IRMAA Medicare Surcharge Calculator
Medicare charges higher premiums when your modified adjusted gross income (MAGI) exceeds certain thresholds. These Income-Related Monthly Adjustment Amounts (IRMAA) apply to both Part B and Part D, based on your tax return from two years prior.
2026 IRMAA Thresholds — Married Filing Jointly
| Tier | MAGI Above | Part B/mo | Part D/mo | Annual Surcharge |
|---|---|---|---|---|
| Standard | — | $202.90 | $0.00 | $0 |
| Tier 1 | $218,000 | $284.10 | +$14.50 | $1,148 |
| Tier 2 | $274,000 | $405.80 | +$37.50 | $2,885 |
| Tier 3 | $342,000 | $527.50 | +$60.40 | $4,620 |
| Tier 4 | $410,000 | $649.30 | +$83.30 | $6,356 |
| Tier 5 | $750,000 | $689.90 | +$91.00 | $6,936 |
How IRMAA Works
IRMAA surcharges are determined by your MAGI from two years ago. For 2026 premiums, Medicare uses your 2024 tax return. MAGI for IRMAA purposes equals your AGI plus tax-exempt interest income.
There are five income tiers above the standard premium. Each tier increases both your Part B and Part D monthly costs. The surcharges are “cliff” based — going $1 over a threshold triggers the full surcharge for that tier.
Roth conversions, capital gains, and other income spikes can temporarily push you into a higher IRMAA tier. Planning conversions to stay just below a tier threshold can save thousands annually.
Life-changing events (retirement, marriage, divorce, death of spouse) may qualify you for a reduction using SSA-44 form.