Do Medicare Premiums Increase With Income? IRMAA Brackets and Appeals

Yes, Medicare premiums do increase with income. Most people pay the standard Part B premium of $202.90 per month in 2026, but once your modified adjusted gross income crosses $109,000 as an individual filer or $218,000 on a joint return, a surcharge called the Income-Related Monthly Adjustment Amount (IRMAA) is added to both your Part B and Part D premiums.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles Depending on how far above the threshold you sit, IRMAA can add roughly $95 to $578 per month to your combined costs. About 8 percent of Part B enrollees pay it.

What IRMAA Is and How You Pay It

The federal government subsidizes roughly 75 percent of Part B costs for most enrollees. Higher earners cover more of their own cost, and at the top bracket that share climbs to about 85 percent.2Social Security Administration. Premiums: Rules for Higher-Income Beneficiaries

Social Security deducts both the Part B and Part D IRMAA amounts directly from your monthly benefit check, no matter how you normally pay your drug plan.3Centers for Medicare & Medicaid Services. 2025 Medicare Parts A & B Premiums and Deductibles If the surcharge is larger than your Social Security payment, or you don’t collect benefits yet, you get a separate bill.

One point that surprises people: switching to Medicare Advantage does not get you out of IRMAA. Advantage plans require Part B enrollment, so the Part B surcharge follows you in. If your Advantage plan includes drug coverage, the Part D surcharge applies as well.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles

2026 Part B Brackets

The surcharge climbs in five steps above the standard premium. Your filing status determines which thresholds apply. For 2026, individual and joint filers pay:1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles

  • $109,000 or less (individual) / $218,000 or less (joint): no surcharge; you pay the standard $202.90 per month.
  • $109,001–$137,000 / $218,001–$274,000: $81.20 surcharge, total $284.10 per month.
  • $137,001–$171,000 / $274,001–$342,000: $202.90 surcharge, total $405.80 per month.
  • $171,001–$205,000 / $342,001–$410,000: $324.60 surcharge, total $527.50 per month.
  • $205,001–$499,999 / $410,001–$749,999: $446.30 surcharge, total $649.20 per month.
  • $500,000 or more / $750,000 or more: $487.00 surcharge, total $689.90 per month.

At the top tier, you’re covering roughly 85 percent of your actual Part B cost, more than triple what most enrollees pay.

2026 Part D Brackets

Part D uses the same income thresholds, but the surcharge is added to whatever your individual drug plan already charges. The 2026 amounts:1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles

  • $109,000 or less (individual) / $218,000 or less (joint): no surcharge.
  • $109,001–$137,000 / $218,001–$274,000: $14.50 per month.
  • $137,001–$171,000 / $274,001–$342,000: $37.50 per month.
  • $171,001–$205,000 / $342,001–$410,000: $60.40 per month.
  • $205,001–$499,999 / $410,001–$749,999: $83.30 per month.
  • $500,000 or more / $750,000 or more: $91.00 per month.

Combined, a single filer earning $210,000 would pay $649.20 for Part B plus an $83.30 Part D surcharge on top of the drug plan’s base premium. That’s $529.60 more per month than someone earning a dollar below the first threshold.

Married Filing Separately Is Treated Harshly

If you’re married, lived with your spouse at any point during the tax year, and file a separate return, the brackets collapse from five tiers into two:1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles

  • $109,000 or less: no surcharge. Standard $202.90 Part B premium and no Part D IRMAA.
  • $109,001–$390,999: $446.30 Part B surcharge (total $649.20) plus $83.30 Part D surcharge.
  • $391,000 or more: $487.00 Part B surcharge (total $689.90) plus $91.00 Part D surcharge.

A married-filing-separately filer earning $110,000 jumps straight to the same Part B surcharge that a joint filer wouldn’t hit until $410,001. There is no gradual ramp. Anyone weighing whether to file separately should factor this in.

Which Income Number Matters, and When

IRMAA is based on modified adjusted gross income: your adjusted gross income from line 11 of Form 1040 plus any tax-exempt interest from line 2a.2Social Security Administration. Premiums: Rules for Higher-Income Beneficiaries Municipal bond interest counts even though it isn’t federally taxed. This is a narrower version of MAGI than the IRS uses in other contexts, where foreign earned income and untaxed Social Security may also get added back.4Internal Revenue Service. Modified Adjusted Gross Income

Social Security doesn’t ask you for a tax return. The IRS sends the number over directly.2Social Security Administration. Premiums: Rules for Higher-Income Beneficiaries If the figure is wrong, you have to fix it with the IRS; Social Security won’t overwrite data the IRS provided.

Because the current year’s return isn’t filed yet when premiums are set, the agency uses a two-year look-back. Your 2026 premiums are based on your 2024 return.5Social Security Administration. Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event Form SSA-44 If the 2024 return isn’t yet available, the agency may fall back on your 2023 return until newer data arrives.6Medicare.gov. Fact Sheet: 2026 Medicare Costs The lag is the source of the most common IRMAA complaint: someone retires in 2024, income drops sharply, and 2026 premiums still reflect the old paycheck.

Events That Can Push You Into a Higher Bracket

A single high-income year can affect your premiums long after the money is gone. Watch for:

  • Roth IRA conversions. Moving money from a traditional IRA or 401(k) into a Roth creates taxable income in the conversion year, which raises MAGI two years later.
  • Capital gains from selling a home or investments. One large realized gain shows up in that year’s MAGI.
  • Required minimum distributions. As balances grow and RMD percentages rise with age, distributions can push MAGI past the first threshold.
  • Pension lump-sum payouts. Taking a lump sum instead of annuity payments concentrates income into one year.

Running the IRMAA math before a planned conversion or asset sale can save real money. The window that matters is the two years before Medicare enrollment and every year afterward, since each year’s return sets premiums two years out. A conversion at 62, for instance, affects premiums at 64, which for most people is before Medicare even begins at 65.

Getting a Surcharge Reduced After a Life Change

If your income has dropped substantially since the year Social Security is using, you can ask for a new determination. The drop has to trace back to a qualifying life-changing event, not simply a bad investment year. Qualifying events are:5Social Security Administration. Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event Form SSA-44

  • Marriage, divorce, or annulment
  • Death of a spouse
  • Work stoppage or reduction, including retirement
  • Loss of income-producing property, such as rental property destroyed in a disaster
  • Loss of pension income
  • Employer settlement payment from a business closure or reorganization

File Form SSA-44 with your local Social Security office. The form asks you to identify the event, give its date, and estimate your new MAGI for the affected year. You can submit it online, by fax, or by mail, and Social Security will want documentation of both the event and the reduced income (an employer letter for a retirement, a certified decree for a divorce, a death certificate for a spouse).7Social Security Administration. Request to Lower an Income-Related Monthly Adjustment Amount (IRMAA) If the request is approved, Social Security recalculates the premium and refunds any overpayment already deducted that year.

Appealing a Determination You Think Is Wrong

A life-changing event request is not the same as an appeal. If Social Security sends you an Initial IRMAA Determination notice and the underlying income figure is wrong, or you disagree with the decision on other grounds, you can challenge it formally.8Medicare. Initial IRMAA Determination

You have 60 days from receipt of the notice to file. Social Security presumes you received it five days after the date printed on it, so the practical deadline is 65 days from the notice date.9Social Security Administration – Program Operations Manual System (POMS). Overview of the Appeals Process for the Income-Related Monthly Adjustment Amount

There are four levels: reconsideration by a Social Security field office, a hearing before an Administrative Law Judge at the Office of Medicare Hearings and Appeals, review by the Medicare Appeals Council, and finally a civil action in federal district court.9Social Security Administration – Program Operations Manual System (POMS). Overview of the Appeals Process for the Income-Related Monthly Adjustment Amount Most disputes end at reconsideration, particularly where the real issue is a life event the original determination didn’t reflect. Going further up the ladder is uncommon and usually turns on disagreements about the underlying income data itself.