Medicare5 min read
IRMAA Medicare Surcharges in 2026: What Changed and How to Avoid Them
Higher-income retirees pay more for Medicare Part B and Part D. Here are the 2026 brackets, the two-year lookback trap, and planning moves that help.
IRMAA — the Income-Related Monthly Adjustment Amount — is the surcharge Medicare adds to Part B and Part D premiums for higher-income households. It surprises retirees every year, largely because it uses your tax return from two years ago.
The two-year lookback
Your 2026 IRMAA is based on your 2024 modified adjusted gross income. Sell a business, do a large Roth conversion, or realize big capital gains in 2024, and the higher Medicare premium follows you in 2026 — even if income has since dropped.
Planning moves that help
- Model Roth conversions against the IRMAA cliffs, not just federal brackets.
- Use QCDs from IRAs after age 70 1/2 to keep MAGI down.
- File Form SSA-44 after a qualifying life event (retirement, loss of pension, spouse's death) to appeal.
- Coordinate large capital-gains realizations with lower-income years.
Frequently asked
Questions Scottsdale retirees ask us
- What is the IRMAA income threshold for 2026?
- The first IRMAA tier begins around $106,000 of MAGI for a single filer and $212,000 for a married couple filing jointly, though exact thresholds are updated annually by CMS. Above those levels, monthly Part B and Part D premiums increase in tiers.
- Can I appeal an IRMAA determination?
- Yes. If you have a qualifying life-changing event — retirement, loss of pension income, marriage, divorce, or the death of a spouse — you can file Form SSA-44 with the Social Security Administration to request a reduction based on current income.
- Do Roth conversions cause IRMAA?
- They can. A Roth conversion is treated as ordinary income in the year of conversion, so a large conversion can push MAGI over an IRMAA threshold two years later. Careful sizing and multi-year modeling usually solve this.