IRMAA Brackets for 2026: Where the Medicare Income Cliffs Are and How to Plan Around Them

The part that surprises most people is the timing. IRMAA looks back two years, so the income you report in your early 60s can decide what you pay for Medicare when you turn 65. This post lays out the 2026 brackets, explains what counts as income, and walks through what to weigh before you adjust anything. For the basics, our answer on what IRMAA is is the short version.

What are the IRMAA brackets for 2026?

The 2026 standard Part B premium is $202.90 a month. Above the first threshold, IRMAA adds a surcharge to that premium, and a separate surcharge to the Part D prescription drug premium. These figures come from the Social Security Administration and CMS and apply to people who file as single or as married filing jointly.

Married people who lived with a spouse during the year but file separately face a steeper schedule, with a much lower top threshold. The CMS fact sheet and the Social Security Administration publish those figures in full.

CMS had not published official 2027 figures when we checked on October 21, 2026. When it does, the thresholds and premiums will change, so check cms.gov before you plan around a specific number.

Which tax year does IRMAA use?

IRMAA generally uses your tax return from two years earlier. For 2026 premiums, Social Security generally uses your 2024 return, or your 2023 return if the IRS has not yet provided the 2024 data. That means income you report this year will generally shape your 2028 premiums.

The delay catches people who retire in the middle of the pattern. A last high-earning year, a bonus, a deferred compensation payout or a large Roth conversion can sit in the lookback year while your paycheck is already gone. If you or your spouse stopped working or reduced hours, the Social Security Administration lets you ask for a new decision, covered below.

What counts as income for IRMAA?

IRMAA uses modified adjusted gross income, or MAGI. The Social Security Administration defines it as your adjusted gross income plus tax-exempt interest. In practice, anything that raises adjusted gross income can raise MAGI, so the list is longer than most people expect. That generally includes the following:

• Pre-tax withdrawals from a 401(k) or traditional IRA, including required distributions.
• Roth conversions, which are taxable in the year you convert.
• Capital gains realized when you sell investments in a taxable account.
• Interest, dividends and the taxable portion of Social Security.
• Payouts from deferred compensation or the sale of company stock.

Qualified withdrawals from a Roth account are generally not included. The details depend on your return, so your CPA should confirm what lands in MAGI for your situation.

Why do the cliffs matter more than the percentages?

Each threshold is a cliff. Cross it by one dollar and the whole next surcharge applies, for the entire year, on both Part B and Part D. Stay under it and you pay the lower tier. That makes a modest amount of income near a threshold more expensive than the same amount in the middle of a tier.

Two details soften the picture. A surcharge applies only to the year’s premiums, and next year’s depends on the next lookback return, so a one-time spike does not follow you forever. And the surcharge is one cost among several. A Roth conversion that adds a year of surcharge may still fit a plan if the later tax picture justifies it, which is a calculation, not a rule.

How do you plan around IRMAA?

Planning around IRMAA means seeing the lookback early and weighing each choice against its other costs. The ideas below are common considerations, not recommendations. Each has trade-offs, results vary by individual tax situation, and a lower reported income is not automatically the better outcome.

• Timing of Roth conversions. Converting in years with lower income can use space beneath a threshold, but the same income appears in a lookback year. Compare the conversion’s long-term tax effect with the premium effect two years later.
• Spreading income across years. Large events such as selling a business interest, exercising stock options or taking a deferred compensation payout can be scheduled in some plans. Plan terms and tax rules limit how much flexibility you have.
• Qualified charitable distributions. For people who give to charity, a direct transfer from an IRA to a charity can satisfy required distributions without adding to adjusted gross income. Eligibility rules and limits apply. See our QCD guide for the mechanics and sources.
• Which account funds spending. Drawing from taxable, pre-tax and Roth accounts in different mixes changes reported income. Our guide to required distributions shows why pre-tax balances can push income up later.
• Reporting a life-changing event. If your income has dropped because you retired, you can request a new IRMAA decision, described next.

Your CPA should run the numbers, since the right answer depends on brackets, state taxes and what else is happening in the same years.

Can you appeal or reduce an IRMAA decision?

Sometimes. If your income has gone down, the Social Security Administration may make a new decision when the cause is one of its listed events. These include marriage, divorce or the death of a spouse, stopping work or reducing hours, loss of income-producing property in a disaster, or certain pension and employer events. You file Form SSA-44 with documentation.

If you think the agency used the wrong tax data, a different process applies. If the IRS figure is wrong, it has to be corrected with the IRS. If the agency’s records are outdated, such as a newer return it has not seen, you can contact Social Security to update them.

What does a hypothetical couple weigh?

Imagine a couple, both 63, who plan to retire at 65 and join Medicare. They hold large pre-tax 401(k) balances, a taxable account and modest Roth savings. They are considering a sizable Roth conversion this year while their paychecks are still coming in.

Their conversion would be taxable income reported now. In two years, that same return becomes the lookback for their first Medicare premiums. If the conversion pushes them across a threshold, they may pay a surcharge on both Part B and Part D for that year.

That does not make the conversion a mistake. They might still convert if their later tax picture justifies it, or they might split the conversion across two years, or wait for a lower-income year after they retire. A projection that includes the surcharge, their tax brackets and the timing of retirement shows the trade-offs. This example is hypothetical, for illustration only, and is not a projection or recommendation for any household.

What mistakes do people make with IRMAA?

• Forgetting the two-year lookback. Income at 63 reaches the premium at 65.
• Looking only at the first threshold. Five tiers sit above it, and the largest jumps can come from large one-time events.
• Treating the surcharge as the only cost. A conversion or gain can be worth paying for, or not, depending on the whole tax picture.
• Missing the appeal route. Many retirees whose income dropped never ask for a new decision.
• Using last year’s brackets. Thresholds and premiums are reset each year.

What are the limits and risks?

• Brackets and premiums change every year. CMS resets them annually under federal law, so a plan built on 2026 figures needs updating.
• A lower reported income is not always better. Pulling income into a different year can raise taxes elsewhere.
• The lookback means decisions take effect late. You will not see a mistake in your premium for two years.
• Appeals depend on documentation and qualifying events. Approval is not automatic.
• Tax law changes. Rules on conversions, charitable distributions and required distributions can change.

Source and as-of date

The figures above reflect the following sources as read on October 21, 2026:

• CMS: 2026 Medicare Parts A & B Premiums and Deductibles, published November 14, 2025, for the Part B premium and income brackets.
• Social Security Administration: Premiums, Rules for Higher-Income Beneficiaries, for Part D surcharges, the MAGI definition, the tax year used and the life-changing event process.

CMS had not published 2027 figures when these sources were read. Confirm current numbers with CMS and Social Security before acting, and coordinate with your tax professional.

What should you do next?

IRMAA is one input in a larger question: what income to report in which years. That is the work inside our ongoing retirement tax planning service, and it sits next to the questions in our guides to the Roth conversion window and the first ten years of retirement.

A good first step is the free Risk Analysis, which takes a few minutes and gives you something concrete to bring to a conversation. When you are ready to look at your own plan, schedule a free 30-minute conversation with Robert Boeck, with no products and no pitch, and bring your CPA into the discussion early.