Medicare Part D

Earn Over $109K? Here's Your 2026 Medicare IRMAA Bill

Santa Maria, Calif. — If you're a higher-income retiree signing up for Medicare or reviewing your coverage this fall, a rule called IRMAA could add hundreds of dollars to your monthly premiums in 2026. The thresholds shift slightly each year, and knowing where you land on the income chart before December 7 can help you plan — or at least avoid a surprise on your first Social Security statement of the new year.

Here's a plain-English look at how the income-related monthly adjustment amount, or IRMAA, works and where the 2026 brackets begin.

What IRMAA actually is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added on top of the standard Part B premium and your Part D drug plan premium if your income is above a certain level. Most people with Medicare pay the standard Part B premium and no IRMAA at all. Only about the top 8% of enrollees pay a surcharge, according to CMS.

The surcharge comes out of your Social Security check (or is billed directly if you're not yet collecting Social Security). Part D IRMAA is billed by Medicare, not by your drug plan — so switching drug plans during Annual Enrollment does not change your IRMAA.

The 2026 income brackets

Medicare uses your modified adjusted gross income (MAGI) from two years back. So your 2026 premiums are based on your 2024 tax return.

For a single filer in 2026, IRMAA kicks in above these income levels:

• Above $109,000
• Above $137,000
• Above $171,000
• Above $205,000
• Above $500,000 (top tier)

For a married couple filing jointly, the thresholds are doubled at the lower tiers:

• Above $218,000
• Above $274,000
• Above $342,000
• Above $410,000
• Above $750,000 (top tier)

Each tier adds a larger surcharge to both Part B and Part D. The exact dollar amounts for 2026 are posted at medicare.gov once CMS finalizes them each fall.

Why the two-year lookback matters

Because Medicare looks at income from two years ago, a recent retiree can get hit with an IRMAA bill based on a working year — even though their current income is much lower. This catches a lot of people off guard.

The good news: if you had a qualifying life-changing event, you can ask Social Security to use more recent income instead. Qualifying events include:

• Retirement or reduced work hours
• Marriage, divorce, or death of a spouse
• Loss of a pension
• Loss of income-producing property (not from a normal sale)

You file Form SSA-44 with documentation. If Social Security agrees, they'll adjust your IRMAA — sometimes going back to the beginning of the year.

How this fits into 2026 Medicare costs

IRMAA is one piece of a bigger picture in 2026. The Part D out-of-pocket cap is $2,100 next year, the maximum Part D deductible is $615, and the old coverage gap ("donut hole") has been replaced by a simpler three-phase structure since 2025. There's also the Medicare Prescription Payment Plan, which lets you spread drug costs across the calendar year in monthly installments.

Santa Maria is in Santa Barbara County, where Medicare Advantage and standalone Part D plan availability is set at the county level. IRMAA, however, is a federal surcharge — it applies the same way whether you live on the Central Coast or across the country.

What to do during Annual Enrollment

Annual Enrollment runs October 15 through December 7. Medicare Advantage Open Enrollment follows, from January 1 through March 31. A few practical steps if you think IRMAA may affect you:

1. Pull your 2024 tax return and compare your MAGI to the brackets above. 2. If you're close to a threshold, talk to a tax professional about whether Roth conversions, capital gains timing, or charitable distributions could keep you under a bracket in future years. 3. If your income has dropped because of retirement or another life event, download Form SSA-44 from ssa.gov. 4. Call your local SHIP (State Health Insurance Assistance Program) for free, unbiased help — California's SHIP is called HICAP.