Yes — Medicare bases your Part B and Part D premiums on your income. Most people pay the standard Part B premium of $202.90 a month in 2026, per the Centers for Medicare & Medicaid Services, but if your modified adjusted gross income from two years ago was above $109,000 (single) or $218,000 (married filing jointly), Medicare adds a monthly surcharge to both Part B and Part D.
Revised: 7/24/26
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The long answer
The surcharge is called IRMAA — the Income-Related Monthly Adjustment Amount. Medicare does not look at this year’s earnings. It uses your federal tax return from two years back, so your 2026 premiums reflect your 2024 income. The measure is modified adjusted gross income, or MAGI: your adjusted gross income plus any tax-exempt interest, such as municipal bond interest.
There are six income tiers. Each one raises the surcharge, and the steps are cliffs — crossing a tier line by even a single dollar moves you to the full higher amount. At the top tier, Part B alone is $689.90 a month. Part A works differently: it stays premium-free for most people no matter how high income goes.
If your income has dropped since 2024 — retirement is the most common reason — you do not have to wait it out. Form SSA-44 asks Social Security to use a more recent year instead, and it can be filed as soon as the qualifying event happens.
Part A stays premium-free for most people regardless of income. Income affects Part B and Part D only.
Printed from JasonKnowsMedicare.com — “Are Medicare Premiums Based on Income?”. The free IRMAA Planning Guide is available at JasonKnowsMedicare.com/pages/free-medicare-guides · Questions: (850) 810-1000
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This page is educational information, not personal financial, tax, or legal advice. For decisions about your own situation, talk with a qualified professional.