IRMAA, Explained: Medicare's 2026 Income Surchargeand When You Can Appeal It
If Social Security’s letter just arrived — the one about your “income-related monthly adjustment amount” — this page is the plain-English version of it. Keep the letter nearby; the numbers on it will match what follows.
IRMAA — the Income-Related Monthly Adjustment Amount — is a surcharge Social Security adds to Medicare premiums when your income from two years ago was above $218,000 (married filing jointly) or $109,000 (single). In 2026 it adds $95.70 to $578.00 a month, per person.
In 2026 the standard Part B premium is $202.90 a month (CMS, 2026 premium tables released November 14, 2025). IRMAA sits on top of that — roughly $1,148 to $6,936 a year, per person. Here is who pays it, why an old tax return decides it, and when you can appeal it.
Who pays IRMAA — and who doesn’t
IRMAA applies when your income two years back was above $218,000 for a couple filing jointly, or above $109,000 filing single (Social Security Administration, 2026 thresholds). The income measure is MAGI — for Medicare purposes, your adjusted gross income plus tax-exempt interest. About 8% of people on Medicare pay IRMAA (CMS).
Two things surprise people. The surcharge applies to each spouse enrolled in Part B — a couple with both spouses on Medicare pays it twice. And there are really two surcharges — one on Part B and one on Part D drug coverage; the figures on this page are the combined amount. If you don’t have Medicare drug coverage, you pay only the Part B portion.
The two-year lookback: why your 2024 tax return sets your 2026 premium
Social Security sets your premium from the most recent complete tax return the IRS can hand them — normally two years back. Your 2026 premiums come from your 2024 return; your 2027 premiums will come from 2025. The system works fine when income is steady. It works badly for one very common situation: you retired. Your 2024 return shows your peak working income; your income today is a fraction of it. Social Security doesn’t know that — unless you tell them. There is a fix, and it’s the rest of this page.
The 2026 IRMAA brackets
For a couple filing jointly, the 2026 surcharge by 2024 income:
| 2024 joint MAGI | Added cost per month, per person | Added cost per year, per person |
|---|---|---|
| Up to $218,000 | $0 | $0 |
| $218,001 – $274,000 | $95.70 | $1,148.40 |
| $274,001 – $342,000 | $240.40 | $2,884.80 |
| $342,001 – $410,000 | $385.00 | $4,620.00 |
| $410,001 – $749,999 | $529.60 | $6,355.20 |
| $750,000 or more | $578.00 | $6,936.00 |
Combined Part B + Part D surcharge above the standard premium, per person enrolled. Filing single, the same monthly amounts apply, with tiers beginning above $109,000. Married filing separately has its own, much steeper structure. Source: CMS-published 2026 Medicare premium tables, released November 14, 2025. CMS publishes the 2027 tables in November 2026; this page will be updated the week they are released.
The IRMAA cliff: one dollar over the line
Look at the table again: the brackets are cliffs, not slopes. One dollar over a line puts you in the next tier for the whole year. At $274,001 of 2024 joint income instead of $274,000, the surcharge rises by about $1,736 a year, per person — from $1,148.40 to $2,884.80.
Can you appeal IRMAA? Sometimes — here’s when
Your letter is one of three situations:
- 1. The numbers are wrong or out of date. If Social Security used incorrect or superseded tax data — an amended return, an IRS error — you can ask them to reconsider the determination itself (Form SSA-561). That path runs on a 60-day clock from your letter, so move promptly.
- 2. The numbers are right, but your life has changed. This is the common one. If your income dropped because of a life-changing event Social Security recognizes, federal rules let you have the surcharge recalculated from your current, lower income. The form for that is SSA-44.
- 3. The numbers are right and standing. If your high-income year was a one-time event — a business sale, a large Roth conversion — it is not a qualifying life-changing event, and SSA-44 relief is not available for it. The consolation is structural: the lookback rolls forward, and a one-time spike falls out of the calculation on its own after one cycle.
Social Security recognizes eight life-changing events. Retirement — “work stoppage” in their vocabulary — is the most common:
- Work stoppage (retirement)
- Work reduction
- Marriage
- Divorce or annulment
- Death of a spouse
- Loss of income-producing property
- Loss of pension income
- Employer settlement payment
Form SSA-44: the free form that lowers it
Form SSA-44 is free from Social Security — download the current version at ssa.gov/forms (opens in a new tab) — or open the form directly: Form SSA-44 (PDF), pick one up at any Social Security office, or handle the whole thing by phone at 1-800-772-1213. The current packet (12-2025 edition) is eight pages — about half of it line-by-line instructions — and the form itself moves through five steps: your life-changing event and its date, your income estimate for the affected year, next year’s estimate if it drops further, your evidence, and signing and filing.
Most filings go wrong on the judgment calls, not the arithmetic — naming the right event, estimating an income you can defend, attaching proof Social Security accepts. If you’d like the filing laid out around the form — which of the eight events fits you, what evidence Social Security accepts for each, and the letter to attach — that’s what The IRMAA Appeal Kit — 2026 Edition is: a $29, 14-page PDF you can read before you ever touch the form.
Doing it yourself
The appeal is self-serviceable if your situation matches one of the eight events cleanly: one form, evidence of the event, and an income estimate you can defend. After you file, Social Security reviews it and mails a new determination — and if they agree, the correction applies to the year in question, including months already overcharged.
The $29 Appeal Kit walks all five steps with a worked example — a couple recovering about $2,297 a year — and carries a 45-day, no-questions-asked refund.
When professional help makes sense
The line isn’t competence — it’s situation. Consider a call if the ambiguous cases are yours: it isn’t clear which event or which year fits; you’re married filing separately; your income sits near a bracket line where a Roth conversion or a capital gain would move you a tier; or your filing came back denied.
Jason Baar is an independent, fee-only Medicare advisor — clients pay a flat fee for analysis, and he accepts no commissions from insurance companies, ever. Licensed insurance agent, Florida license W149493. To be plain about what’s for sale here: Jason doesn’t sell SSA-44 filing as a service — the $29 kit is his entire IRMAA process, written down. The consulting packages (they start at $250) buy analysis of your broader Medicare decisions, and if you bought the kit first, the $29 counts toward any package, with no expiration date. If you’d rather talk before anything, call (850) 810-1000.
Vetting any helper — Jason included: the questions to ask before hiring a Medicare advisor are published on this site, with his answers on the record.
For the printout: www.JasonKnowsMedicare.com/products/irmaa-appeal-kit · (850) 810-1000.
IRMAA questions, answered
Is IRMAA recalculated every year?
Yes. Each year’s premiums are set fresh from the tax return two years back — 2026 from 2024, 2027 from 2025. A one-time income spike affects one year and rolls out on its own.
Do both spouses pay IRMAA?
Each spouse enrolled in Part B pays their own surcharge. A couple above the joint threshold with both spouses on Medicare pays it twice; with one spouse on Medicare, once.
Is IRMAA based on AGI or MAGI?
MAGI — for Medicare purposes, your adjusted gross income plus tax-exempt interest, taken from the return two years back.
Does IRMAA apply to Part D?
Yes. There is a Part B surcharge and a separate Part D surcharge; the table above shows the combined figure. Without Medicare drug coverage, only the Part B portion applies.
Is Form SSA-44 really free?
Yes — from ssa.gov/forms, any Social Security office, or 1-800-772-1213. Nobody needs to pay for the form itself.
This page is general information, not legal or tax advice. It is not affiliated with, endorsed by, or approved by the Social Security Administration, CMS, or the Medicare program. Every dollar figure comes from the CMS-published 2026 Medicare premium tables released November 14, 2025, and Social Security Administration published rules. Page updated July 17, 2026.