What are the 2026 Medicare IRMAA thresholds?

TL;DR. For 2026, the first IRMAA tier begins at $106,000 MAGI for single filers and $212,000 for married filing jointly, using 2024 tax-year income. Higher tiers apply above that, with the top tier kicking in above $394,000 single / $788,000 joint. IRMAA adds a surcharge on top of the 2026 standard Part B premium of $206.90/month. The two-year look-back is the detail that catches most retirees by surprise.

The 2026 brackets

IRMAA (Income-Related Monthly Adjustment Amount) is tiered. The 2026 thresholds, based on 2024 MAGI, are approximately:

| Tier | Single filer MAGI | MFJ MAGI | Total Part B premium (approx.) | |---|---|---|---| | Standard | ≤ $106,000 | ≤ $212,000 | $206.90 | | Tier 1 | $106,001–$133,000 | $212,001–$266,000 | $289.00 | | Tier 2 | $133,001–$167,000 | $266,001–$334,000 | $412.20 | | Tier 3 | $167,001–$200,000 | $334,001–$400,000 | $535.40 | | Tier 4 | $200,001–$394,000 | $400,001–$788,000 | $658.60 | | Tier 5 | > $394,000 | > $788,000 | $699.00 |

Part D IRMAA surcharges follow the same tier structure but apply on top of the retiree's Part D plan premium. (The exact published totals for 2026 are set by SSA/CMS and may differ slightly from the approximations above — confirm before publishing client-facing documents.)

The two-year look-back

The rule that catches retirees: 2026 IRMAA is based on 2024's Modified Adjusted Gross Income (Adjusted Gross Income plus tax-exempt interest). A retiree who earned a high salary in 2024 and then retired pays the 2024-based IRMAA surcharge in 2026 even though 2026 income is dramatically lower.

A Life-Changing Event (LCE) appeal through SSA can reduce IRMAA for retirees who experienced a qualifying event — work stoppage, work reduction, marriage, divorce, death of a spouse, loss of income-producing property. Form SSA-44 is the request form.

Why this matters for Roth conversions

A Roth conversion raises MAGI in the conversion year. That MAGI becomes the IRMAA basis two years later. A $50,000 conversion in 2024 that pushes a single filer from $90,000 MAGI to $140,000 MAGI puts them in Tier 2 for 2026 — adding roughly $2,500/year in surcharges.

Advisors planning Roth conversions for clients at or near Medicare age have to either accept that IRMAA impact or stage the conversion to avoid bracket crossings. The Retirement Tax Planner, Roth Conversion, and Medicare IRMAA calculators need to work together to surface this tradeoff.

What a calculator should actually show

A useful IRMAA calculator shows:

• Current-year IRMAA based on the relevant two-year-prior MAGI
• The tier the retiree is in and the distance to the next threshold
• The annualized surcharge cost
• The two-year forward look (this year's MAGI → IRMAA two years from now)
• Both Part B and Part D surcharges

AdvisorCal's Medicare IRMAA calculator handles this, and the Roth Conversion calculator shows the IRMAA downstream effect of a conversion.

Key facts

• 2026 Part B standard premium: $206.90/month.
• 2026 Tier 1 threshold (single): MAGI > $106,000.
• 2026 Tier 1 threshold (MFJ): MAGI > $212,000.
• 2026 Top-tier threshold (single): MAGI > $394,000.
• Two-year look-back: 2024 MAGI determines 2026 IRMAA.
• LCE appeal form: SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event).
• Annual reset: thresholds adjust each year based on inflation; always verify current-year figures against CMS/SSA.

Common follow-ups

Is MAGI the same as AGI for IRMAA? Close. IRMAA MAGI is AGI plus tax-exempt interest (muni-bond interest). For most retirees the two are similar, but tax-exempt bond income does count.

Does IRMAA apply to Part A? No. IRMAA applies to Part B and Part D only. Part A is generally premium-free for those with sufficient work history.

Can a one-time capital gain push me into IRMAA? Yes. A large capital gain in 2024 increases MAGI and therefore 2026 IRMAA. The LCE appeal does not cover investment gains as a qualifying event.

Are IRMAA thresholds indexed to inflation? Yes, thresholds adjust annually. The top-tier threshold is separately set and doesn't follow the same indexing rule as lower tiers — check the current year.

When this doesn't apply

Retirees with only Part A (no Part B or Part D) have no IRMAA exposure. Those enrolled in Medicare Advantage still pay Part B and any IRMAA surcharge to CMS, even when plan premiums are paid to the Medicare Advantage carrier.

Sources

• CMS — 2026 Medicare premiums fact sheet
• SSA — Medicare Part B and Part D premiums
• SSA — Form SSA-44 Life-Changing Event

Try AdvisorCal

AdvisorCal's Medicare IRMAA calculator and Roth Conversion planner show the downstream IRMAA impact of conversions. Full 42-tool access. Start a 14-day free trial — no credit card.

AdvisorCal provides software tools, not investment, tax, or legal advice. Consult a qualified professional for decisions specific to your client or personal situation.