.gov and Medicare.gov. Source: CMS and SSA, 2026.
2026 IRMAA brackets (based on 2024 income), married filing jointly
| MAGI (married filing jointly, 2024) | Total Part B (monthly) | Part B IRMAA | Part D IRMAA |
|---|---|---|---|
| $218,000 or less | $202.90 | $0 | $0 |
| $218,001 to $274,000 | $284.10 | $81.20 | $14.50 |
| $274,001 to $342,000 | $405.80 | $202.90 | $37.50 |
| $342,001 to $410,000 | $527.50 | $324.60 | $60.40 |
| $410,001 to $750,000 | $649.20 | $446.30 | $83.30 |
| $750,000 or more | $689.90 | $487.00 | $91.00 |
IRMAA resets every year. For the current-year figures, see SSA.gov and Medicare.gov. Source: CMS and SSA, 2026.
Married filing separately uses a compressed three-tier schedule: at or below $109,000, the standard premium applies; above $109,000 up to $391,000, the total Part B premium is $649.20 plus an $83.30 Part D surcharge; at or above $391,000, it is $689.90 plus $91.00. (CMS and SSA, 2026.)
How the Bracket Structure Works
IRMAA uses a tier system. The lowest tier is the standard premium, with no surcharge. Each tier above that adds a larger monthly surcharge to both your Part B premium and your Part D premium. There are several tiers, and the top tier applies a much larger surcharge than the first tier above the standard.
Three things are important about how the tiers behave:
- It is a cliff, not a slope. If your income crosses a threshold by even a small amount, you pay the entire surcharge for that tier for the whole year. There is no partial or prorated surcharge.
- Both Part B and Part D have their own surcharge schedules, but they are tied to the same income tiers. If you land in tier two for Part B, you also pay tier two for Part D.
- The tiers are per person. Each spouse on Medicare pays their own surcharge based on the household income reported on the joint return.
We do not list specific current-year dollar amounts on this page because the thresholds and surcharges are updated annually. Always confirm the current figures at Medicare.gov or SSA.gov before making a decision.
What Counts as MAGI for IRMAA
For IRMAA, MAGI is your Adjusted Gross Income (the AGI line on your federal tax return) plus any tax-exempt interest income. The categories of income that flow into MAGI include:
- Wages, salary, bonuses, and self-employment income.
- Traditional IRA, 401(k), 403(b), and pension withdrawals.
- The taxable portion of Social Security benefits.
- Interest, dividends, and capital gains.
- Rental and royalty income.
- Tax-exempt interest income (for example, from municipal bonds). This is the "modified" piece of MAGI.
What is not counted toward MAGI for IRMAA includes qualified Roth IRA and Roth 401(k) withdrawals, HSA distributions used for qualified medical expenses, return of basis from after-tax accounts, life insurance proceeds, and most gifts and inheritances.
The Two-Year Lookback Explained
Medicare and SSA do not know your current-year income in real time. They use the most recent tax return the IRS has on file, which is almost always the return from two years prior. Here is an example using neutral, hypothetical framing:
Example. A premium year is "Year Y." The IRMAA for Year Y is based on the federal tax return you filed for "Year Y minus 2." So if you are 65 in Year Y and enrolling in Medicare for the first time, your Part B and Part D premiums for Year Y are based on the tax return from the year you were 63.
The lookback has three practical effects:
- Your first Medicare premium is set by your pre-retirement income. If you were a high earner at 63, you can owe IRMAA at 65 even if you have already retired.
- A one-time income spike echoes forward. A Roth conversion, the sale of a property above the capital gains exclusion, or a pension lump sum in one year can push IRMAA up two years later.
- Income drops also echo forward. If your income drops naturally (for example, because RMDs ended a deferral period), IRMAA may not catch up to your lower income for two years. If the drop is caused by a qualifying life-changing event, you do not have to wait. See our guide to appealing IRMAA with Form SSA-44.
Filing Status: Married Filing Jointly vs. Married Filing Separately
Filing status materially changes how the IRMAA brackets apply.
- Single, head of household, or qualifying widow(er): The single schedule applies.
- Married filing jointly: The thresholds are roughly double the single thresholds, and the household income is split across the same tiers.
- Married filing separately: A separate, much narrower schedule applies. It starts at a much lower income and has fewer tiers, so a married filing separately taxpayer can land in a very high IRMAA tier at a much lower income than a single filer.
This is one of the most important and least known pieces of IRMAA planning. Couples who are weighing whether to file jointly or separately for a given year should consider IRMAA, not just income tax, in the decision.
How Often the Brackets Change
The IRMAA thresholds and surcharge amounts are updated each year by the federal government, usually announced in the fall before the premium year begins. The thresholds are adjusted for inflation in most years, so they generally rise a small amount each year. The surcharge dollar amounts also change each year because they are calculated from the standard Part B premium.
Because the dollar figures change every year, this page does not list specific current-year amounts. For the latest published numbers, always check Medicare.gov or SSA.gov.
Frequently Asked Questions
How does the IRMAA bracket system work?
IRMAA uses income tiers. The first tier is the standard premium with no surcharge. Each higher tier adds a larger surcharge to both Part B and Part D. Crossing a threshold by even a small amount moves you into the next tier for the entire year.
What tax year does IRMAA use?
IRMAA uses the most recent federal tax return on file with the IRS, which is almost always the return from two years prior to the premium year.
What income counts toward MAGI for IRMAA?
MAGI for IRMAA is your Adjusted Gross Income plus any tax-exempt interest income. It includes wages, retirement account withdrawals, the taxable portion of Social Security, interest, dividends, capital gains, rental income, and tax-exempt interest.
How are the brackets different for married filing jointly vs. married filing separately?
Married filing jointly uses thresholds roughly double the single thresholds. Married filing separately uses a separate, much narrower schedule that starts at a much lower income and can produce a much larger surcharge.
Do the IRMAA brackets change every year?
Yes. The thresholds and surcharge amounts are updated each year. Current-year figures are published at Medicare.gov and SSA.gov.
If I cross a bracket by a small amount, do I really pay the whole surcharge?
Yes. IRMAA is a cliff system, not a phase-in. Even a small amount of income over a threshold moves you into the next tier for the full year.
References
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Not sure which IRMAA tier you will land in next year? I am a licensed independent agent based in Omaha. I can walk you through how the brackets and the two-year lookback apply to your specific situation. Free consultation, no pressure.
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Written by Nick Depke, licensed independent insurance agent (NPN 19158595), Depke Insurance Agency, Omaha, NE.