IRMAA brackets 2026 have been finalized, determining the income‑related premium surcharges for Medicare beneficiaries in the United States. These updated brackets use income from tax year 2024 to calculate higher monthly premiums for Part B medical coverage and Part D prescription drug coverage in 2026. Understanding these brackets is essential for planning and managing healthcare costs in the coming year.
This article breaks down the confirmed brackets, surcharge amounts, how the look‑back process works, and practical guidance for beneficiaries navigating these costs.
Understanding IRMAA and Its Impact on Medicare Costs
The Income‑Related Monthly Adjustment Amount (IRMAA) is an additional charge applied to standard Medicare Part B and Part D premiums for those whose income exceeds certain thresholds. High‑income beneficiaries pay more for coverage than those below the thresholds. IRMAA is calculated based on Modified Adjusted Gross Income (MAGI) from two years prior, meaning 2024 income affects 2026 premiums. Recognizing how these surcharges work allows retirees to plan ahead and avoid unexpected financial burdens.
How the Look‑Back Rule Works
IRMAA uses a two‑year look‑back, reviewing MAGI reported on your federal tax return from two years before the year of coverage. Tax‑exempt interest is added to determine MAGI. If this income exceeds the threshold for your filing status, an IRMAA surcharge is applied. Life events that significantly lower income may allow beneficiaries to appeal for adjustments, but the base calculation relies on past tax records.
2026 Part B IRMAA Brackets and Premiums
The 2026 Part B IRMAA brackets reflect adjustments for inflation and increased healthcare costs. The base Part B premium is set at $202.90 per month for beneficiaries below the first income threshold. Surcharges increase in tiers based on MAGI.
Part B IRMAA Structure for 2026:
- Base Premium: $202.90 (individual ≤ $109,000 / married ≤ $218,000)
- Tier 1: $284.10 (individual > $109,000–$137,000 / married > $218,000–$274,000)
- Tier 2: $405.80 (individual > $137,000–$171,000 / married > $274,000–$342,000)
- Tier 3: $527.50 (individual > $171,000–$205,000 / married > $342,000–$410,000)
- Tier 4: $649.20 (individual > $205,000–$500,000 / married > $410,000–$749,000)
- Highest Tier: $689.90 (individual ≥ $500,000 / married ≥ $750,000)
Higher income leads to significantly higher monthly premiums, with the top tiers representing substantial annual costs for beneficiaries.
2026 Part D IRMAA Surcharge Brackets
Part D prescription coverage surcharges also apply for high-income beneficiaries. These surcharges are added to base Part D plan premiums, whether through standalone plans or Medicare Advantage plans with integrated drug coverage.
Part D IRMAA Surcharges for 2026:
- Tier 0: $0.00 (individual ≤ $109,000 / married ≤ $218,000)
- Tier 1: $14.50 (individual > $109,000–$137,000 / married > $218,000–$274,000)
- Tier 2: $37.50 (individual > $137,000–$171,000 / married > $274,000–$342,000)
- Tier 3: $60.40 (individual > $171,000–$205,000 / married > $342,000–$410,000)
- Tier 4: $83.30 (individual > $205,000–$500,000 / married > $410,000–$749,000)
- Highest Tier: $91.00 (individual ≥ $500,000 / married ≥ $750,000)
Combined with Part B premiums, these surcharges can significantly increase total monthly Medicare costs for higher-income retirees.
Key Changes From Previous Years
The first IRMAA threshold has increased for 2026, meaning beneficiaries must have slightly higher MAGI before surcharges apply. Single filers now begin surcharges above $109,000, and joint filers above $218,000. The top-tier thresholds remain fixed at $500,000 for singles and $750,000 for couples through 2028. These adjustments are in line with inflation indexing.
Impact on Medicare Advantage Members
Beneficiaries in Medicare Advantage plans with integrated drug coverage still pay IRMAA surcharges. Part B surcharges are added to plan premiums, and Part D surcharges are added to drug costs. This can result in substantial monthly payments for high-income individuals.
Income Planning Strategies
Since IRMAA is based on income from two years prior, careful financial planning can help manage exposure. Strategies may include timing retirement account withdrawals, managing capital gains, or considering Roth conversions to lower MAGI. Early planning can reduce the likelihood of high surcharges in future years.
Appeals and Life Changes
Beneficiaries who experience significant life events, such as retirement, loss of a spouse, or disability, can appeal IRMAA determinations. Filing the appropriate forms with the Social Security Administration allows reassessment based on current or expected income. Prompt and accurate documentation is necessary for successful adjustments.
Real World Impact on Monthly Premiums
For 2026, Part B premiums range from $202.90 to $689.90, and Part D surcharges range from $0 to $91.00. Combined, high-income beneficiaries can see thousands of dollars added to annual healthcare costs. Understanding these amounts is critical for effective budgeting and planning.
Percent of Beneficiaries Affected
Approximately 8% of Medicare enrollees fall into IRMAA brackets. While a minority, the financial impact for those affected is substantial. Awareness and proactive planning are crucial for managing these extra costs.
Notification and Timing
Beneficiaries are typically notified by the Social Security Administration in late fall or early winter about their 2026 IRMAA premiums. Reviewing these notices carefully ensures accuracy and allows time to plan payments or file appeals if necessary.
Looking Ahead
IRMAA brackets are adjusted annually for inflation and other factors. Beneficiaries should monitor changes each year and plan taxable events with future Medicare costs in mind. While top-tier thresholds remain fixed through 2028, year-to-year adjustments in lower brackets can affect premiums.
Final Takeaways
Understanding the 2026 IRMAA brackets is essential for Medicare beneficiaries. By knowing the thresholds, surcharges, and planning strategies, retirees can prepare for healthcare costs and avoid unexpected financial burdens. Managing income effectively and monitoring notices from Social Security ensures better financial control over medical and prescription expenses.
How are you preparing for 2026 Medicare costs, and which strategies will help you manage higher premiums? Share your insights and stay informed as new updates are released.