If you’re on Medicare—or about to be—you may have heard people grumbling about something called IRMAA. It sounds intimidating, but the idea behind it is pretty simple.

IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an extra charge added to your Medicare Part B (medical insurance) and Part D (prescription drug coverage) premiums if your income is above certain levels. The catch? Medicare looks at your income from two years ago to decide what you’ll pay today.

So for 2026, Medicare uses your 2024 tax return to determine whether you owe an IRMAA surcharge.

Most people with Medicare pay only the standard premiums. But if your modified adjusted gross income (MAGI) was more than $109,000 for an individual or $218,000 for a married couple filing jointly, IRMAA may apply.

2026 Medicare Part B & Part D IRMAA Chart

2024 Income (MAGI)	Part B Premium (2026)	Monthly Part D IRMAA
≤ $109,000 (individual) ≤ $218,000 (joint)	$202.90 Standard Premium	$0 + plan premium
$109k–$137k / $218k–$274k	$284.10	$14.50 + plan premium
$137k–$171k / $274k–$342k	$405.80	$37.50 + plan premium
$171k–$205k / $342k–$410k	$527.50	$60.40 + plan premium
$205k–$500k / $410k–$750k	$649.20	$83.30 + plan premium
≥ $500k / ≥ $750k	$689.90	$91.00 + plan premium

Note:

• The Part B amount already includes the standard $202.90 premium.
• The Part D amount is added to whatever premium your drug plan charges.

A Real-Life Example

Let’s say Mary, a retired teacher, earned $145,000 in 2024 due to a pension, Social Security, and a one-time IRA withdrawal.

In 2026, Mary falls into the $137,000–$171,000 IRMAA bracket, which means:

• Her Part B premium jumps from $202.90 to $405.80 per month
• She also pays an extra $37.50 per month on top of her Part D drug plan premium

That’s an additional $240 per month, or nearly $2,900 a year, compared to someone paying only the standard Medicare premiums.

And here’s the part that surprises many retirees: even if Mary’s income drops in 2026, Medicare will still charge IRMAA unless she files an appeal showing a life-changing event like retirement, loss of income, divorce, or death of a spouse.

Why This Matters

IRMAA affects only about 8% of Medicare beneficiaries, but those who are impacted often don’t see it coming—especially during the early retirement years when required minimum distributions, home sales, or investment income can spike taxable income.

The good news? With the right planning—and the right guidance—many people can reduce or even avoid IRMAA surprises. You may be able to appeal using form SSA-44 if you’ve retired or had a major income change. But you must do so within 60 days upon receiving notice from Social Security. Contact our office or your local financial advisor for more information.

Tonya Aiken

“We Make Insurance Easy”

Louisiana Senior Advisors, llc