IRMAA is an extra amount some people pay for Medicare Part B and Medicare Part D when their income is above annual thresholds. It is based on income from two years before the premium year, which is why the surcharge can feel delayed.
Quick definition
Income-Related Monthly Adjustment Amount means Medicare adds a monthly surcharge when Medicare MAGI is above the bracket for your filing status.
How IRMAA works
Medicare uses a two-year lookback. For example, 2026 IRMAA brackets generally use 2024 Medicare MAGI. If that earlier income is above a threshold, Social Security can add a monthly amount to Part B and Part D.
See the 2026 IRMAA brackets and then estimate your surcharge.
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Sponsor this placementWhat income counts?
IRMAA is based on Medicare MAGI, not just taxable income. Medicare MAGI generally starts with adjusted gross income and adds tax-exempt interest.
Read the Medicare MAGI guide for common income types such as capital gains, Roth conversions, pensions, dividends, and municipal bond interest.
Is IRMAA monthly or annual?
IRMAA is charged monthly, but an annual estimate is often easier to understand. A monthly surcharge can become a meaningful yearly cost when both Part B and Part D apply.
Can IRMAA be appealed?
Sometimes. The SSA-44 process is mainly for specific life-changing events, such as work stoppage, work reduction, marriage, divorce, death of a spouse, or loss of pension income. It usually is not a fix for every one-time income spike.
Review the SSA-44 appeal guide before assuming an appeal applies.
Get IRMAA bracket updates
Receive annual Medicare premium and bracket updates in plain English.
Where to go next
Start with the 2026 bracket table, learn what counts in Medicare MAGI, and then use the calculator to estimate how close your income is to the next threshold.