Higher-income Medicare beneficiaries pay more for Part B and Part D through IRMAA, the Income-Related Monthly Adjustment Amount. In 2026, Part B runs from the standard $202.90 a month up to $689.90 a month at the top income tier, per the Centers for Medicare & Medicaid Services, and a separate Part D surcharge of up to $91.00 a month is added on top of whatever your drug plan charges.
Revised: 7/24/26
Jason Baar
Fee-Only Medicare Advisor
NPN #2033715
It shows where Medicare’s five income lines sit in 2026, what counts toward them, and the timing moves that can keep you under.
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The long answer
“High income” starts lower than many people expect: modified adjusted gross income above $109,000 for a single filer or $218,000 for a couple filing jointly, measured from your tax return of two years earlier. Six tiers follow, and at the very top the combined surcharges add up to about $6,936 a year per person.
That per-person point matters for couples. IRMAA applies to each spouse on Medicare individually, so a couple whose joint income sits in a surcharge tier pays the added amount twice — once on each set of premiums.
What you get for the higher premium is unchanged: the same Part B and the same drug coverage as everyone else. That is why, in my fee-only practice, I treat IRMAA as a cost to be measured and managed with income timing — not a reason to change how you get your Medicare coverage.
Printed from JasonKnowsMedicare.com — “High-Income Medicare Premiums”. The free IRMAA Planning Guide is available at tally.so/r/81gEEA · Questions: (850) 810-1000
This page is educational information, not personal financial, tax, or legal advice. For decisions about your own situation, talk with a qualified professional.