What MAGI year is used for 2026 IRMAA?

SSA uses a 2-year lookback. Your 2026 Medicare premiums are based on your 2024 modified adjusted gross income — the tax return you filed in spring 2025.

How is MAGI calculated for IRMAA?

IRMAA MAGI = Form 1040 AGI (line 11) + tax-exempt interest (line 2a), plus any excluded foreign earned income or housing (IRC §911), excluded savings-bond interest used for education (§135), and excluded Puerto Rico or American Samoa income (§§931, 933) — 42 U.S.C. §1395r(i)(4)(A). It does not add back the student loan interest deduction or nontaxable Social Security.

Can I appeal an IRMAA determination?

Yes, using Form SSA-44 if you experienced a qualifying life-changing event: marriage, divorce or annulment, death of spouse, work stoppage or reduction, loss of income-producing property, loss of pension, or employer settlement payment. Roth conversions and one-time capital gains do not qualify.

Does IRMAA apply per spouse?

Yes. Each Medicare-enrolled spouse pays the IRMAA surcharge separately based on the household's joint MAGI. A couple in Tier 2 for 2026 would each pay an extra $240.40 a month ($202.90 Part B + $37.50 Part D surcharges) — $5,769.60 a year combined, just in IRMAA.

How does the IRMAA cliff work?

IRMAA is a cliff, not a graduated phase-in. Earning $1 over a bracket threshold pushes you to the higher tier for the entire year. A married couple crossing the first 2026 cliff at $218,000 MAGI by $1 owes about $2,297 in extra annual premiums ($81.20 Part B + $14.50 Part D surcharges = $95.70 a month each).

When are 2026 IRMAA brackets and premiums announced?

CMS announces Medicare Part B premiums and IRMAA brackets each November for the following year. The 2026 figures were released in November 2025. SSA mails individual IRMAA determination letters in late November and December.

Will the 2027 Social Security COLA cover my Part B premium increase?

Not necessarily. CMS announces the following year's Part B premium in November, one month after SSA announces the COLA in mid-October. When the Part B premium rises, it absorbs part of the gross COLA before the check hits your bank account — see our 2027 Social Security COLA projection tracker for current estimates.

What strategies reduce IRMAA exposure?

Common strategies: (1) spread Roth conversions across multiple years to stay under the next bracket, (2) harvest tax losses to offset gains, (3) use Qualified Charitable Distributions (QCDs) from IRAs at age 70½+ to reduce MAGI, (4) defer IRA withdrawals where possible, and (5) coordinate large one-time income events with SSA-44 documentation when a qualifying event exists.

Medicare Planning

2026 Medicare IRMAA Brackets

A practical guide to the income-related surcharges Medicare adds to your Part B and Part D premiums — and how to plan around them.

Also see: the 2026 IRMAA planning brief for the current-year MAGI targets and Roth-conversion sizing rules.

Updated August 24, 2026Reviewed for 2025 & 2026 tax years

We verify every calculator and guide against primary IRS sources — Revenue Procedures, IRS publications, and the tax code — and cite them so you can check the numbers yourself.

About Our Editorial Process

What are the 2026 IRMAA brackets?

For 2026, IRMAA begins above $109,000 MAGI (single) or $218,000 (MFJ). Surcharges add $81.20–$487.00/month to Part B (on top of the $202.90 base) and $14.50–$91.00/month to Part D. The 2026 brackets use your 2024 tax return.

•2026 Part B base premium: $202.90/month
•First IRMAA tier (single): MAGI above $109,000
•First IRMAA tier (MFJ): MAGI above $218,000
•2-year lookback — 2026 premiums use your 2024 MAGI
•Each Medicare-enrolled spouse pays the surcharge separately

IRMAA quietly costs more high earners than they realize. The 2-year lookback means a great 2024 — a Roth conversion, a business sale, a real estate gain — drives 2026 Medicare costs even if your income has dropped back down. And because IRMAA is a cliff, planning matters more than the marginal tax math suggests.

Real-world scenario

Couple sells a rental in 2024, $260,000 MAGI

That one-time MAGI bump pushes them from $0 IRMAA into Tier 1 for 2026. Both on Medicare, the surcharge is $95.70/month each = $2,296.80/year. SSA-44 doesn't cover capital gains — they pay it. The fix is upstream: harvest losses in the sale year, time the sale across two tax years, or use a 1031 exchange where appropriate.

The part most people miss

The Part D surcharge applies to anyone enrolled in Medicare drug coverage — a stand-alone Part D plan or a Medicare Advantage plan with drug coverage, including employer-sponsored Part D — even a basic plan. Original Medicare (Parts A and B) has no drug coverage, so with no Part D enrollment there's no Part D IRMAA. SSA deducts it from your Social Security check (or Medicare bills you directly if you've deferred SS). Many enrollees don't realize they're paying IRMAA on Part D until they read their year-end SSA-1099.

2026 IRMAA Brackets

Tier	Single MAGI	MFJ MAGI	Part B / mo	Part D / mo
0	≤ $109,000	≤ $218,000	$202.90	+$0.00
1	$109K–$137K	$218K–$274K	$284.10	+$14.50
2	$137K–$171K	$274K–$342K	$405.80	+$37.50
3	$171K–$205K	$342K–$410K	$527.50	+$60.40
4	> $205K and < $500K	> $410K and < $750K	$649.20	+$83.30
5	≥ $500K	≥ $750K	$689.90	+$91.00

Source: CMS Annual Release of Part B Premiums (November 2025). Part D surcharge stacks on top of whatever your Part D plan charges.

Married filing separately and lived with your spouse at any time in the tax year SSA uses (2024 for 2026): MAGI $109,000 or less — $202.90 Part B, no Part D surcharge; above $109,000 and below $391,000 — $649.20 Part B, +$83.30 Part D; $391,000 or more — $689.90, +$91.00. If you lived apart from your spouse all year, use the Single column.

Run your numbers in the IRMAA Calculator

How IRMAA MAGI Is Calculated

For IRMAA, MAGI is (42 U.S.C. §1395r(i)(4)(A)):

Form 1040, line 11 (Adjusted Gross Income)
+ Form 1040, line 2a (tax-exempt interest, including muni bonds)
+ any excluded foreign earned income or housing (Form 2555, IRC §911)
+ any excluded savings-bond interest used for education (IRC §135)
+ any excluded Puerto Rico or American Samoa income (IRC §§931, 933)

For most retirees that is simply AGI plus muni-bond interest. IRMAA MAGI does not add back the student loan interest deduction or nontaxable Social Security.

When You Can Appeal (Form SSA-44)

SSA accepts IRMAA appeals only for specific "life-changing events":

Marriage, divorce/annulment, or death of spouse
Work stoppage or reduction (retirement counts)
Loss of income-producing property (not a voluntary sale)
Loss or reduction of certain pension income
Employer settlement payment from a closed/bankrupt employer

What does not qualify: Roth conversions, voluntary asset sales, one-time capital gains, RMDs, or simply earning more in your lookback year.

Planning Strategies to Manage IRMAA

Roth conversion laddering: Spread conversions across years to stay just under bracket thresholds. The 2026 MFJ Tier 1 cliff at $218,000 is the most common target.
Tax-loss harvesting: Realize losses in the same year as planned gains to keep MAGI down — particularly important in lookback years.
Qualified Charitable Distributions (QCDs): At 70½+, route up to $111,000 (2026 limit; $108,000 in 2025) of IRA distributions directly to charity. QCDs are excluded from AGI, lowering MAGI dollar-for-dollar.
Bunch capital gains into one year: If you'll pay IRMAA anyway, realize more gains in that lookback year and skip the next.
HSA contributions: Pre-Medicare, max HSA contributions to lower AGI in lookback years.
Watch the December cliff: A year-end Roth conversion that nudges MAGI $500 over a bracket costs a two-person Medicare household about $2,297 or more in 2026 IRMAA — usually a worse trade than waiting.

Frequently Asked Questions

Disclaimer: This calculator provides estimates for educational purposes only. Not tax, legal, or financial advice. Results may vary based on your specific circumstances. Consult a qualified CPA or tax professional for personalized guidance.