What Is Medicare IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount.
It is an additional surcharge added to your Medicare Part B and Part D premiums if your income is above certain limits.
Many people are surprised to learn that Medicare premiums are not the same for everyone. Higher-income beneficiaries pay more for Medicare coverage.
IRMAA is determined by the Social Security Administration using your tax return from approximately two years prior.
For example:
- Your 2026 Medicare premiums are generally based on your 2024 tax return.
Standard Medicare Part B Premium
Most people pay the standard monthly Medicare Part B premium.
However, if your income exceeds Medicare’s IRMAA thresholds, your Part B premium increases significantly.
Medicare Part B Covers:
- Doctor visits
- Outpatient care
- Lab work
- Preventive services
- Durable medical equipment
- Physical therapy
- Ambulance services
Part B is an important component of Original Medicare.
What Income Counts for IRMAA?
Medicare uses your:
Modified Adjusted Gross Income (MAGI)
This generally includes:
- Taxable income
- Capital gains
- IRA withdrawals
- Pension income
- Rental income
- Certain tax-exempt interest income
2026 Medicare IRMAA Income Brackets
Your Medicare Part B premiums increase as income rises.
Individual Tax Filers
| Income | IRMAA Applies? |
|---|---|
| Below threshold | Standard Part B premium |
| Higher income levels | Increased premiums |
Married Filing Jointly
| Combined Income | IRMAA Applies? |
|---|---|
| Below threshold | Standard Part B premium |
| Higher income levels | Increased premiums |
Medicare updates IRMAA brackets annually.
Common Reasons IRMAA Happens
Many retirees trigger IRMAA unexpectedly due to:
- Selling a home or business
- Large IRA withdrawals
- Roth conversions
- Capital gains
- Required Minimum Distributions (RMDs)
- Pension payouts
Even a one-time income spike can temporarily increase Medicare premiums.
Can You Appeal IRMAA?
Yes.
If your income has dropped because of a major life event, you may qualify for an IRMAA reconsideration.
Common Qualifying Events:
- Retirement
- Marriage
- Divorce
- Death of a spouse
- Loss of income-producing property
- Employer pension reduction
You can request a review using:
Social Security Form SSA-44
Does IRMAA Affect Medicare Supplement Plans?
No.
IRMAA only affects:
- Medicare Part B premiums
- Medicare Part D prescription drug premiums
It does not increase the cost of:
- Medicare Supplement (Medigap) plans
- Medicare Advantage plan premiums directly
How to Reduce Future IRMAA Costs
Some retirees work with financial and tax professionals to reduce future IRMAA exposure by:
- Managing IRA withdrawals carefully
- Spreading out Roth conversions
- Monitoring capital gains
- Coordinating retirement income strategies
Planning ahead can potentially save thousands in Medicare premiums over time.
Need Help Understanding Medicare Costs?
Choosing the right Medicare coverage can be confusing, especially when premiums, IRMAA, supplements, and Medicare Advantage plans are all involved.
If you have questions about Medicare Supplement plans, Part B premiums, or how Medicare works in Pennsylvania, we can help.
Speak With a Local Medicare Supplement Specialist
- Personalized guidance
- Medicare Supplement comparisons
- Plan G vs Plan N analysis
- Pennsylvania Medicare expertise
Contact us today for a free Medicare review.
