New IRMAA Brackets for 2026

What does it cost to earn one dollar too much in retirement? In 2026 it can cost you more than $2,000. That’s the IRMAA cliff, the income-based surcharge that stacks on top of your Medicare Part B and Part D premiums, and the 2026 brackets are now set.

IRMAA stands for Income-Related Monthly Adjustment Amount. It’s the Medicare surcharge, and the cruel part is that it’s a cliff, not a ramp. Go one dollar over a bracket line and you pay the full higher premium for all twelve months.

What changed for 2026

The standard Part B premium is $202.90 a month for 2026, up from the prior year, with a $283 annual deductible. That’s the floor. Above it, the surcharge tiers kick in based on your income.

Here are the 2026 Part B IRMAA tiers by modified adjusted gross income:

• Single up to $109,000, joint up to $218,000: no surcharge. You pay $202.90.
• Single $109,000 to $137,000, joint $218,000 to $274,000: total Part B premium of $284.10.
• Single $137,000 to $171,000, joint $274,000 to $342,000: $405.80.
• Single $171,000 to $205,000, joint $342,000 to $410,000: $527.50.
• Single $205,000 to $500,000, joint $410,000 to $750,000: $649.20.
• Single $500,000 and up, joint $750,000 and up: $689.90.

Part D adds its own surcharge on top of whatever your drug plan charges, running from $14.50 a month at the second tier up to $91.00 at the top.

The trap nobody mentions

Here’s the part most people miss. Your 2026 surcharge runs on your 2024 tax return. Medicare uses a two-year lookback, so the income that sets your premium this year is income you reported two years ago.

That means the damage is already done by the time you see the bill. A big Roth conversion in 2024, a property sale, a fat capital gain, an inherited IRA you cashed out, all of it lands on your Medicare premium in 2026. Most people never connect the two because two years is long enough to forget. The surcharge also hits per person, so a married couple both on Medicare pay it twice.

What to do about it

The fix lives two years upstream, which means the planning for your 2026 premium happened in 2024 and the planning for 2028 is happening right now. Watch the line before you take income. A single dollar over a IRMAA threshold buys the entire higher tier, so the last dollar of a Roth conversion is the most expensive dollar you’ll convert. If you can size a conversion to stop just under a bracket, you keep the benefit and skip the penalty. That’s the whole idea behind doing Roth conversions without tripping IRMAA.

If your income spiked because of a one-time event like selling a business or a spouse’s death, you can appeal. File Form SSA-44 with Social Security for a life-changing event, and the surcharge can come off. Most people never file it because they don’t know it exists.

IRMAA is one of the few bills you can see coming two years out. The whole game is to look up, find the nearest line, and stop short of it. Run the two-year lookback math before you take the income, not after the bill arrives.