Medicare Premium & IRMAA Calculator 2026
The standard Medicare Part B premium for 2026 is $202.90/month. But if your modified adjusted gross income exceeds $109,000 (single) or $218,000 (married filing jointly), you pay IRMAA surcharges that can push your Part B premium to $689.90/month — more than triple the base rate.
David Duley· Founder & CEO
Published March 29, 2026
Reviewed by Jon Ragsdale for factual accuracy, source quality, and clarity.
Medicare costs are not just about age. They are also about income, timing, and policy. A retiree can go from the standard Part B premium to a much higher monthly bill because of IRMAA, often based on income from two years earlier rather than what they earn today.
That lag is what makes this a policy-risk topic. The program rules are public, but the household effect often arrives later and feels surprising. This page helps translate those rules into a number you can plan around.
Medicare premiums aren’t one-size-fits-all. Higher-income beneficiaries pay IRMAA surcharges that can triple your Part B premium. Enter your income to see your exact 2026 Medicare costs — including Part B, Part D, IRMAA surcharges, and deductibles.
How PRIA Approached This
This calculator was written by David Duley and reviewed by Jon Ragsdale. PRIA treats tools like this as household policy-risk explainers, not generic widgets. We separate current law from proposals when relevant, translate public rules into plain English, and present the output as an educational estimate rather than personalized advice.
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Frequently Asked Questions
- How much is Medicare Part B in 2026?
- The standard Medicare Part B premium for 2026 is $202.90 per month, up from $185.00 in 2025. Higher-income beneficiaries pay IRMAA surcharges that can push the total Part B premium up to $689.90 per month.
- What is IRMAA and how does it work?
- IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge on Medicare Part B and Part D premiums for higher-income beneficiaries. It is based on your modified adjusted gross income (MAGI) from 2 years prior — your 2024 tax return determines your 2026 IRMAA. There are 6 tiers, with surcharges ranging from $0 to $487.00/month for Part B.
- What are the 2026 IRMAA brackets for single filers?
- For single filers in 2026: no surcharge below $109,000 MAGI; $81.20/month surcharge at $109,000-$137,000; $202.90 at $137,000-$171,000; $324.70 at $171,000-$214,000; $446.40 at $214,000-$500,000; and $487.00 above $500,000. These surcharges are added to the standard $202.90 Part B premium.
- What are the 2026 IRMAA brackets for married filing jointly?
- For married filing jointly in 2026: no surcharge below $218,000 MAGI; $81.20/month at $218,000-$274,000; $202.90 at $274,000-$342,000; $324.70 at $342,000-$428,000; $446.40 at $428,000-$750,000; and $487.00 above $750,000.
- Can I appeal my IRMAA surcharge?
- Yes. If your income decreased since 2024 due to a life-changing event (retirement, marriage, divorce, death of spouse, work stoppage, or loss of income-producing property), you can file SSA Form SSA-44 to request IRMAA be based on your more recent, lower income.
- Does IRMAA affect Part D premiums too?
- Yes. IRMAA applies to both Part B and Part D. Part D IRMAA surcharges range from $13.70 to $85.80/month in 2026, added on top of your plan's premium. The surcharges follow the same income brackets as Part B IRMAA.
- What is the Medicare Part D out-of-pocket cap?
- The 2026 Part D out-of-pocket cap is $2,100, up from $2,000 in 2025. This was introduced by the Inflation Reduction Act. Once you reach $2,100 in out-of-pocket Part D spending, you pay $0 for covered drugs for the rest of the year.
- How much does Medigap cost?
- The average Medigap (Medicare Supplement) premium is about $164/month nationally, but varies widely by plan type, age, location, and insurer. Medigap Plan G is the most popular, typically ranging from $120-$250/month. Medigap premiums are not subject to IRMAA.
- What income is used for IRMAA — AGI or MAGI?
- IRMAA uses Modified Adjusted Gross Income (MAGI), which is your adjusted gross income plus tax-exempt interest income (such as municipal bond interest). This is Line 11 of Form 1040 plus Line 2a. Roth IRA distributions do not count toward MAGI.
- How can I avoid IRMAA surcharges?
- Strategies include spreading Roth conversions across multiple years to stay below thresholds, timing capital gains realizations, using tax-exempt income sources (Roth distributions, municipal bonds), and coordinating large income events with your tax advisor. If you are newly retired, file Form SSA-44 to use your current lower income.
- What is the Part A deductible for 2026?
- The Medicare Part A inpatient hospital deductible for 2026 is $1,736 per benefit period. Most people pay no monthly premium for Part A if they or their spouse paid Medicare taxes for at least 40 quarters (10 years of work).
- How does this calculator work?
- Enter your 2024 MAGI and filing status, and we look up your IRMAA bracket to calculate your Part B premium, Part D surcharge, and total monthly Medicare cost. You can optionally include Part D and Medigap premiums for a complete picture.
Medicare premiums depend on your income. See your exact 2026 costs including IRMAA surcharges.
Start Free Watch →Medicare Premium Calculator: The Short Answer
Medicare premiums are not flat for everyone. Your baseline premium may be straightforward, but higher-income retirees can face sharp jumps because of IRMAA surcharges on Part B and Part D. That means tax planning and Medicare planning are often the same conversation.
What Is IRMAA?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge on Medicare Part B and Part D premiums for higher-income beneficiaries. It’s based on your modified adjusted gross income from two years prior — so your 2024 tax return determines your 2026 IRMAA.
IRMAA affects roughly 7% of Medicare beneficiaries. If you recently retired or had a one-time income spike (Roth conversion, home sale, pension lump sum), you may be temporarily pushed into a higher bracket.
Why The Two-Year Lookback Matters
The two-year lookback is where many households get caught off guard. You can retire, see your current income fall, and still get billed based on a higher-income year from before. That makes one-time tax events more expensive than many retirees expect.
The premium itself is only part of the story. IRMAA also changes how you should think about Roth conversions, capital gains, and large distributions near Medicare age.
Why Medicare Costs Belong In Tax Planning
Medicare premiums are one of the clearest examples of a household cost being shaped by tax rules rather than just healthcare usage. That is why premium planning, withdrawal planning, and retirement tax planning need to be coordinated instead of handled separately.
2026 Medicare Cost Summary
- Part B premium: $202.90/month (standard) up to $689.90/month (highest IRMAA tier)
- Part B deductible: $283/year
- Part A deductible: $1,736 per benefit period
- Part D average premium: $46.50/month + IRMAA surcharge
- Part D out-of-pocket cap: $2,100/year (IRA provision)
- Medigap average premium: $164/month (varies by plan and location)
How to Reduce Your IRMAA
If your income has dropped since 2024 due to a “life-changing event” — retirement, marriage, divorce, death of a spouse, work stoppage, or loss of income-producing property — you can request an IRMAA reduction by filing Form SSA-44 with Social Security. CMS will use your more recent (lower) income instead.
Proactive strategies to avoid IRMAA include:
- Spreading Roth conversions across multiple years to stay below thresholds
- Timing capital gains and pension distributions to avoid bracket jumps
- Using tax-exempt income (Roth distributions, municipal bonds) that doesn’t count toward MAGI
- Coordinating with your tax advisor before large one-time income events
Part D Out-of-Pocket Cap: New for 2025–2026
The Inflation Reduction Act introduced a $2,000 annual out-of-pocket cap on Part D prescription drug spending in 2025, rising to $2,100 in 2026. Once you hit $2,100 in out-of-pocket Part D costs, you pay nothing for covered drugs for the rest of the year. This is a major change — previously there was no cap, and beneficiaries in the catastrophic phase still paid 5% of drug costs indefinitely.
Related Analysis
- Medicare Changes 2026 — Complete guide to premiums, drug pricing, and MA plan reforms
- Medicare Advantage Plans 2026 — What is Part C and what’s changing
- Social Security Calculator — Estimate your monthly benefit alongside your Medicare costs