When Medicare costs rise, most people assume premiums went up for everyone. But IRMAA is different. IRMAA Income Related Monthly Adjustment Amount is an additional surcharge applied only to higher-income Medicare beneficiaries. If your income crosses certain thresholds, Medicare Part B and Part D can cost far more than the standard premium. And in 2026, many retirees will see IRMAA added to their bill because it’s based on Modified Adjusted Gross Income from 2024. Understanding how it works and how to appeal it can save thousands.

What IRMAA Means for Medicare Costs

IRMAA affects only people whose income is above set federal thresholds. While most retirees will pay the standard 2026 Medicare Part B premium of $22.90, anyone in a higher bracket will pay significantly more. The challenge is that IRMAA appeals are often misunderstood, and many are denied simply because individuals don’t know which situations qualify.

Income Thresholds for IRMAA in 2026

For 2026, the government looks back at 2024 income tax returns when determining who pays IRMAA. The thresholds are straightforward:

• Single filers pay IRMAA if income exceeds $109,000
• Married couples filing jointly pay IRMAA if income exceeds $218,000
  Once you cross those limits, even by one dollar, you enter Level 1 of IRMAA. From there, surcharges increase across five income tiers.

IRMAA Cost Brackets for 2026

IRMAA increases rapidly as income rises, and each bracket has a different monthly charge:

• $109,000–$137,000 (single) → $284.10 per month
• Around $171,000 (single) → $405.80 per month
• $205,000–$500,000 (single) → $249.20 per month
• Over $500,000 (single or married filing jointly each) → $689.90 per month
  Married couples pay the same bracketed amounts per person, meaning both spouses can face IRMAA simultaneously.

When You Can Appeal IRMAA

Fortunately, IRMAA is not always permanent. If your income dropped because of a qualifying “life-changing event,” you can appeal using the SSA-44 form. These approved events include:

• Marriage
• Divorce or annulment
• Death of a spouse
• Retirement
• Work reduction or stoppage
• Loss of income-producing property (not due to market fluctuation)
• Loss of pension income
• Employer settlement payment
  If one of these applies, you can request a lower IRMAA calculation using your current income rather than the higher income from 2024.

Situations That Do Not Qualify for an Appeal

Some events feel financially significant but do not qualify for IRMAA relief. These include:

• Selling investment property at a large capital gain
• Taking a big withdrawal from an IRA or 401(k)
• Cashing out a Roth account
• Receiving a large severance package
  These situations increase your income for the year and cannot be appealed once IRMAA is triggered.

IRMAA Is Not a Lifetime Penalty

Many retirees think IRMAA is permanent but it’s not. IRMAA is recalculated every year. For example, in 2027 the Social Security Administration will look at your 2025 income to determine whether you still owe IRMAA. If income changes annually, appeals may need to be repeated each year.