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Most Medicare Part B enrollees pay $202.90 per month in 2026. If your modified adjusted gross income (MAGI) on your 2024 federal tax return exceeds the threshold for your filing status, Medicare adds an income-related monthly adjustment amount (IRMAA). Your total Part B premium can reach $689.90 per month. Part D IRMAA works differently: it is added to the premium charged by your prescription-drug plan. The income test generally uses a tax return from two years earlier, so 2026 premiums usually reflect 2024 income.
What IRMAA is—and how it differs from the standard premium
IRMAA is the income-related monthly adjustment amount applied to Medicare premiums for people whose income falls above federally defined tiers. It does not buy extra Medicare benefits. It changes what you pay for Part B and, separately, what you pay toward Part D.
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The standard 2026 Part B premium is $202.90 per month, and the annual Part B deductible is $283. Those figures apply to beneficiaries in the lowest income tier. Higher-income beneficiaries pay the standard premium plus an adjustment; Medicare publishes the resulting amount as a total monthly Part B premium. See the Centers for Medicare & Medicaid Services’ 2026 Medicare Costs publication.
Part D uses a separate calculation. Your income-related amount is added to the premium of the prescription-drug plan you selected, so the total Part D bill depends on both your plan and your IRMAA tier. The government’s published Part D national base premium for 2026 is $38.99; that figure is used to estimate IRMAA and the Part D late-enrollment penalty, not to state the price of every plan.
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Which tax year Medicare uses for 2026 IRMAA
For 2026, Social Security generally looks at MAGI reported on your 2024 federal income-tax return. MAGI for this purpose is generally your adjusted gross income plus tax-exempt interest. The two-year lookback means a change in your 2026 wages, investment income or business income normally does not immediately change the premium determination for that same year.
Filing status is decisive. Medicare applies different thresholds to an individual return, a joint return and a married person filing separately. The table below reproduces the 2026 schedule. The amounts in the last column are total monthly Part B premiums, not merely the surcharge.
2026 Part B premiums by income and filing status
| MAGI on 2024 return | Individual return | Joint return | Married filing separately | 2026 monthly Part B total |
|---|---|---|---|---|
| Lowest tier | $109,000 or less | $218,000 or less | $109,000 or less | $202.90 |
| Tier 2 | Above $109,000 to $137,000 | Above $218,000 to $274,000 | Not applicable | $284.10 |
| Tier 3 | Above $137,000 to $171,000 | Above $274,000 to $342,000 | Not applicable | $405.80 |
| Tier 4 | Above $171,000 to $205,000 | Above $342,000 to $410,000 | Not applicable | $527.50 |
| Tier 5 | Above $205,000 and below $500,000 | Above $410,000 and below $750,000 | Above $109,000 and below $391,000 | $649.20 |
| Highest tier | $500,000 or more | $750,000 or more | $391,000 or more | $689.90 |
The married-filing-separately column is intentionally different from the other columns: the 2026 table does not provide applicable middle tiers for that filing status. Do not assume that an individual or joint threshold applies to a separate return.
These thresholds and totals are annual values for the 2026 premium year and can change when CMS publishes a new schedule. A late-enrollment penalty, if you owe one, can make your actual Part B charge higher than the table amount.
How much Part D IRMAA adds in 2026
Part D IRMAA is not a replacement for your drug-plan premium. It is an additional monthly amount collected from you and added to the plan’s own charge. Because plan premiums vary, two people in the same income tier can have different total Part D bills.
| 2024 MAGI tier | Individual return | Joint return | Married filing separately | 2026 Part D IRMAA added each month |
|---|---|---|---|---|
| Lowest tier | $109,000 or less | $218,000 or less | $109,000 or less | $0 |
| Tier 2 | Above $109,000 to $137,000 | Above $218,000 to $274,000 | Not applicable | $14.50 |
| Tier 3 | Above $137,000 to $171,000 | Above $274,000 to $342,000 | Not applicable | $37.50 |
| Tier 4 | Above $171,000 to $205,000 | Above $342,000 to $410,000 | Not applicable | $60.40 |
| Tier 5 | Above $205,000 and below $500,000 | Above $410,000 and below $750,000 | Above $109,000 and below $391,000 | $83.30 |
| Highest tier | $500,000 or more | $750,000 or more | $391,000 or more | $91.00 |
For example, a beneficiary in the $37.50 Part D IRMAA tier pays the chosen plan’s stated premium plus $37.50 each month. The $38.99 national base premium is an estimating reference, not a universal plan premium. Medicare’s costs page explains that plan premiums vary.
Why a higher-income beneficiary pays more
The official schedule is a tiered rule tied to MAGI. Once the applicable threshold is exceeded, Medicare assigns the beneficiary to the corresponding tier and charges the standard Part B premium plus the amount reflected in that tier’s total. For Part D, the tiered amount is added to the selected plan premium.
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IRMAA does not mean that higher-income beneficiaries receive a different Part B or Part D benefit package. Coverage rules, deductibles, coinsurance and the drug plan’s formulary remain governed by the Medicare program and the selected plan. IRMAA changes the premium obligation.
Government publications establish the thresholds and the two-year lookback but do not present a detailed policy rationale for why each tier is set at its particular level. The practical reason your bill is higher is therefore the published income formula, not a separate medical determination or a change in your benefits.
Understanding MAGI and threshold boundaries
Use the income figure Social Security identifies for IRMAA, rather than simply adding up wages or looking at taxable income. The published definition generally starts with adjusted gross income and adds tax-exempt interest. Your return’s filing status is just as important as the dollar amount.
Thresholds are written with precise boundaries. An individual with MAGI of exactly $109,000 remains in the lowest tier, while an amount above $109,000 enters Tier 2. The same principle applies at every listed boundary: $137,000, $171,000, $205,000 and $500,000 for an individual return, with different figures for joint returns. A small amount over a cutoff can therefore produce a different monthly total for the entire premium year.
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For married filing separately, the official 2026 schedule lists the lowest tier through $109,000, then a Tier 5 range above $109,000 and below $391,000, followed by the highest tier at $391,000 or more. The table does not supply middle-tier amounts for that filing status, so do not interpolate them.
What the premium differences mean in a household budget
The standard Part B amount is $202.90 each month, or $2,434.80 over 12 months. At $284.10, Tier 2 costs $81.20 more per month than the standard amount, or $974.40 more over a year. Tier 3 is $405.80 monthly, Tier 4 is $527.50, Tier 5 is $649.20 and the highest tier is $689.90.
These are Part B comparisons only. They do not include the $283 annual Part B deductible, a late-enrollment penalty, a Medicare Advantage or Medigap premium, cost sharing for care, or any Part D plan premium. A household comparing total Medicare spending must add those separate items.
Part D IRMAA can also be viewed annually: the monthly additions of $14.50, $37.50, $60.40, $83.30 and $91.00 equal $174, $450, $724.80, $999.60 and $1,092 over 12 months, respectively. Those calculations still exclude the selected drug plan’s own premium.
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Annual notice
Social Security sends an annual IRMAA adjustment notice. Medicare.gov says beneficiaries should generally receive the notice in November for the coming year. Keep it: it states the income information used, the assigned tier and the adjustment amounts. The official explanation is available in the Social Security Income-Related Monthly Adjustment Amount Notice guidance.
Deduction from Social Security or Railroad Retirement benefits
If you receive Social Security or Railroad Retirement Board benefits, Part B premiums are usually withheld from that payment. The deduction can include Part B IRMAA. Part D IRMAA is generally collected separately each month rather than folded into the drug plan’s advertised premium.
Direct Medicare billing
If you do not receive Social Security or Railroad Retirement benefits, Medicare bills you directly for Part B. A direct Part B bill includes any applicable Part B IRMAA and is sent every three months. Part D IRMAA is billed monthly. Medicare’s premium-payment instructions describe these collection methods.
What to do when your current income is lower than the tax return used
A two-year lookback can produce an unfair-looking result after a major income-reducing life event. A 2024 tax return may show a large capital gain, a business sale or two salaries even though your household income is substantially lower in 2026. Medicare’s handbook directs people in that situation to Social Security’s process for requesting a lower IRMAA determination.
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- Read the adjustment notice. Confirm the tax year, filing status and income figure Social Security used.
- Identify the life event and the resulting reduction. The available process is intended for circumstances in which a qualifying life event reduced your income; Social Security decides whether the facts meet its requirements.
- Contact Social Security using the current instructions. Start with the process described in the Medicare and You Handbook 2026 and Social Security’s instructions linked from your notice. The handbook and notice contain the current forms and submission directions.
- Provide the requested evidence. Social Security determines what documentation is needed and whether the claimed event supports a lower amount. The materials cited here do not establish a guaranteed list of qualifying events, documents or an outcome, so follow the agency’s current requirements rather than relying on a generic checklist.
- Keep the determination and appeal information. Social Security’s IRMAA decision includes appeal rights. If the agency does not change the amount, the notice explains how to challenge the determination and any applicable deadline.
Do not simply stop paying while a request is pending. Continue following the payment instructions on your bill or benefit statement unless Social Security or Medicare gives you different written directions.
Common situations that explain a higher bill
Your income crossed a threshold by a small amount
IRMAA uses tiers rather than a gradual percentage applied to every dollar. Crossing a threshold can move you into the next published monthly amount. Review the MAGI figure Social Security used and your filing status; do not compare only with your current paycheck.
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You are comparing a Part B total with a Part D surcharge
The Part B figures in the table are complete monthly Part B premiums. The Part D figures are additions only. Comparing $649.20 of Part B with $83.30 of Part D without accounting for the underlying drug-plan premium produces the wrong conclusion.
Your filing status changed
A joint return, an individual return and a married-filing-separately return have different thresholds. A change in filing status can alter which row applies even if household income is unchanged. Check the status on the tax return Social Security used, not merely your present household arrangement.
You expected the premium to reflect this year’s income
For 2026, the normal reference year is 2024. A current-year reduction does not automatically reset the premium. Use the lower-IRMAA process if a qualifying life event makes the older return unrepresentative.
You owe a late-enrollment penalty as well
IRMAA is separate from late-enrollment penalties. A penalty can increase the amount you actually owe beyond the standard or IRMAA-tier figure shown in the CMS table.
A practical worksheet for checking your 2026 amount
- Locate your 2024 federal tax return and note MAGI, not just taxable income.
- Confirm whether Social Security classified the return as individual, joint or married filing separately.
- Match the income to the correct 2026 row in the Part B table.
- For Part B, treat the table’s figure as the total monthly premium before any separate late-enrollment penalty.
- For Part D, find your added IRMAA amount, then add it to the premium of your selected drug plan.
- Compare the result with your November IRMAA notice, benefit deduction or Medicare bill.
- If the notice uses income or filing status that is wrong, or if a later income-reducing life event makes it unrepresentative, contact Social Security and preserve the appeal information.
How the amounts compare over a year
| 2026 Part B tier | Monthly total | 12-month Part B total |
|---|---|---|
| Standard tier | $202.90 | $2,434.80 |
| Tier 2 | $284.10 | $3,409.20 |
| Tier 3 | $405.80 | $4,869.60 |
| Tier 4 | $527.50 | $6,330.00 |
| Tier 5 | $649.20 | $7,790.40 |
| Highest tier | $689.90 | $8,278.80 |
The annual figures above multiply the published monthly Part B totals by 12; they do not include a Part D plan premium, Part D IRMAA, a late-enrollment penalty, Medigap or Medicare Advantage premiums, or cost sharing for care.
Timing and recordkeeping checklist
Keep three documents together: the 2024 return used for the calculation, the November IRMAA notice and the bill or benefit statement showing collection. Check that the filing status and income figure on the notice match the return. If they do not, contact Social Security promptly using the instructions on the notice and retain copies of everything submitted.
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Key distinctions to remember
- Standard versus IRMAA: $202.90 is the standard 2026 Part B premium; the higher amounts are total Part B premiums for higher income tiers.
- Part B versus Part D: Part B IRMAA is reflected in a total Part B amount, while Part D IRMAA is an add-on to your plan premium.
- Old return versus current circumstances: 2026 normally uses 2024 MAGI, so a later reduction requires a Social Security review rather than an automatic adjustment.
- Premium versus benefit: Paying IRMAA does not provide a different Medicare benefit package.
- Published schedule versus future years: The figures here apply to 2026 and should be checked against CMS’s next annual schedule when it is released.
Frequently Asked Questions
What is IRMAA?
IRMAA is the income-related monthly adjustment added when the MAGI on the tax return used for the premium year exceeds the applicable threshold. It raises what you pay for Part B and adds a separate amount to Part D, but it does not change your Medicare benefits.
How much is the standard Medicare Part B premium in 2026?
The standard Part B premium is $202.90 per month in 2026. The annual Part B deductible is $283.
What income triggers IRMAA in 2026?
For an individual return, MAGI above $109,000 triggers the next tier. For a joint return, the first cutoff is above $218,000. Married-filing-separately returns have their own schedule, with no listed middle tiers in the 2026 table.
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Normally, no. For 2026, Social Security generally uses MAGI from your 2024 federal tax return, a two-year lookback.
Why is my Medicare premium higher than $202.90?
Your 2024 MAGI may have placed you above the lowest tier, or a late-enrollment penalty may also apply. Check the income, filing status and tier on your November notice.
Is Part D IRMAA my entire drug-plan premium?
No. Part D IRMAA is an additional monthly amount. Add it to the premium charged by your selected prescription-drug plan; the $38.99 national base premium is an estimating reference, not every plan’s price.
Can I appeal IRMAA if my income went down?
You can ask Social Security to review a lower-IRMAA request when a qualifying life event reduced your income. Social Security decides whether the facts and evidence meet its requirements, and its determination includes appeal information.
How are IRMAA charges collected?
For most people receiving Social Security or Railroad Retirement benefits, Part B premiums are deducted from the benefit payment. People who do not receive those benefits generally receive a direct Part B bill every three months. Part D IRMAA is billed monthly.
The Bottom Line
Bottom line: Most beneficiaries pay $202.90 a month for Part B in 2026. Social Security generally uses 2024 MAGI and filing status to assign an IRMAA tier, taking total Part B premiums as high as $689.90. Part D IRMAA is separate and is added to your plan’s premium. If a later income-reducing life event makes the older return unrepresentative, follow Social Security’s lower-IRMAA and appeal instructions.
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