2026 IRMAA tiers: the complete Medicare surcharge tables
IRMAA — the income-related monthly adjustment amount — is the surcharge Medicare adds to Part B and Part D premiums for higher-income beneficiaries. For 2026, the standard Part B premium is $202.90/month (with a $283 annual deductible), and the surcharges below are added on top of it — and on top of whatever your Part D drug plan charges (the 2026 national base beneficiary premium is $38.99).
Three mechanics matter more than the exact dollars. First, IRMAA uses a two-year lookback: your 2026 premium is set by your 2024 MAGI (AGI plus tax-exempt interest). Second, every boundary is a cliff — one dollar of MAGI over a threshold buys the entire tier’s surcharge for the year. Third, IRMAA is assessed per person: a married couple both on Medicare pays it twice.
2026 tiers — individual returns (single and head of household)
| 2024 MAGI (individual return) | Part B surcharge /mo | Part B total /mo | Part D surcharge /mo | Extra cost /yr per person |
|---|---|---|---|---|
| Up to $109,000 | $0.00 | $202.90 | $0.00 | $0 |
| Over $109,000 up to $137,000 | $81.20 | $284.10 | $14.50 | $1,148 |
| Over $137,000 up to $171,000 | $202.90 | $405.80 | $37.50 | $2,885 |
| Over $171,000 up to $205,000 | $324.60 | $527.50 | $60.40 | $4,620 |
| Over $205,000 up to $500,000 | $446.30 | $649.20 | $83.30 | $6,355 |
| Over $500,000 | $487.00 | $689.90 | $91.00 | $6,936 |
2026 tiers — married filing jointly
| 2024 MAGI (joint return) | Part B surcharge /mo | Part B total /mo | Part D surcharge /mo | Extra cost /yr per person |
|---|---|---|---|---|
| Up to $218,000 | $0.00 | $202.90 | $0.00 | $0 |
| Over $218,000 up to $274,000 | $81.20 | $284.10 | $14.50 | $1,148 |
| Over $274,000 up to $342,000 | $202.90 | $405.80 | $37.50 | $2,885 |
| Over $342,000 up to $410,000 | $324.60 | $527.50 | $60.40 | $4,620 |
| Over $410,000 up to $750,000 | $446.30 | $649.20 | $83.30 | $6,355 |
| Over $750,000 | $487.00 | $689.90 | $91.00 | $6,936 |
2026 tiers — the married-filing-separately special table
MFS filers who lived with their spouse at any point in the year get a deliberately punitive two-row table: there are no intermediate tiers, so the first dollar over $109,000 jumps straight to the fourth-highest surcharge level. (An MFS filer who lived apart from their spouse all year is treated under the individual table instead.)
| 2024 MAGI (separate return, lived with spouse) | Part B surcharge /mo | Part B total /mo | Part D surcharge /mo | Extra cost /yr per person |
|---|---|---|---|---|
| Up to $109,000 | $0.00 | $202.90 | $0.00 | $0 |
| Over $109,000 up to $391,000 | $446.30 | $649.20 | $83.30 | $6,355 |
| Over $391,000 | $487.00 | $689.90 | $91.00 | $6,936 |
Which MAGI, exactly?
IRMAA’s MAGI is its own definition: adjusted gross income plus tax-exempt interest. Municipal-bond income that never shows up in your federal tax escapes the brackets but still counts here. What does not count: Roth IRA and Roth 401(k) withdrawals, HSA withdrawals for medical costs, and return of basis from a taxable account. Social Security reports your premium determination each fall based on the latest return the IRS has furnished — usually two years back, occasionally three if you filed late.
How the tiers interact with a retirement plan
The lookback is what makes IRMAA a planning problem rather than a billing detail. Income you realize at 63 — a Roth conversion, a large capital gain, a final bonus — sets the premium you pay at 65, when many people first enroll. A joint-return couple who crosses the first threshold by one dollar pays about $2,296 more that year (both spouses, Parts B and D combined); crossing into the top tier costs a couple roughly $13,872 a year. The thresholds are inflation-indexed annually and published only weeks before the year starts, so multi-year plans are always aiming at estimated lines. If a “life-changing event” like retirement drops your income after the lookback year, Form SSA-44 can get the surcharge recalculated using the more recent year.
Try it in Deorbit Plan
The simulator prices IRMAA per person from each year’s MAGI-two-years-back, using the tier table for your filing status (all four tables above are built in) and indexing thresholds along every inflation path. The Taxes & MAGI chart can overlay the IRMAA tier thresholds and the MAGI line so you can see exactly which years cross. In the Strategy panel, the cliff-margin guard caps fill-bracket Roth conversions to keep a chosen buffer below the nearest IRMAA (or ACA) boundary, and the Strategy Lab reports each strategy’s closest cliff approach.
Educational content only — not financial, tax, or investment advice.
See how this plays out with your own numbers. Try it in the simulator →
References
- CMS — 2026 Medicare Parts A & B premiums and deductibles (full IRMAA tables)
- CMS — 2026 Part D bid information ($38.99 base beneficiary premium)
- Medicare.gov — Medicare costs (income-based premium adjustments)
- 20 CFR §418.1105 — What is the modified adjusted gross income threshold?
- NCOA — How to request an adjustment to your IRMAA Medicare premium (SSA-44)