The Medicare surcharge — officially the Income-Related Monthly Adjustment Amount, or IRMAA — is an extra monthly amount added to Part B and Part D premiums for people with higher incomes. In 2026 it applies when modified adjusted gross income on your 2024 tax return is above $109,000 (single) or $218,000 (married filing jointly), and it ranges from $95.70 to $578.00 a month depending on income, per the Social Security Administration.
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
Roughly 8% of people on Medicare pay the surcharge, per the Centers for Medicare & Medicaid Services. If you receive Social Security, the Part B portion is usually deducted from your monthly payment. The Part D portion is billed by Medicare itself, not by your drug plan — and it applies even if your drug plan’s own premium is $0.
The two-year lag is what surprises people most. Medicare uses the most recent tax return the IRS has on file, which is generally two years old. A strong income year at age 63 or 64 can therefore show up as a surcharge in your first year on Medicare.
If your income has dropped since the measured year — you retired, lost a spouse, or divorced — form SSA-44 asks Social Security to use your current, lower income instead. Otherwise the surcharge simply resets each year as newer returns come in.
Printed from JasonKnowsMedicare.com — “The Medicare Surcharge: What It Is and Who Pays It”. 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.