Medicare IRMAA Calculator 2026

IRMAA — Income-Related Monthly Adjustment Amount — is a surcharge added to your Medicare Part B and Part D premiums when your income exceeds certain thresholds. For 2026, surcharges range from $95.70 to $578.00 per month above the $202.90 base premium. That's up to $6,936 per year per person, or nearly $14,000 for a couple both enrolled in Medicare.

The surcharge is assessed per person and based on your 2024 modified adjusted gross income (MAGI) — a two-year look-back. If your income dropped since 2024 because you retired or had another qualifying life event, you can request a reduction using SSA Form SSA-44.

Why this matters for planning: IRMAA operates on a cliff structure — even $1 over a threshold can cost hundreds of dollars more per year. A retiree whose 2024 MAGI lands at $138,000 instead of $137,000 pays an extra $1,736/year in Medicare premiums for 2026. Roth conversions, QCDs, and withdrawal ordering can all move the needle.

Estimate your 2026 IRMAA

2026 IRMAA Bracket Table

IRMAA tiers are determined by your 2024 MAGI. Surcharges apply per Medicare enrollee — a couple on Medicare each pay based on their joint MAGI, so the household surcharge is effectively doubled.

Enter your income above to highlight your tier. Showing: Single / MFS

Part B base premium: $202.90/month (2026, CMS). Part D surcharge is added to your plan's own premium. Tier 5 thresholds ($500K single / $750K MFJ) are frozen through 2027.¹

What counts as MAGI for IRMAA?

MAGI for IRMAA purposes is your adjusted gross income (AGI) plus tax-exempt interest income. It includes:

Wages, self-employment income, business income
Traditional IRA and 401(k) distributions and RMDs
Taxable Social Security benefits (up to 85%)
Pension and annuity income
Capital gains and dividends
Roth IRA conversions (these count as income in the year converted)
Tax-exempt bond interest

It does not include: Roth IRA distributions (after age 59½ from a qualified account), qualified charitable distributions (QCDs), Health Savings Account (HSA) distributions for medical expenses, or return of after-tax basis.

How to reduce your IRMAA tier

Roth conversions in low-income years. Converting traditional IRA to Roth before RMDs begin (age 73/75) builds tax-free balances that produce no MAGI in future years. A $2M traditional IRA that generates $80,000/year in RMDs might push a single retiree into Tier 2 or 3 every year. Converting a portion during the 60-73 window reduces both future RMDs and future IRMAA. Use the Roth conversion calculator →
Qualified Charitable Distributions (QCDs). Once you reach age 70½, direct IRA transfers to charity (up to $111,000/year in 2026) are excluded from MAGI entirely.³ Unlike a cash withdrawal followed by a charitable deduction, a QCD never appears in income — it satisfies your RMD without raising your IRMAA exposure. For a retiree in Tier 2 at $150,000 MAGI, a $14,000 QCD drops them to Tier 1, saving $1,736/year. See RMD and QCD planning →
Tax-loss harvesting. Realized capital losses in your taxable account offset gains, reducing MAGI. Pair with rebalancing to keep the tax benefit without a wash-sale violation. Effective when large gains from appreciated positions would otherwise push you over a threshold.
Deferring year-end income. If a Roth conversion, RMD, or sale would push you just over a threshold, splitting it across two tax years can keep each year under the cliff. Note: this requires accurate income projection — miscalculating in the first year doesn't let you "take it back."
IRMAA appeal — Life Changing Event (LCE). If your 2024 income was elevated but your situation has since changed (retirement, work reduction, divorce, death of spouse, loss of pension, employer settlement ended), you can file SSA Form SSA-44 to request that Medicare use more recent income data. Processing takes 6-8 weeks; submit promptly if your 2026 MAGI is much lower than 2024.²

Planning scenario: A married couple, both 72, has joint MAGI of $230,000 — $12,000 above the $218,000 Tier 1 threshold. They're each paying $284.10/mo Part B + $14.50/mo Part D instead of base, costing $2,296/year extra as a couple ($95.70/mo × 2 × 12). A $12,000 QCD from one spouse's IRA — directed to a charity they already support — reduces joint MAGI to $218,000 (Tier 0), eliminating the entire surcharge. The QCD also satisfies part of their RMD, so it costs them nothing beyond what they would have donated anyway.

Related calculators

Roth Conversion Calculator — model conversions that reduce future RMD-driven MAGI and IRMAA
RMD Calculator — project required distributions that directly add to MAGI each year
Social Security Claiming Calculator — SS benefits count toward MAGI; timing affects IRMAA exposure
Safe Withdrawal Rate Calculator
Match with a retirement income specialist

Sources

CMS — 2026 Medicare Parts A & B Premiums and Deductibles. Part B base premium $202.90/month; full IRMAA surcharge table by income tier. Tier 5 thresholds frozen through 2027.
SSA — Medicare Premiums. IRMAA income tiers, the 2-year look-back rule, and SSA Form SSA-44 Life Changing Event appeal process.
IRC § 408(d)(8) — Qualified Charitable Distributions. QCD annual limit $111,000 (2026, indexed per SECURE 2.0). QCDs excluded from gross income and MAGI.
Kiplinger — 2026 Medicare IRMAA Brackets and Surcharges for Parts B and D. Full income bracket table with per-tier Part B and D surcharges cross-checked against CMS data.
Medicare.gov — Medicare Costs Overview. Part B and D premium structure and how IRMAA applies.

IRMAA premiums verified against CMS.gov and SSA.gov for 2026. Part D surcharges cross-checked with Kiplinger. 2026 surcharges apply to beneficiaries whose 2024 MAGI exceeded the applicable thresholds. Values current as of April 2026.

Get help managing IRMAA and Medicare costs

A retirement income specialist can model the multi-year interaction between Roth conversions, RMDs, QCDs, and IRMAA tiers — and build a plan that minimizes lifetime Medicare surcharges. For many retirees with $1M+ in traditional accounts, this planning is worth $20,000–$60,000 over a 10-year horizon. Free match, no obligation.