IRMAA stands for income-related monthly adjustment amount, an extra charge added to your Medicare Part B and Part D premiums when your income from 2 years ago was above a set level. For 2026, that level is modified adjusted gross income above $109,000 for individual tax returns or $218,000 for joint returns, based on 2024 tax returns. If your income has dropped because of a life-changing event, such as retirement or the death of a spouse, you can ask Social Security to lower it using form SSA-44.
What is IRMAA?
Most people pay the standard Part B premium, which the Centers for Medicare & Medicaid Services (CMS) set at $202.90 a month for 2026. People with higher incomes pay more. CMS says these income-related amounts affect roughly 8% of people with Part B.
Part D works the same way. If you pay IRMAA for Part D, you pay the extra amount on top of your plan's premium. Medicare's booklet on income and drug premiums says the Part D extra amount is deducted from your Social Security, Railroad Retirement, or Office of Personnel Management benefit, no matter how you usually pay your plan premium. If you get a bill for it, pay Medicare, not your drug plan.
What are the 2026 IRMAA brackets?
CMS published these 2026 amounts. Income is your 2024 modified adjusted gross income.
Part B (full coverage)
| Individual return | Joint return | Total monthly Part B premium |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 |
| Above $205,000 and less than $500,000 | Above $410,000 and less than $750,000 | $649.20 |
| $500,000 or more | $750,000 or more | $689.90 |
Part D (added to your plan premium)
| Individual return | Joint return | Extra monthly amount |
|---|---|---|
| $109,000 or less | $218,000 or less | $0 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $60.40 |
| Above $205,000 and less than $500,000 | Above $410,000 and less than $750,000 | $83.30 |
| $500,000 or more | $750,000 or more | $91.00 |
Married people who lived with their spouse during the year but filed separately have different brackets. See the CMS fact sheet for those.
Why is Medicare using my income from 2 years ago?
Social Security uses the most recent tax return information the Internal Revenue Service (IRS) has shared with it. For 2026 premiums, that's usually your 2024 return. This is why IRMAA often surprises people in the first years of retirement. The income on that older return may include a salary you no longer earn.
How do I ask for a lower IRMAA?
Social Security says you can ask to lower IRMAA if you've had a life-changing event that reduced your income. Its list of life-changing events includes:
- Marriage
- Divorce
- Death of a spouse
- Loss of income
- An employer settlement payment
Form SSA-44 lists other events too. Read the form, or ask Social Security whether your situation counts.
You can:
- Submit online by signing in to your Social Security account and filling out form SSA-44.
- Fax or mail the completed SSA-44 and your evidence to a Social Security office.
- Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and say you want to lower your IRMAA because of a life-changing event.
Have proof ready, like a letter from your employer showing your retirement date, a death certificate, or a divorce decree. You'll also give an estimate of your current year's income.