For many retirees, navigating the complexities of Social Security and Medicare is already daunting—but a little-known surcharge called IRMAA could make the financial planning process even more challenging. The Income-Related Monthly Adjustment Amount (IRMAA) is a hidden cost that can unexpectedly shrink your Social Security check if you’re not aware of how it works. And come 2026, some noteworthy changes may bring even more surprises for higher-income retirees. If you’re not taking IRMAA into account, you could find yourself paying significantly more for Medicare—reducing the benefits you’ve worked all your life to receive.
This surcharge isn’t new, but what’s changing is how more retirees are slipping into higher IRMAA brackets due to inflation and income growth, without realizing it. The impact? A noticeable chunk of your check could vanish before it ever reaches your bank account. This article explores what IRMAA is, how it’s set to affect Social Security in 2026, who is most vulnerable, and what smart steps you can take now to protect your retirement income.
Overview of IRMAA and 2026 Medicare changes
| Term | Definition |
| IRMAA | Income-Related Monthly Adjustment Amount; a Medicare surcharge for higher-income beneficiaries |
| Impact | Reduces the net amount of Social Security benefits received after Medicare premium deductions |
| 2026 Change | More beneficiaries may cross into higher IRMAA brackets due to inflation adjustments |
| Who’s Affected | Retirees with modified adjusted gross income (MAGI) above specific thresholds |
| Common Triggers | Capital gains, Roth conversions, required minimum distributions (RMDs) |
| Solution | Proactive income planning, Roth strategies, filing for IRMAA appeal (SSA-44 Form) |
What is IRMAA and why it matters
IRMAA stands for Income-Related Monthly Adjustment Amount, a surcharge added to Medicare Part B and Part D premiums for individuals with higher incomes. More than just a nuanced line item, IRMAA directly decreases the Social Security payment you receive, because Medicare premiums are typically deducted from those benefits. If your income increases even modestly in retirement, you could quickly find yourself in a higher IRMAA tier—and with hundreds or even thousands of dollars less in your pocket annually.
The surcharge applies in addition to the standard Medicare Part B premium, which for 2024 is $174.70 per month per person. For those subject to the highest IRMAA tier, that premium can more than double, jumping well above $500 monthly. Worse still, these costs are stealthy. No warning is required before IRMAA is applied, and many retirees only realize it when they notice a smaller Social Security deposit.
How 2026 inflation calculations could push more retirees into IRMAA
In 2026, bracket creep is expected to push scores of middle-income retirees unexpectedly into IRMAA territory. The income thresholds for IRMAA are adjusted annually for inflation, but income itself—especially from retirement account withdrawals, pensions, and capital gains—is growing even faster. This mismatch is subtly but surely drawing in more retirees who never imagined they’d pay higher premiums for Medicare.
Currently, IRMAA kicks in for individuals with a modified adjusted gross income (MAGI) above $103,000 and for married couples filing jointly with MAGI above $206,000. That number will likely adjust slightly in 2026, but many retirees will still find themselves pushed over the line due to RMDs, real estate sales, or Roth conversions designed to manage taxes. The result? Unintended entry into the IRMAA crosshairs.
Who qualifies and why it matters
If you think IRMAA only affects the wealthy, think again. The formula includes all sources of income—Social Security benefits, traditional IRA withdrawals, dividends, capital gains, and even tax-exempt interest. Many middle-class retirees who have saved diligently could be pulled into a higher premium bracket as they trigger income events like downsizing or executing a Roth conversion.
Understanding how MAGI is calculated—and how even one-time events can affect it—is essential. For example, selling a home, cashing in stocks, or withdrawing a large sum from a 401(k) could increase your MAGI for that year and surprise you with a higher IRMAA the following year. Since Medicare uses tax data from two years prior to calculate IRMAA, what you do in 2024 will affect your premium in 2026.
“Many retirees are blindsided by IRMAA. It’s not well-publicized and planning mistakes are often costly.”
— Jane Matthews, Certified Financial Planner
Winners and losers under the IRMAA structure
| Group | Impact |
| High-income retirees | Pay significantly more in Medicare premiums, reducing net Social Security benefits |
| Proactive planners | Minimize IRMAA exposure through strategic withdrawals, conversions, and income smoothing |
| Uninformed retirees | Face surprise income-related surcharges with no opportunity to revise previous income decisions |
| Low-income seniors | Unaffected by IRMAA; continue paying standard Medicare premiums |
Smart strategies to avoid or reduce IRMAA
While IRMAA can dramatically affect your Social Security check, it’s not unavoidable. With wise planning, retirees can manage their income to stay within lower brackets. One of the most effective strategies is executing partial Roth conversions early in retirement. These conversions move money from a traditional IRA to a Roth, increasing your current taxable income but reducing future required distributions that could push you into IRMAA territory.
Another smart move involves capital gains planning. If you anticipate selling a rental property or portfolio assets, pick a year with low additional income, or spread sales across multiple years. Keeping MAGI just under the IRMAA thresholds in even one key year could save a couple hundreds—or even thousands—of dollars.
How to appeal your IRMAA surcharge
If you’ve had a life-changing event like retirement, divorce, death of a spouse, or loss of income, you may be able to appeal your IRMAA through Form SSA-44. This form lets you request a reduction based on updated income information, rather than relying on the two-year-old data Social Security typically uses.
“A recent retirement or one-time income spike shouldn’t automatically hike your Medicare premiums for two years. Appealing through SSA-44 offers real relief.”
— James Lin, Medicare Consultant
Make sure to provide documentation of the qualifying event and explain why your income won’t stay at the higher level. It’s important to act proactively—waiting too long means you’ll continue paying higher premiums unnecessarily.
What changed this year
In 2024, updated premium brackets and standard increases in Social Security benefits created a paradox. Many retirees were pleased to see a cost-of-living adjustment (COLA) to their monthly checks, only to find that a larger portion of it was gobbled up by Medicare premium increases, especially for those impacted by IRMAA. With the trend continuing, the scenario in 2026 looks even more urgent for many retirees.
Medicare Part D premiums also factor into IRMAA, bringing surprise increases that may not correspond with improved benefits. Taking proactive steps now in 2024 could be your key to protecting your 2026 benefits before it’s too late.
Frequently Asked Questions about IRMAA
What income qualifies for IRMAA calculation?
Modified Adjusted Gross Income (MAGI), which includes wages, pensions, capital gains, dividends, and even tax-exempt interest, is used to calculate your IRMAA bracket.
How will I know if IRMAA affects me?
The Social Security Administration will send you a letter informing you about your IRMAA premium adjustment based on your IRS tax return from two years ago.
Can I avoid IRMAA completely?
If you manage your income meticulously to stay below the threshold, or use Roth strategies and timed asset sales, you may avoid it altogether.
How do I file for an IRMAA appeal?
Use Social Security’s Form SSA-44. Supporting documentation regarding life-changing events is required.
Does IRMAA affect both Medicare Part B and Part D?
Yes, both Part B (medical insurance) and Part D (prescription drug coverage) include IRMAA surcharges for higher-income individuals.
Is IRMAA a permanent surcharge?
No. It’s recalculated annually based on your income from two years prior. If your income drops, so may your IRMAA.
Does IRMAA affect my spouse if I’m the only high earner?
If you’re married and filing jointly, the combined income is considered. Both of you may pay the surcharge if your MAGI exceeds the joint thresholds.
Are Roth IRA withdrawals included in IRMAA income?
No. Qualified Roth IRA withdrawals are not included in MAGI, making them a useful tool in IRMAA mitigation planning.
About the Author
