Medicare IRMAA Calculator

This is a cliff, not a slope. One dollar over a line raises your premium for the whole year. And it looks back two years, so a one-off event reaches forward long after the money is gone.

The income that counts

Adjusted gross income plus any tax-exempt interest. Two years back is the return they use.

The surcharge is charged per person.

Your surcharge this year

-

Extra each month, per person
$0
Your Part B premium
$0
Room before the next line
$0
One dollar over would cost
$0
Standard premium, for comparison
$0

Where the money goes

Each block is sized by its share, so you can see whether extra each month or your Part B premium is the bigger part without reading a single number.

Try a different number

Move it and watch

-

at {v} for your income from two years ago

What this assumes

And what you can change

You take the standard deductionMost people do
You are paid the same all yearNo bonus, no part year
No city or county tax on topA few places add their own
Not what you expected?

Why your own figure may differ

Your payslip shows less. Union dues, parking and repayments come off after tax and are not counted here.
Your employer withheld the wrong amount. Common after a raise or a new job. It settles when you file.
You have income this does not know about. Freelance work, interest and dividends all change the picture.

Every bracket, and what it costs

Each line is a cliff. Staying one dollar below one is worth real money.

Medicare IRMAA brackets
Income up toPart B premiumDrug surchargeCosts you a year

The standard Part B premium for 2026 is $202.9. Above each income line a fixed surcharge is added to both that and your drug coverage. There is no phasing in - crossing a line applies the whole surcharge for the year, and each person on Medicare pays it separately.

Medicare IRMAA: real examples

Three incomes, and the cliff between them. Click any card to load it.

  • Just under the line

    $108,999 of income

    One dollar below the first bracket.

    You pay nothing extra. But one more dollar of income would cost you $1,148 for the year - that is the cliff.

    Load this scenario in the calculator →
  • Just over it

    $110,000 of income

    A thousand dollars more.

    Now $95.70 a month, or $1,148 a year. There is no phasing in - the whole surcharge lands at once.

    Load this scenario in the calculator →
  • A couple pays twice

    $250,000 joint income

    Both spouses on Medicare.

    $2,297 a year, not $1,148. The lines are joint but the surcharge is per person, and couples miss this constantly.

    Load this scenario in the calculator →

Common questions about Medicare IRMAA

What is IRMAA?

A surcharge added to your Medicare Part B and prescription drug premiums if your income is above a set line. The name stands for income-related monthly adjustment amount. Most people never hear of it until a letter arrives telling them their premium has gone up.

Why is it based on income from two years ago?

Because that is the most recent tax return the government has when premiums are set. It means a one-off event - selling a house, a large Roth conversion, cashing in shares - reaches forward two years and raises your premiums long after the money has been spent.

What makes it worse than an ordinary tax?

It is a cliff, not a slope. One dollar over a line raises your premium for the entire year. There is no phasing in. A tiny amount of extra income can cost you over a thousand pounds, which almost no other part of the tax system does.

Do both spouses pay it?

Yes, and this is the part couples miss. The income lines are based on your joint income, but the surcharge is charged per person. A couple both on Medicare pays it twice, so the real cost is double what the table appears to show.

Can I appeal it?

Yes, if your income has fallen because of a life-changing event - retirement, losing a job, divorce, the death of a spouse. You file a form asking them to use your current income rather than the two-year-old return. It is worth doing, and many people do not know it exists.

How do I avoid it?

Watch the lines in the years that count, two years before you go on Medicare and every year after. Timing a Roth conversion, a property sale or a large withdrawal to stay under a line can be worth more than any investment decision that year.

The guide behind this calculator

Brackets, surcharges and the $202.9 standard premium are the 2026 figures, read from the Social Security Administration on 2026-08-18. SSA states the 2026 adjustment normally uses the tax return for tax year 2024. Brackets change every year.