Part B IRMAA Brackets 2026: What You Need to Know
Medicare Part B is a cornerstone of health coverage for many retirees, but for higher-income beneficiaries, there’s an additional cost: the Income-Related Monthly Adjustment Amount, better known as IRMAA. Understanding the Part B IRMAA brackets 2026 and how those adjustments work can help you plan your income, taxes, and healthcare costs.
What Is IRMAA — and Why It Matters
IRMAA is a surcharge added to Medicare Part B (and Part D) premiums for people whose income exceeds certain thresholds. Rather than base your premium solely on your age or election timing, IRMAA considers your Modified Adjusted Gross Income (MAGI) from two years earlier. In other words: your 2024 tax return determines what you pay for Medicare in 2026,
MAGI for Medicare includes your AGI (Adjusted Gross Income) plus certain tax-exempt sources like municipal bond interest.
Because of this “look-back,” proper planning in advance is critical; a one-time income spike (for example, a large capital gain or Roth conversion) in 2024 could significantly increase your 2026 Medicare premiums.
The 2026 IRMAA Brackets for Medicare Part B
Here’s a breakdown of the 2026 IRMAA income brackets (based on 2024 MAGI) and what they mean for your monthly Medicare Part B premium.
| MAGI (2024) | Filing Status | 2026 Part B Premium Estimate |
|---|---|---|
| Up to $109,000 | Single | $202.90 (no surcharge) |
| $109,001 – $137,000 | Single | $284.10 |
| $137,001 – $171,000 | Single | $405.80 |
| $171,001 – $205,000 | Single | $527.50 |
| $205,001 – $499,999 | Single | $649.20 |
| $500,000+ | Single | $689.90 (top IRMAA tier) |
For couples filing jointly, the thresholds roughly double (e.g., up to $218,000 for no surcharge).
Why 2026 Premiums Are Rising
- The base Part B premium is increasing significantly: for 2026, it’s $202.90/month; up from $185 in 2025.
- Surcharges (IRMAA) are also escalating. The top surcharge for Part B is projected around $487/month, putting the total premium at $689.90 for the highest bracket.
- These adjustments are not just about inflation: the IRMAA brackets themselves are being re-indexed, which will pull more people into higher tiers over time.
Putting that in perspective: many beneficiaries on fixed incomes could face a bigger Medicare burden and it’s especially important for those with variable or investment income.
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Strategies to Manage or Reduce IRMAA
Because IRMAA hinges on reported MAGI from two years prior, you may have opportunities now (for your 2024 tax year) to influence your 2026 Medicare costs. Here are some strategies:
- Mind your MAGI
- Prioritize tax-efficient withdrawals in retirement (e.g., Roth conversions, IRA/401(k) distributions) to control your AGI.
- Consider timing of capital gains: if you realize large gains in 2024, you may push yourself into a higher IRMAA bracket.
- Use strategic charitable giving
- Qualified Charitable Distributions (QCDs) from your IRA can lower your taxable income without affecting your MAGI in the same way as other income sources.
- File an SSA-44 (Life-Changing Event)
- If your income drops significantly (due to retirement, unemployment, or other life events), you can file a Form SSA-44 to request a re-determination of IRMAA.
- But note: you need documentation, like proof of reduced income, to support your case when submitting.
- Plan ahead for Medicare Advantage vs Medigap
- Higher IRMAA could make certain Medigap (supplement) plans less attractive; it may also influence whether Part D surcharges make a zero-premium Medicare Advantage plan more favorable.
Things to Consider
- Your 2024 income matters – a lot. What you earned (or didn’t) in 2024 directly impacts your 2026 Medicare Part B costs.
- IRMAA is rising. Even modest increases in MAGI could push you into a higher surcharge bracket.
- You have agency. With smart tax planning and proactive strategies, you may be able to mitigate how much IRMAA you pay, but timing and strategy matter.
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