2026 Medicare IRMAA Explained: Why Some People Pay More for Medicare

Excerpt: If your income is above certain levels, you may pay more for Medicare Part B and Part D. Here’s a simple look at 2026 IRMAA, how your income affects Medicare costs, and what may happen if your income decreases after retirement.

If you're preparing for Medicare and have started looking at the costs, you may have come across a term that isn't exactly self-explanatory:

IRMAA.

IRMAA stands for Income-Related Monthly Adjustment Amount.

In simple terms, if your income is above certain levels, you may pay more for Medicare Part B and Part D.

And here's the part that sometimes surprises people:

For 2026, Social Security generally looks at your income from 2024.

So let's walk through what that means.

What Is IRMAA?

Most people pay the standard Medicare Part B premium.

However, individuals with higher incomes may have an additional amount added to their Medicare costs.

IRMAA can affect:

Medicare Part B: Your monthly Part B premium increases based on your income level.

Medicare Part D: An additional IRMAA amount may be added on top of the premium you pay for your prescription drug plan.

The higher your income, the higher the adjustment may be.

What Are the 2026 IRMAA Income Levels?

For 2026, the IRMAA determination is based on your 2024 Modified Adjusted Gross Income, or MAGI.

Here is the breakdown provided in the 2026 Medicare IRMAA chart:

The Part D amounts shown above are added to your prescription drug plan premium.

KELLIE'S NOTE:

Why Is Medicare Looking at My Income From Two Years Ago?

This is one of the most common sources of confusion with IRMAA.

Social Security generally determines IRMAA using the tax return information from two years earlier. For 2026, that means looking at your 2024 income.

But think about how much can change in two years.

Maybe in 2024 you were:

Working full-time.

Receiving bonuses.

Earning significantly more than you do now.

And now you're retired.

So you may be looking at your Medicare premium thinking:

“But I don't make that anymore.”

That's an important question to ask.

What If My Income Dropped Because I Retired?

If your income has decreased because of retirement or another qualifying life event, you may be able to ask Social Security to review your IRMAA determination.

The 2026 IRMAA information specifically notes that people whose income decreases because of retirement or another life event may request a review using Form SSA-44.

This is why I don't want you to assume that a letter saying you'll pay IRMAA is automatically the end of the conversation.

Read the notice.

Understand why you're being charged.

And if your circumstances have changed, find out whether a review may be appropriate.

Why Should I Think About IRMAA Before Retirement?

Because Medicare is part of your retirement planning.

When we're preparing for retirement, we don't want to look only at:

“When should I enroll in Medicare?”

We also want to ask:

“What might Medicare cost me?”

Understanding IRMAA ahead of time can help you avoid being caught off guard when your Medicare premiums begin.

And if you're planning to retire soon, it's another reason to start the Medicare conversation before your last day of work.

Do I Need to Figure This Out on My Own?

No.

And you don't need to become an expert on Medicare tax rules either.

If you're approaching Medicare eligibility and concerned about IRMAA, we can talk through what it means for your Medicare coverage and what questions you may need to ask.

For individual tax advice or questions about calculating your MAGI, I'll always encourage you to speak with your tax professional.

My job is to help you understand how these pieces fit into your Medicare decisions.

Planning for Medicare Is Part of Planning for Retirement

There is more to Medicare than simply choosing a plan.

Your retirement date, employer coverage, prescriptions, doctors, income, and Medicare timeline can all become part of the conversation.

That's why I like to start early.

We'll look at where you are, talk through the Medicare pieces that apply to you, and make sure you understand what to expect.

You don't have to figure it all out by yourself.

Guiding You Into Retirement With Confidence.

Ready to start planning? Schedule a complimentary consultation and let's talk through your Medicare transition together.