Will I pay Medicare IRMAA surcharges?
IRMAA (Income-Related Monthly Adjustment Amount) raises your Medicare Part B and Part D premiums once your income crosses a threshold — and it's a cliff, not a slope: one dollar over the line costs you the entire tier's surcharge. Enter your filing status and income from two years ago to see where you land. Everything runs in your browser.
A simplified approximation using 2026 CMS-published premiums and IRMAA thresholds, not tax or medical advice. It does not account for future inflation indexing of thresholds, Part A premiums, Medigap or Medicare Advantage costs, or life-changing-event appeals. Talk to a tax professional or Medicare counselor before making decisions based on it.
What is IRMAA?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to standard Medicare Part B (medical) and Part D (prescription drug) premiums for higher earners. Everyone pays the same base premium; IRMAA adds a extra fixed dollar amount on top, based on your income — it isn't a percentage or a gradual phase-in.
The 2-year lookback
Medicare doesn't know your current income when it sets next year's premium, so it looks back two years: your 2026 premium is based on your 2024 tax return's Modified Adjusted Gross Income (MAGI). This lookback is why a single high-income year — a large Roth conversion, capital gain, or final working year — can trigger a surcharge two years later, even if your income has since dropped.
Why it's a cliff, not a slope
Each IRMAA tier applies in full once your MAGI reaches its threshold — there's no phase-in. Earning even $1 more than a tier's cutoff moves your entire premium (not just the income above the line) into the higher tier, adding thousands of dollars a year for both spouses on Medicare. This is why planners pay close attention to MAGI in the two years before Medicare enrollment.
Strategies people search for
- Timing Roth conversions — spreading conversions across years, or completing them before age 63 (two years before Medicare eligibility) to avoid tripping a future tier.
- Appealing via Form SSA-44 — if you've had a "life-changing event" (retirement, divorce, loss of income-producing property, death of a spouse), you can ask Social Security to use a more recent, lower income instead of the 2-year-old figure.
- Bracket-aware withdrawal order — coordinating which accounts you draw from in the years feeding into your Medicare lookback to avoid crossing a threshold unnecessarily.
Keep the plan honest
Planomy applies the same IRMAA tiers and 2-year MAGI lookback inside your full retirement projection — so Roth conversions and withdrawal decisions account for their effect on future Medicare premiums, not just current-year taxes.
Frequently asked questions
What income is used for IRMAA?
IRMAA is based on modified adjusted gross income from your tax return, usually from two years earlier. For example, Medicare premiums for one year generally use income reported on the return filed two years before that year.
Why is IRMAA called a cliff?
IRMAA is a cliff because crossing a threshold by even one dollar can move you into the next surcharge tier. That higher tier can increase monthly Part B and Part D costs for the entire year.
Can an IRMAA surcharge be appealed?
Sometimes. If your income dropped because of a qualifying life-changing event such as retirement, marriage, divorce, or death of a spouse, you may be able to ask Social Security to use a more recent income year.
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