Medicare treats you as a higher-income beneficiary when modified adjusted gross income from two years ago exceeds $109,000 for a single filer or $218,000 for a couple filing jointly, per the Social Security Administration. Above those levels you pay income-based surcharges on Part B and Part D — while your actual coverage stays exactly the same as everyone else’s.
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
The surcharge — called IRMAA, the Income-Related Monthly Adjustment Amount — has six steps. Part B moves from the standard $202.90 a month to $284.10 at the first tier and as high as $689.90 at the top, per the Centers for Medicare & Medicaid Services, with Part D surcharges from $14.50 to $91.00 a month added separately. Only about 8% of people on Medicare pay any of this, per CMS.
For married couples, the surcharge applies to each person on Medicare individually. Joint income in a surcharge tier means both spouses’ premiums carry the added amount — effectively doubling the household cost of crossing a threshold.
Because the test is annual and always two years behind, high income in any single year — final working years, a business sale, a large conversion — passes through as one year of higher premiums. The system re-scores you every year as new tax returns arrive.
Printed from JasonKnowsMedicare.com — “Medicare and High Income: What Changes and What Doesn't”. 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.