Short answer
For 2026, IRMAA starts when your 2024 MAGI is above $109,000 (single) or $218,000 (married filing jointly). The first tier raises Part B from $202.90 to $284.10 a month and adds $14.50 to Part D. The top tier, $500,000 single or $750,000 joint, brings Part B to $689.90 plus $91.00 for Part D (CMS 2026 Part B fact sheet, November 14, 2025).
IRMAA stands for Income-Related Monthly Adjustment Amount. It is the surcharge the Social Security Administration tacks on to your Medicare Part B and Part D premiums once your modified adjusted gross income (MAGI) crosses certain thresholds. The surcharge is permanent for the year. If you cross a bracket by $1, you pay the full surcharge for all twelve months.
IRMAA uses a two-year lookback: your 2026 Medicare premium is based on the MAGI shown on your 2024 tax return. That timing matters because most people only notice IRMAA after the bill arrives in January, two full tax years after they could have done anything about it.
The surcharge applies to every Medicare-enrolled individual in your household. A married couple both on Medicare who cross a single bracket pays the surcharge twice, once each.
Below are the IRMAA brackets and total monthly premiums for 2026 (the Part B base premium is $202.90/month for 2026, per the CMS 2026 fact sheet). MAGI is your 2024 modified adjusted gross income; the bracket determines what you pay now.
| 2024 MAGI (Single) | 2024 MAGI (MFJ) | Part B Surcharge | Total Part B | Part D Surcharge |
|---|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $0.00 | $202.90 | $0.00 |
| $109,001-$137,000 | $218,001-$274,000 | $81.20 | $284.10 | $14.50 |
| $137,001-$171,000 | $274,001-$342,000 | $202.90 | $405.80 | $37.50 |
| $171,001-$205,000 | $342,001-$410,000 | $324.60 | $527.50 | $60.40 |
| $205,001-$499,999 | $410,001-$749,999 | $446.30 | $649.20 | $83.30 |
| ≥ $500,000 | ≥ $750,000 | $487.00 | $689.90 | $91.00 |
Source: CMS fact sheet “2026 Medicare Parts A & B Premiums and Deductibles” (November 14, 2025). Part B deductible for 2026: $283. Checked October 3, 2026.
Married filing separately (and you lived with your spouse at any time during the year) uses a much harsher scale:
| 2024 MAGI (MFS) | Total Part B | Part D Surcharge |
|---|---|---|
| ≤ $109,000 | $202.90 | $0.00 |
| Above $109,000, below $391,000 | $649.20 | $83.30 |
| ≥ $391,000 | $689.90 | $91.00 |
Source: same CMS 2026 fact sheet. Test your own numbers in the IRMAA bracket calculator.
The math nobody shows you: Crossing the top bracket as a married couple both on Medicare costs ($487.00 + $91.00) × 12 × 2 = $13,872 per year in surcharges alone, on top of base premiums.
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IRMAA brackets are cliffs, not phase-ins. One dollar over $109,000 MAGI as a single filer costs you the full first-bracket surcharge for every month of 2026. Same for crossing into the second, third, fourth, or fifth tier.
Single retiree, MAGI of $136,500 from pensions and dividends. She converted $700 of Traditional IRA to Roth in December 2024 to "use up" remaining headroom in her 22% bracket. That $700 pushed her 2024 MAGI to $137,200, into the second IRMAA tier. Result: she pays an extra ($202.90 - $81.20 + $37.50 - $14.50) = $144.70/month in 2026 surcharges, or $1,736.40 for the year. The federal tax on the $700 conversion was $154. Net cost of the "optimization": $1,736 in IRMAA plus $154 in income tax.
Married couple, joint MAGI tracking around $280,000 from a mix of pensions, Social Security, and dividends. They sold a rental property for $80,000 of long-term capital gain in 2024. That pushed MAGI to $360,000, over the third bracket line ($342,000 MFJ). Their Part B surcharge jumps from the second tier ($202.90 each) to the third ($324.60 each). Annual Part B surcharge increase across both spouses: ($324.60 - $202.90) × 12 × 2 = $2,920.80/year for 2026.
73-year-old widower with $1.8M IRA. First RMD: roughly $68,000. Combined with $40K Social Security and $25K pension, his 2024 MAGI hit $133,000. That crosses the first IRMAA line ($109,000 single). He pays approximately $1,148/year more for Medicare in 2026 than a single filer under the line. A QCD strategy could have eliminated the surcharge entirely.
This is the lever most retirees overlook. Interest credited inside a deferred MYGA does not appear on your 1040 until you take a withdrawal. That makes the MYGA a structural IRMAA defense.
The contrast:
Worked example: $500,000 for 7 years, single filer with $95,000 of base MAGI:
| Year | CD at 4.50% (interest taxable) | MYGA at 5.60% (deferred) | IRMAA delta |
|---|---|---|---|
| 1 | MAGI = $117,500 (tier 1) | MAGI = $95,000 (no surcharge) | $1,148/yr saved |
| 2 | MAGI = $118,510 (tier 1) | MAGI = $95,000 (no surcharge) | $1,148/yr saved |
| 3 | MAGI = $119,565 (tier 1) | MAGI = $95,000 (no surcharge) | $1,148/yr saved |
| 4-7 | Continues in tier 1 ($1,148/yr Part B + D surcharge) | $0 surcharge | $1,148/yr saved each year |
| 7-year IRMAA savings | n/a | n/a | ~$8,039 |
Plus the MYGA grows 110 bps faster than the CD. Total 7-year advantage on $500K: roughly $22,000 of extra growth + $8,039 of IRMAA savings = $30,039 in the MYGA's favor, in this specific case.
Caveat: MYGA distributions are eventually ordinary income, and if you wait until 73, RMDs (if it's an IRA MYGA) can trigger the same IRMAA problem. The MYGA defers the IRMAA, it doesn't erase it. The goal is to align withdrawals with low-MAGI years.
If you're age 70½ or older, you can send up to $111,000 per year (2026 limit, IRS Notice 2025-67) directly from your IRA to a 501(c)(3) charity. The QCD counts toward your RMD but does not appear in your MAGI. For charitable retirees over age 73, the QCD is the single most powerful IRMAA tool available. See our QCD rules guide.
IRMAA's two-year lookback means your 2026 premium is based on 2024 MAGI. So Roth conversions done at age 63 hit your 2025 MAGI, which determines your 2027 IRMAA (the year you turn 65). Convert before age 63 to keep conversions out of the IRMAA lookback window. See Roth conversion vs MYGA bucket.
Realized capital losses offset realized gains and up to $3,000 of ordinary income per year. In a year when you know you're flirting with an IRMAA cliff, harvesting losses in your brokerage can pull you back under the threshold.
If you have HSA-eligible coverage in your 60s, max contributions ($4,400 self-only / $8,750 family for 2026 per IRS Rev. Proc. 2025-19, plus $1,000 catch-up at 55+) reduce MAGI. You stop contributing the month you enroll in Medicare.
If your MAGI dropped due to a qualifying life event (retirement, death of spouse, divorce, loss of pension, work stoppage), you can file Form SSA-44 to ask SSA to use a more recent year. The form is short. Submit it as soon as the life event happens. Do not wait for the IRMAA letter.
Not yet. As of October 3, 2026, CMS has not published 2027 premiums or IRMAA brackets. It released the 2026 figures on November 14, 2025, so expect 2027 numbers in the fall. Two things are already known: 2027 IRMAA will be based on your 2025 MAGI, and the income thresholds are indexed to inflation, so they normally rise a little each year. Plan with a cushion of a few thousand dollars below the 2026 lines rather than an exact guess.
Yes, if both are on Medicare. On a joint return, the couple’s combined MAGI picks the bracket, and each spouse then pays the surcharge on his or her own premium. At the first tier that is $95.70 a month each ($81.20 Part B plus $14.50 Part D), or $2,296.80 a year for the couple. If only one spouse is on Medicare, only that spouse pays, but the bracket still uses the joint MAGI.
Your 2026 premium is already set by your 2024 return, so nothing you do in 2026 lowers it, with one exception: a Form SSA-44 appeal if a life-changing event (retirement, death of a spouse, divorce, loss of pension) cut your income. What you do in 2026 sets your 2028 premium. The working levers are QCDs, keeping Roth conversions and capital gains just under a bracket line, and holding interest in tax-deferred accounts instead of a taxable CD.
Yes. IRMAA is recalculated every year from the tax return two years earlier, so a one-time spike (a home sale, a big Roth conversion) costs you one year of surcharges, not a permanent one. If your income falls back under $109,000 single or $218,000 joint, the surcharge drops off two years later. Medicare premiums, IRMAA included, count as medical expenses, so they are deductible only if you itemize and your total medical costs exceed 7.5% of AGI.
As a licensed insurance producer, I run the IRMAA line before I recommend where a client’s safe money goes, because the surcharge is a cliff and a small amount of interest can cross it. My first question is how far 2026 MAGI sits below the next line. If the answer is under $25,000, taxable CD or Treasury interest can tip it.
Example (2026 CMS figures): single retiree, MAGI $100,000 before interest, $300,000 to place. In a CD paying 4.35% (the low end of the best national 5-year CDs on September 24, 2026, per DepositAccounts) the $13,050 of yearly interest pushes MAGI to $113,050, over the $109,000 line, and costs $1,148.40 a year in surcharges two years later. In a deferred MYGA, no interest is reported until withdrawal, so MAGI stays at $100,000. The MYGA only moves the income; I plan the withdrawals for low-income years. See how the deferral is taxed later in non-qualified annuity tax rules, and for large IRAs, how a QLAC lowers RMDs that feed MAGI. For conversions, see the Roth conversion strategy guide.
The MAGI used for IRMAA is not the MAGI used for Roth contribution limits or any other tax purpose. It is a specific calculation:
IRMAA MAGI = AGI + tax-exempt interest (municipal bond interest)
Most retirees miss two items:
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This article is general educational information, not personalized financial, tax, or legal advice. All rates, IRS limits, Social Security PIA factors, IRMAA brackets, FDIC/NCUA coverage, and state guaranty fund coverage figures are current as of the publication date and subject to change. IRMAA brackets and Roth/Traditional IRA limits cited reflect IRS guidance for 2026 and may be updated by the IRS or SSA; confirm current figures at irs.gov and ssa.gov before acting. Hans Goldstein is an independent licensed insurance producer (NPN 20602398) appointed with multiple A-rated annuity carriers; he does not sell bank CDs, money market funds, or Treasury securities and is not affiliated with any bank, brokerage, or government agency discussed. No compensation has been received from any third party in connection with this article. Bank CDs are FDIC-insured deposit products; credit union share certificates are NCUA-insured; money market funds are SEC-regulated investment products with no FDIC coverage; Treasuries are direct obligations of the U.S. government; MYGAs are insurance contracts backed by carrier balance sheets and state guaranty associations. These are different product categories with different protections, tax treatments, and trade-offs. Always confirm current rates and tax law with the issuer or a CPA before acting.
Hans Goldstein is an Enrolled Agent, admitted to practice before the Internal Revenue Service. Not affiliated with or endorsed by the IRS. General education, not tax or legal advice for your situation.