The Learn Library · Topic hub
Medicare & IRMAA
Medicare premiums are means-tested, and the income on a tax return from two years ago sets what you pay today. This hub gathers the guides on Parts A–D, the 2026 IRMAA brackets, enrollment windows, and how income decisions ripple into premiums — with the numbers in one place.
Standard Part B premium
$202.90/mo
2026 standard rate; annual Part B deductible is $283.
IRMAA begins above
$109,000 · $218,000
Single · married filing jointly MAGI — 2024 income sets 2026 premiums.
First IRMAA tier
$284.10/mo
Part B, plus a $14.50/mo Part D surcharge — per person.
Top IRMAA tier
$689.90/mo
Part B at MAGI of $500,000+ single / $750,000+ joint, plus $91.00 Part D.
Initial enrollment window
7 months
Three months before your 65th birth month, the month itself, and three after.
Part B late penalty
+10% per year
Added to the standard premium for each full 12 months of delay — permanently.
Educational reference, not advice. Figures are for 2026 and are explained, with sources, in the guides below.
The guides
Medicare and IRMAA: what higher-income households need to know
Parts A–D, the 2026 IRMAA income-surcharge brackets, enrollment windows, and how income decisions affect what you pay.
Read Related · 6 min readRoth conversions: when they pay off and how to time them
Conversions raise MAGI in the year you convert — and, through the look-back, Medicare premiums two years later. How to size them.
Read Related · 7 min readThe order you draw down accounts is a tax decision
Which withdrawals count toward IRMAA income, which do not, and how sequencing keeps a plan under the premium cliffs.
Read Related · 5 min readOne Dollar Over $218,000 Can Raise a Couple's Medicare Premiums About $2,300 a Year
IRMAA is a cliff: crossing $218,000 of joint MAGI by a single dollar triggers roughly $2,300 a year in extra Medicare premiums for a couple.
ReadRun your own numbers
2026 Federal Tax Bracket Lookup
Find your marginal and effective rate for 2026 — the income picture behind every IRMAA threshold conversation.
Open the calculatorAll planning tools
The full set — retirement projection, Social Security comparison, Roth conversion illustration, and the Retirement Checkup.
Browse the toolsNot sure where your plan stands? Find your gaps across income, taxes, resilience, and clarity in about three minutes.
Take the CheckupCommon questions
At what income level does IRMAA begin in 2026?
IRMAA applies when MAGI exceeds $109,000 for single filers or $218,000 for married filing jointly, based on 2024 income for 2026 premiums. Below those thresholds, you pay only the standard Part B premium of $202.90/month.
Does IRMAA apply to Medicare Advantage (Part C) plans?
Yes. Medicare Advantage enrollees still pay the Part B premium and any applicable IRMAA surcharge. If the plan includes Part D coverage, the Part D IRMAA surcharge also applies.
What is the Medicare two-year look-back and can it be corrected?
Social Security sets each year's IRMAA using tax data from two years prior. If income dropped due to a qualifying life-changing event — retirement, divorce, death of a spouse, or loss of pension — beneficiaries can file Form SSA-44 with Social Security to request use of more recent income, and may receive retroactive refunds.
If my spouse and I both have Medicare, do we each pay IRMAA?
Yes. IRMAA is assessed per beneficiary. A married couple where both spouses are enrolled in Parts B and D will each pay their own surcharge based on joint modified adjusted gross income.
How do Roth conversions affect IRMAA?
Roth conversions increase MAGI in the conversion year. Because of the two-year look-back, a conversion today affects Medicare premiums two years from now. Sizing conversions to stay within a target IRMAA bracket — or completing them before Medicare eligibility — is one of the most consequential planning decisions for higher-income pre-retirees.
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Educational illustration. Not personalized advice.