If you’re a Medicare beneficiary with higher income, you may pay extra premiums through the Income-Related Monthly Adjustment Amount (IRMAA). This surcharge affects both Medicare Part B (medical insurance) and Part D (prescription drug coverage), and understanding how it works can help you plan your healthcare costs.
How IRMAA Works
The surcharge is based on your Modified Adjusted Gross Income (MAGI) from two years prior. For 2026 IRMAA calculations, Medicare will use your 2024 tax return income. This two-year lag means changes in your current income won’t immediately affect your Medicare premiums.
2026 Income Thresholds
For 2026, single filers earning more than $109,000 and married couples filing jointly with income above $218,000 will pay additional premiums. The surcharge increases with higher income brackets, with the highest earners paying the most.
For example, a single person earning between $109,001 and $137,000 will pay an estimated additional $74.80 monthly for Part B and $14.50 for Part D coverage.
Automatic Deduction
IRMAA is typically deducted automatically from your Social Security check. If you don’t receive Social Security benefits, Medicare will bill you directly.
Planning Ahead
Since IRMAA is based on past income, consider how retirement, investment gains, or other income changes in 2024 might affect your 2026 Medicare costs. The surcharge applies regardless of whether you have traditional Medicare or Medicare Advantage with prescription coverage.