IRMAA is an extra monthly amount people with higher incomes may pay for Part B and Part D. It stands for Income-Related Monthly Adjustment Amount. The charge is based on income, not late enrollment.

Who Pays IRMAA in 2026?

For 2026, IRMAA begins when the income measure Medicare uses, called modified adjusted gross income, is above $109,000 for most individual filers or above $218,000 for married couples filing jointly. Different thresholds apply to some married people filing separately.

Social Security generally uses 2024 tax-return information to set 2026 IRMAA. Modified adjusted gross income for this purpose generally includes adjusted gross income plus tax-exempt interest.

The 2026 standard Part B premium is $202.90. Higher-income enrollees pay the standard amount plus an adjustment. Part D IRMAA is added to the plan's premium and is paid through Social Security or directly to Medicare, not to the drug plan.

Can You Appeal IRMAA?

The next step depends on why you think the amount should change:

  • If you disagree with the decision, ask for a review (called reconsideration). Follow the notice’s appeal instructions; the usual deadline is 60 days after receiving it. SSA explains the appeal right.
  • Ask for a new decision after a qualifying life-changing event. Retirement or reduced work, for example, can lower income enough to change IRMAA. Use Form SSA-44 and provide the event and income evidence. If your tax information was corrected, ask Social Security which review process applies.

Example: a 2026 adjustment based on 2024 wages may not reflect lower income after retirement in 2026. Ask SSA to consider the qualifying retirement and an estimate of your newer income with records to support it. A one-time gain from selling an asset, by itself, is not a qualifying life-changing event merely because it will not recur.

Keep the adjustment notice, relevant tax return and evidence of the change. Identify whether you are disputing the decision or reporting a qualifying event so you use the right process and deadline.

Medicare policy sources last checked: October 8, 2026.