IRMAA Risk Checker — Are You Paying a Hidden Medicare Surcharge?

What Is IRMAA?

IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an extra charge added to your Medicare Part B and Part D premiums if your income exceeds certain thresholds. Unlike most Medicare costs, IRMAA is based on your tax return from two years ago — so your 2024 income determines your 2026 surcharge.

The standard Part B premium in 2026 is $202.90 per month. But if your Modified Adjusted Gross Income (MAGI) was above $106,000 (single) or $212,000 (married filing jointly) in 2024, you’ll pay significantly more — up to $628.90 per month at the highest tier. That’s an extra $5,112 per year, per person.

Key Facts About IRMAA

It’s not a one-time fee. IRMAA is charged every month on top of your standard premium, and it resets annually based on your latest tax return.
RMDs are a major trigger. Required Minimum Distributions from traditional IRAs and 401(k)s count as taxable income and can push retirees into higher IRMAA brackets unexpectedly.
Life events can provide relief. If your income dropped due to retirement, death of a spouse, divorce, or other qualifying events, you can file Form SSA-44 to request a reduction.
Strategies exist to reduce it. Roth conversions, QLACs (Qualified Longevity Annuity Contracts), and careful income timing can help manage or eliminate the surcharge over time.

2026 IRMAA Brackets (Single Filers)

MAGI (2024)	Part B Monthly Premium	Extra Annual Cost
$106,000 or less	$202.90	$0 (standard)
$106,001 – $133,500	$285.00	$985
$133,501 – $167,000	$406.90	$2,448
$167,001 – $200,000	$528.80	$3,911
$200,001 – $500,000	$594.00	$4,693
Over $500,000	$628.90	$5,112

Frequently Asked Questions

Can I avoid IRMAA if I’m already paying it?

Yes, in many cases. If you’ve experienced a qualifying life event (retirement, marriage, divorce, death of a spouse, loss of income), you can file Form SSA-44 with Social Security to request a reassessment using your current income instead of the two-year-old figure. Additionally, proactive strategies like Roth conversions and QLACs can reduce future MAGI and potentially eliminate IRMAA entirely.

Why is IRMAA based on income from two years ago?

Medicare uses your most recently available tax return, which is typically from two years prior. For 2026 premiums, the Social Security Administration looks at your 2024 tax return (filed in 2025). This “look-back” means a one-time income spike — such as selling a home or taking a large IRA distribution — can trigger IRMAA even if your current income is much lower.

Does IRMAA apply to Medicare Advantage plans?

Yes. IRMAA applies to Medicare Part B (which covers outpatient services) and Part D (prescription drug coverage) regardless of whether you have Original Medicare or a Medicare Advantage plan. The surcharge is added to your Part B and Part D premiums on top of whatever your plan charges.

What is a QLAC and how does it help with IRMAA?

A QLAC (Qualified Longevity Annuity Contract) is a special type of deferred annuity you can purchase inside a traditional IRA or 401(k). You can move up to $200,000 into a QLAC, and that amount is excluded from your RMD calculations. Since RMDs add to your taxable income (MAGI), reducing them can directly lower or eliminate your IRMAA surcharge. The QLAC pays guaranteed income later, typically starting at age 80 or 85.

Are You Paying a Hidden Medicare Surcharge?

What Can You Do About It?

Roth Conversions

QLAC (Qualified Longevity Annuity Contract)

Life Event Appeal (SSA-44)

Want Help Reducing Your Medicare Costs?