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
This free printable PDF explains the Medicare surcharge in plain language for people seeing it for the first time, with the Part B and Part D tables in one place. No email address or form.
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 guide What Medicare Actually Costs at Higher Incomes is available at JasonKnowsMedicare.com/pages/free-medicare-guides · Questions: (850) 810-1000
You can find all 10 free Medicare guides as PDFs on the Free Medicare Guides page.
This page is educational information, not personal financial, tax, or legal advice. For decisions about your own situation, talk with a qualified professional.