If your income is above $109,000 (single) or $218,000 (joint), you're paying IRMAA surcharges that could add $1,000 to $6,000+ per year to your Medicare costs. Here's how to fight back.
IRMAA (Income-Related Monthly Adjustment Amount) is Medicare's surcharge on higher-income beneficiaries. If your Modified Adjusted Gross Income (MAGI) exceeds certain thresholds, you pay more for both Part B and Part D premiums.
The key wrinkle: IRMAA uses a 2-year lookback. Your 2026 IRMAA is based on your 2024 tax return. This means a large income event in 2024 — selling a house, taking a big IRA distribution, exercising stock options — hits your Medicare premiums two years later.
MAGI = Adjusted Gross Income (AGI) + tax-exempt interest income. That's Line 11 of your 1040 plus any tax-exempt bond interest.
| Single MAGI | Joint MAGI | Part B Monthly | Annual Surcharge |
|---|---|---|---|
| ≤$109,000 | ≤$218,000 | $202.90 | $0 |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | $974 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 | $2,435 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 | $3,895 |
| $205,001–$499,999 | $410,001–$749,999 | $649.20 | $5,356 |
| ≥$500,000 | ≥$750,000 | $689.90 | $5,844 |
Part D IRMAA also applies at the same income thresholds, adding $13.70 to $81.00/month to your Part D premium.
IRMAA is a cliff, not a slope. Cross the threshold by $1 and you jump to the next tier. Someone with $109,000 MAGI pays $202.90/month. Someone with $109,001 pays $284.10/month — an extra $974/year on $1 of income. That's why tax planning around these thresholds is so critical.
A printable reference card with all 2026 IRMAA brackets for single, joint, and MFS filers — plus the Part D IRMAA add-ons.
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If your income dropped due to a life-changing event, you can ask Social Security to use your current income instead of the 2-year lookback. File Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event).
Marriage or divorce. Death of a spouse. Work stoppage or reduction (retirement). Loss of income-producing property (through disaster, fraud, etc.). Loss of pension income. Settlement from an employer or former employer (due to closure, bankruptcy, or reorganization).
Provide documentation: retirement letter, death certificate, divorce decree, final pay stub, or other proof. SSA will reassess your IRMAA based on your estimated current-year income.
If you retired in 2024 or 2025 and your income dropped significantly, file SSA-44 immediately. Don't wait for SSA to figure it out — they won't. You need to proactively request the reconsideration. Bring your documentation to your local Social Security office or mail it with the form. This is one of the most impactful financial moves you can make in early retirement.
Traditional IRA/401k distributions count as income and can push you into higher IRMAA tiers. Roth IRA distributions do not count toward MAGI.
The strategy: convert traditional IRA funds to Roth in lower-income years (the "bridge years" between retirement and age 72/73 when RMDs start). Yes, you'll pay income tax on the conversion — but the tax hit is planned and controlled, and the money grows tax-free in the Roth forever after.
IRMAA impact: Roth conversions DO increase your MAGI in the year of conversion. But if you do them strategically in low-income years and stay below the IRMAA threshold, you avoid the surcharge. Then when RMDs start, they're smaller (because you already converted some), keeping your MAGI lower.
Remember the 2-year lookback. A Roth conversion in 2024 affects your 2026 IRMAA. Plan conversions in years when your other income is low enough that the conversion doesn't push you over a threshold.
If you're 70½ or older and give to charity, QCDs are one of the most powerful IRMAA reduction tools available.
A QCD lets you transfer up to $105,000 per year (2026) directly from your IRA to a qualified charity. The distribution satisfies your Required Minimum Distribution (RMD) but does not count as taxable income and does not increase your MAGI.
This means you can fulfill your RMD, support a charity you care about, and keep your MAGI below IRMAA thresholds — all in one move.
Capital loss harvesting: Sell investments at a loss to offset capital gains, reducing your MAGI. You can deduct up to $3,000 in net capital losses per year against ordinary income, with excess carried forward.
Timing large distributions: Don't take a massive IRA distribution in one year. Spread it across two or more years to stay below IRMAA thresholds in each year.
Municipal bond interest caution: Tax-exempt interest from muni bonds IS added to your AGI when calculating MAGI for IRMAA. Ironically, "tax-free" income still triggers the surcharge.
Married Filing Separately — usually avoid: MFS has brutal IRMAA thresholds with only 3 tiers: standard (≤$109k), 3.2x ($109–391k), and 3.4x (≥$391k). Almost all MFS filers pay a surcharge. Filing jointly is almost always better for IRMAA.
Consider amending your return: If you filed MFS in 2024 and realize filing jointly saves you thousands in IRMAA, you can amend (Form 1040-X). SSA will use the amended return.
A good tax advisor who understands IRMAA will pay for themselves in the first year. Most CPAs don't think about Medicare surcharges when doing tax planning. Find one who does. The strategies above can save $1,000 to $5,000+ per year — every year — for the rest of your life on Medicare.
Understanding how IRMAA interacts with your plan choice can save you even more. Chapter's licensed advisors can help you find plans — including Part B giveback plans — that reduce your total Medicare costs. Free, no obligation.
Chapter's advisors are licensed, independent, and don't charge you anything — they're paid by insurance companies, not by you.