Medicare Part B IRMAA is an extra monthly charge added on top of your regular Part B premium if your income is above certain IRS thresholds, and it can significantly increase what you pay for Medicare each month.

What IRMAA Is

  • IRMAA stands for Income-Related Monthly Adjustment Amount , an income-based surcharge for Medicare Parts B and D.
  • It affects higher-income beneficiaries only; most people on Medicare do not pay IRMAA.

Who Has To Pay It

  • For 2026, IRMAA applies if your modified adjusted gross income (MAGI) is above about $109,000 for single filers or $218,000 for married couples filing jointly, based on your 2024 tax return.
  • Social Security looks back two years at your tax return, so your 2024 income drives your 2026 IRMAA decision.

How Much It Can Cost

  • The standard Medicare Part B premium in 2026 is about $202.90 per month.
  • With IRMAA, total Part B premiums in 2026 can range roughly from $284.10 up to about $689.90 per month, depending on your income bracket.

How It’s Calculated And Billed

  • IRMAA uses several income brackets on a sliding scale; the higher your income, the larger the surcharge, with five main tiers that rise gradually and a top tier that is currently frozen until 2028.
  • The extra Part B IRMAA is usually added automatically to your monthly bill (often via Social Security benefit withholding), and you receive a determination letter explaining why and how much you owe.

Can You Appeal IRMAA?

  • You can ask Social Security to reconsider if your income has dropped due to a “life-changing event” (such as retirement, divorce, or death of a spouse), which may reduce or remove IRMAA.
  • If you disagree with the initial decision beyond that, there is a formal appeals process described in Social Security guidance and Medicare publications.

Information gathered from public forums or data available on the internet and portrayed here.