If your income exceeds certain thresholds, you could pay hundreds more per month in Medicare premiums. Use our free calculator to estimate your 2026 IRMAA surcharge — then talk to Buffer about strategies to reduce it.
Calculate Your IRMAA ↓Enter your Modified Adjusted Gross Income (MAGI) from your 2024 tax return and filing status to estimate your 2026 Medicare surcharges.
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge added on top of your standard Medicare Part B and Part D premiums if your income exceeds certain thresholds. The surcharge is determined by the Social Security Administration (SSA) using your Modified Adjusted Gross Income (MAGI) from your tax return two years prior. For 2026, that means your 2024 tax return.
IRMAA is not a tax — it is an additional premium. It applies to everyone enrolled in Medicare Part B, whether you have Original Medicare or a Medicare Advantage plan. If you also have Part D prescription drug coverage (standalone or through an Advantage plan), you pay a separate Part D surcharge as well. The surcharge is calculated on a sliding scale with five income brackets above the standard threshold.
Your MAGI for IRMAA purposes is your Adjusted Gross Income (AGI) from IRS Form 1040, Line 11, plus any tax-exempt interest income (Form 1040, Line 2a). This includes:
Wages & salaries, Social Security (taxable portion), traditional IRA / 401(k) distributions, Roth conversions, capital gains, pensions, rental income, business income, tax-exempt bond interest
Qualified Roth IRA withdrawals, Health Savings Account (HSA) distributions, tax-free return of basis, life insurance proceeds, gifts and inheritances
Medicare determines your IRMAA surcharge in the fourth quarter of the prior year, using the most recent tax data the IRS has processed. For 2026 premiums, that is your 2024 tax return. This creates a planning window — and a potential trap if you have a one-time income spike.
IRMAA is a cliff surcharge, not a gradual phase-in. Being just $1 over an income bracket threshold triggers the full surcharge for that tier — for both Part B and Part D. For example, a married couple filing jointly with $218,001 in MAGI pays an additional $81.20/month in Part B and $14.50/month in Part D — over $1,148 per year in surcharges from a single dollar of income.
The first four brackets are adjusted for inflation annually. The fifth bracket ($500,000 / $750,000) is frozen through 2027 and may be indexed beginning in 2028. The standard Part B premium for 2026 is $202.90/month.
| Single Filer MAGI | Joint Filer MAGI | Part B Monthly | Part D Surcharge | Annual Extra Cost |
|---|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $202.90 (standard) | $0.00 | $0 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | +$14.50 | $1,148 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | +$37.50 | $2,885 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | +$60.40 | $4,620 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.20 | +$83.30 | $6,355 |
| ≥ $500,000 | ≥ $750,000 | $689.90 | +$91.00 | $6,935 |
Married individuals filing separately face a compressed bracket structure — jumping from the standard premium directly to the second-highest surcharge tier.
| MAGI (Filing Separately) | Part B Monthly | Part D Surcharge | Annual Extra Cost |
|---|---|---|---|
| ≤ $109,000 | $202.90 (standard) | $0.00 | $0 |
| $109,001 – $390,999 | $649.20 | +$83.30 | $6,355 |
| ≥ $391,000 | $689.90 | +$91.00 | $6,935 |
The most effective way to manage IRMAA is to plan your income in the years leading up to and during Medicare eligibility. These strategies work best when coordinated between your Medicare advisor and financial planner.
Convert portions of traditional IRA/401(k) balances to Roth accounts before Medicare eligibility. This increases MAGI now (during lower-income years) but permanently reduces taxable income in retirement, keeping future MAGI below IRMAA thresholds.
If you are 70½ or older, use QCDs to satisfy Required Minimum Distributions (RMDs) by donating directly from your IRA to a qualified charity. QCDs are excluded from AGI, reducing your MAGI without losing the charitable benefit.
Avoid large capital gains in a single year. Spread asset sales across tax years, harvest losses to offset gains, and consider the timing of any property sales relative to the two-year IRMAA lookback window.
In retirement, balance withdrawals across taxable accounts, tax-deferred accounts (IRAs/401k), and tax-free accounts (Roth/HSA). Use Roth and HSA funds to fill gaps and keep total MAGI just below the next IRMAA cliff.
If a one-time income event is unavoidable (home sale, business sale, large distribution), plan the timing so the IRMAA impact hits in only one premium year. Accelerate or defer income to consolidate the hit rather than spreading it across multiple lookback periods.
While municipal bond interest is federally tax-free, it is added back to your AGI for IRMAA purposes. High allocations to muni bonds can push you over a bracket threshold even though the income is otherwise tax-advantaged.
If your income has dropped significantly since the tax year used for your IRMAA determination, you do not have to wait two years for the surcharge to adjust. You can file Form SSA-44 with the Social Security Administration to request a new determination based on a qualifying life-changing event.
A change in marital status that affects your filing status and household income.
Loss of a spouse that changes your filing status and household income level.
Retirement, involuntary job loss, or a significant reduction in work hours or compensation.
Loss due to disaster, fraud, or other event beyond your control that eliminated a source of income.
Cessation or reduction of pension payments from an employer or government plan.
Receipt of a settlement from a former employer (added as a qualifying event in recent years).
Complete Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event) and submit it to your local Social Security office along with documentation of the event and your revised income estimate. You can submit the form in person, by mail, or by fax. Buffer can help you determine if you qualify and guide you through the process.
Answers to the most common questions we receive from clients about the Medicare income-related monthly adjustment amount.
Buffer Insurance can help you understand your IRMAA exposure and coordinate with your financial advisor on income strategies to reduce your Medicare premiums. Free consultation — no cost to you.
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