Medicare IRMAA Income Surcharge Guide (2026): MAGI Brackets, Part B & D Premiums, and Appeals

Best for retirees whose income spikes from Roth conversions, capital gains, or returning to work. IRMAA (Income-Related Monthly Adjustment Amount) adds surcharges to Part B and Part D premiums based on tax-return income from two years prior.

How IRMAA is calculated

• Uses Modified Adjusted Gross Income (MAGI) from your tax return two years before the premium year.
• Higher brackets add flat monthly surcharges to both Part B and Part D—stacks on top of base premiums.
• Married filing jointly brackets differ from single filers—plan joint Roth conversions carefully.

Life-changing event appeals

• You may request a new determination after divorce, death of spouse, work stoppage, or income reduction.
• Submit SSA form with supporting documents—appeals are not automatic.
• Pair with enrollment timing in /guides/medicare-part-b-late-enrollment-buying-guide.

Scenario: Roth conversion at 63

A couple converts $200,000 to Roth at 63. Two years later at Medicare enrollment, IRMAA surcharges may apply even if income normalized—model conversions before age 63 or spread over years.

Scenario: widow with income drop

A surviving spouse's income falls below the threshold after a death. Filing a life-changing event appeal with the death certificate and recent tax return may remove IRMAA for the current premium year.

Buying checklist

• Review MAGI projections two years ahead of Medicare start.
• Compare Advantage vs Medigap total cost including IRMAA in /guides/medicare-advantage-vs-medigap-buying-guide.
• Part D penalty still applies separately—/guides/medicare-part-d-late-enrollment-buying-guide.
• Medigap basics: /guides/medicare-supplement-buying-guide-2026.

FAQ

Q: Does IRMAA affect Medigap premiums? A: IRMAA applies to Part B and Part D—not private Medigap carrier premiums.

Q: How long does IRMAA last? A: Usually for the calendar year tied to the referenced tax return unless you successfully appeal.

Q: Are Roth withdrawals counted for IRMAA? A: Qualified Roth distributions may not increase MAGI—conversions do.

Related guides

• Plan letters: /guides/medicare-medigap-plan-letters-deep-guide-2026
• Compare Medicare products: /insurance/medicare