IRMAA Brackets 2026: The Complete Guide for Financial Advisors

Back to Resources

Your client just did a $95,000 Roth conversion. Smart move for long-term tax planning. But two years from now, that conversion pushes their MAGI $3,000 over the next IRMAA tier, triggering $4,752 in additional Medicare premiums they didn’t see coming. For a married couple, double it.

This is the planning gap that costs retirees thousands every year: IRMAA brackets operate on a two-year lookback, they apply per person, and they interact with every other income decision you’re making for your clients. Getting the brackets right is table stakes. Planning around them is where the real value lives.

Here’s everything you need to know about the 2026 IRMAA brackets, the planning strategies that actually work, and the interactions most advisors miss.

---

What Are the 2026 IRMAA Brackets?

IRMAA (Income-Related Monthly Adjustment Amount) is the Medicare surcharge that applies when a beneficiary’s modified adjusted gross income exceeds certain thresholds. The surcharge is added to the standard Medicare Part B and Part D premiums.

For 2026, the standard Part B premium is $202.90 per month. IRMAA surcharges are layered on top of this (and on top of your Part D plan premium) based on your client’s MAGI from two years prior (2024 tax return for 2026 premiums).

2026 IRMAA Part B Premium Brackets

Filing Status: Single	Filing Status: Married Filing Jointly	Monthly Part B Premium	Monthly IRMAA Surcharge	Annual Cost Per Person
$109,000 or less	$218,000 or less	$202.90	$0	$2,435
$109,001 to $137,000	$218,001 to $274,000	$284.10	$81.20	$3,409
$137,001 to $171,000	$274,001 to $342,000	$405.80	$202.90	$4,870
$171,001 to $205,000	$342,001 to $410,000	$527.50	$324.60	$6,330
$205,001 to $499,999	$410,001 to $749,999	$649.20	$446.30	$7,790
$500,000 or more	$750,000 or more	$689.90	$487.00	$8,279

Source: CMS 2026 Medicare Parts A & B Premiums and Deductibles

2026 IRMAA Part D Surcharges

Filing Status: Single	Filing Status: Married Filing Jointly	Monthly Part D Surcharge	Annual Cost Per Person
$109,000 or less	$218,000 or less	$0	$0
$109,001 to $137,000	$218,001 to $274,000	$14.50	$174
$137,001 to $171,000	$274,001 to $342,000	$37.50	$450
$171,001 to $205,000	$342,001 to $410,000	$60.40	$725
$205,001 to $499,999	$410,001 to $749,999	$83.30	$1,000
$500,000 or more	$750,000 or more	$91.00	$1,092

Part D surcharges are added to whatever your client pays for their Part D plan premium.

Total Annual IRMAA Cost by Tier (Per Person, Part B + Part D Combined)

Tier	Single MAGI Range	MFJ MAGI Range	Annual IRMAA Surcharge Per Person	Annual Surcharge Per Couple
No IRMAA	≤$109,000	≤$218,000	$0	$0
Tier 1	$109,001 to $137,000	$218,001 to $274,000	$1,148	$2,297
Tier 2	$137,001 to $171,000	$274,001 to $342,000	$2,886	$5,772
Tier 3	$171,001 to $205,000	$342,001 to $410,000	$4,620	$9,240
Tier 4	$205,001 to $499,999	$410,001 to $749,999	$6,355	$12,710
Tier 5	$500,000 or more	$750,000 or more	$6,936	$13,872

The jump from no IRMAA to Tier 1 costs a couple $2,297 per year. From Tier 1 to Tier 2, the additional cost is $3,475. From Tier 4 to Tier 5, crossing the $500K/$750K threshold adds another $581 per person. These are not trivial amounts, and they recur every year your client’s income stays above the threshold.

---

The Two-Year Lookback: Why IRMAA Planning Requires a Multi-Year Lens

IRMAA uses a two-year MAGI lookback. This means the income decisions you and your client make today won’t affect their Medicare premiums until two years later. This creates both a planning challenge and a planning opportunity.

The Challenge

A Roth conversion executed in 2026 affects IRMAA premiums in 2028. If your client is currently below the IRMAA threshold and you’re planning a multi-year Roth conversion strategy, you need to project their MAGI for every year in the sequence and check the IRMAA impact two years downstream for each one.

This gets complex fast. A five-year Roth conversion ladder starting in 2026 requires checking IRMAA implications for 2028, 2029, 2030, 2031, and 2032. Each year’s conversion amount affects a different premium year. And if the TCJA/OBBBA bracket changes shift income levels, the interaction compounds.

The Opportunity

The lookback also creates a planning window. If your client is retiring at 63 and won’t start Medicare until 65, the income in years 63 and 64 determines their initial IRMAA tier. This is the golden window: the two years before Medicare begins are the most valuable Roth conversion years because:

1. The client may have lower income (no longer earning a salary)
2. Tax brackets may be favorable (especially in the 12% or 22% bracket)
3. The IRMAA impact of the conversion doesn’t hit until they’re already on Medicare, so the conversion itself happens IRMAA-free
4. But the MAGI from these years sets their first IRMAA tier

The optimal strategy often involves front-loading Roth conversions in years 63-64 up to just below the IRMAA Tier 1 threshold, then reducing conversion amounts once on Medicare to manage the ongoing surcharge.

Life Events That Can Reset the Lookback

The SSA allows IRMAA appeals (formally called “life-changing event” requests using Form SSA-44) when a qualifying event causes income to drop significantly. Qualifying events include:

• Marriage or divorce
• Death of a spouse
• Work stoppage or reduction
• Loss of income-producing property
• Loss of pension income
• Employer settlement payment

If your client retired in 2025 and their 2024 tax return (the lookback year for 2026 premiums) reflects a full year of employment income, file an SSA-44 with 2025 income documentation. The SSA can use the more recent year instead, potentially eliminating or reducing IRMAA.

This is one of the most underutilized planning tools. Many advisors don’t file the appeal because they don’t realize it exists or assume it won’t be approved. The approval rate for legitimate life-changing events is high.

---

The Five IRMAA Planning Strategies Every Advisor Should Know

1. The Bracket Management Approach: Know Your IRMAA Room

Before making any income decision for a Medicare-eligible client, calculate their “IRMAA room”: the dollars of additional income they can receive before crossing into the next IRMAA tier.

For a married couple filing jointly with projected MAGI of $240,000, they’re already in Tier 1. Their room to Tier 2 is $266,000 minus $240,000 = $26,000. This means they can receive up to $26,000 in additional income (from a Roth conversion, capital gain, IRA distribution, or any other source) before jumping to the next tier.

The cost of crossing from Tier 1 to Tier 2 is $3,181 per year for a couple. So that $26,001st dollar of income effectively costs $3,181 in additional IRMAA surcharges. That’s a 12,234% marginal rate on that single dollar.

This cliff effect is why IRMAA planning must be precise, not approximate.

2. Roth Conversion Optimization Within IRMAA Constraints

Roth conversions are one of the most powerful long-term tax planning tools. But they increase MAGI in the conversion year, which flows through to IRMAA two years later.

The optimal approach:

Step 1: Calculate the client’s projected MAGI for the conversion year, excluding the conversion.

Step 2: Determine which IRMAA tier they’ll be in based on that MAGI (remember, this MAGI affects premiums two years later).

Step 3: Calculate the room to the next IRMAA tier.

Step 4: Compare the cost of jumping to the next tier ($1,052 to $3,181 per year per couple) against the long-term tax savings of a larger Roth conversion.

Step 5: In many cases, converting up to the next tier boundary is optimal. In some cases, deliberately jumping one tier is worth it if the conversion amount is large enough to justify the additional IRMAA cost.

The math: if a $50,000 Roth conversion saves $12,000 in future taxes (at 24% on $50,000) but costs $3,181 in IRMAA surcharges for one year, the net benefit is $8,819. The conversion is still worth doing. But if the conversion only saves $6,000 in taxes and costs $3,181 in IRMAA, the net is only $2,819, which changes the urgency.

This kind of analysis requires modeling both the tax impact and the IRMAA impact together. They’re not separate calculations; they interact. The right Roth conversion software handles both dimensions simultaneously.

3. The Widow/Widower IRMAA Trap

This is the planning gap most advisors miss entirely.

When a spouse dies, the surviving spouse files as Single starting the year after death. The IRMAA brackets for Single filers are roughly half the MFJ brackets through Tier 4 ($109K single vs $218K MFJ, $137K vs $274K, etc.). At the top tier, the asymmetry is even more pronounced: $500,000 for Single vs $750,000 for MFJ, not $1,000,000. This means a couple that was comfortably below the IRMAA threshold as MFJ filers can suddenly be deep into a higher tier as a Single filer, with no change in actual income.

Example: A couple with $300,000 MAGI filing jointly is in IRMAA Tier 1 ($218,001 to $274,000). One spouse dies. The surviving spouse still has roughly $200,000 in income (reduced somewhat due to one fewer Social Security check, but pension and IRA distributions continue) and now files Single. That $200,000 against Single brackets lands them in Tier 3 ($171,001 to $205,000). Their annual IRMAA surcharge per person jumps from $1,148 to $4,620. That’s an additional $3,472 per year in Medicare costs for the surviving spouse, triggered by the filing status change combined with income that didn’t drop proportionally.

Planning for this means:
– Modeling the surviving spouse scenario for every client approaching Medicare age
– Considering Roth conversions while both spouses are alive to reduce future RMD-driven income
– Positioning assets in tax-free accounts that don’t count toward MAGI
– Ensuring the surviving spouse’s projected income doesn’t create an IRMAA spike

4. Income Timing and Asset Location

Not all income counts toward IRMAA MAGI equally, and not all income can be timed.

Income that counts toward IRMAA MAGI:
– Traditional IRA/401(k) distributions (including RMDs)
– Roth conversions
– Taxable Social Security benefits
– Capital gains (including from mutual fund distributions)
– Pension income
– Rental income
– Business income
– Tax-exempt interest (this is the one that surprises people)

Income that does NOT count:
– Roth IRA distributions (qualified)
– Return of basis from non-qualified account sales (only the basis portion; any capital gain above basis does count)
– Loans (including reverse mortgage proceeds, which are loan advances, not income)
– Life insurance death benefits (per IRC Section 101(a)(1), with limited exceptions for transfer-for-value)
– HSA distributions for qualified medical expenses

This creates a clear asset location strategy: money in Roth accounts, HSAs, and cash-value life insurance generates income that doesn’t trigger IRMAA. Money in traditional IRAs, pensions, and taxable accounts does.

For clients approaching Medicare, every dollar moved from traditional to Roth before age 63 is a dollar that won’t trigger IRMAA premiums for the rest of their life.

5. The IRMAA-Aware Withdrawal Sequence

Most withdrawal strategies optimize for tax efficiency: draw from taxable accounts first, then tax-deferred, then Roth. But this sequence ignores IRMAA.

An IRMAA-aware withdrawal sequence considers:
– The IRMAA tier boundary as an additional “bracket” to manage around
– The two-year delay between the withdrawal and its IRMAA impact
– The cumulative lifetime IRMAA cost of each withdrawal strategy

In some cases, drawing more from Roth accounts earlier (even though they’re “last” in the traditional sequence) reduces MAGI enough to drop an IRMAA tier. The annual savings of $2,000 to $6,000 per couple can exceed the tax benefit of preserving the Roth for later.

This is where retirement income planning and IRMAA planning intersect. You can’t optimize one without considering the other.

---

How the One Big Beautiful Bill Act (OBBBA) Changes IRMAA Planning

The OBBBA, which replaced the expiring TCJA provisions, restructures federal tax brackets for 2026 and beyond. While it doesn’t directly change IRMAA bracket thresholds (those are set by CMS based on CPI), it changes the income landscape that determines where clients fall:

• New bracket structure means some clients will have higher or lower taxable income at the same gross income level
• SALT cap changes ($40,400 MFJ, phaseout beginning at $505,000, with a drop back to $10k in 2030) affect high-tax-state clients’ total MAGI
• QBI deduction changes (new phase-in thresholds at $75,000/$150,000) affect business-owner clients
• Senior standard deduction (new for 2026) reduces taxable income for older filers

Each of these changes can shift a client into or out of an IRMAA tier. Advisors need to reproject IRMAA exposure for every Medicare-eligible client using the new 2026 parameters, not the old 2025 ones. For a full breakdown of the OBBBA changes, see our TCJA sunset and OBBBA advisor guide.

---

IRMAA Planning in Practice: A Case Study

Meet Robert and Linda, ages 68 and 66. Both are on Medicare. Combined MAGI: $258,000 (traditional IRA distributions, Social Security, pension).

Current IRMAA status: Married Filing Jointly, MAGI $258,000. They’re in Tier 1 ($218,001 to $274,000). Annual IRMAA surcharge: $2,297 for the couple.

The question: Robert wants to do a Roth conversion. How much can he convert without jumping to Tier 2?

The calculation:
– Current MAGI: $258,000
– Tier 2 starts at: $274,001
– IRMAA room: $16,000
– A $16,000 Roth conversion keeps them in Tier 1

What happens if they convert $60,000 instead?
– New MAGI: $318,000
– New IRMAA tier: Tier 2 ($274,001 to $342,000)
– Annual IRMAA cost: $5,772 (vs $2,297 currently)
– Additional IRMAA cost from the conversion: $3,475 for one year (the premium year two years from now)
– Tax on the $60,000 conversion at 22% bracket: $13,200
– Total cost: $16,675
– Long-term Roth benefit (avoiding tax on growth + RMDs at potentially higher rates): depends on timeline, but often $25,000+ over 15 years

The verdict: The $60,000 conversion is likely worth the one-year IRMAA bump. But a $16,000 conversion is essentially “free” from an IRMAA perspective, so at minimum, they should convert $16,000. That’s $16,000 moved to tax-free growth at zero IRMAA cost.

The deeper question: What about next year, and the year after? A five-year Roth conversion strategy of $60,000/year means five years of Tier 2 IRMAA costs (starting two years after each conversion). That’s $3,475 x 5 = $17,375 in total additional IRMAA costs. Is the long-term Roth benefit worth $17,375 plus the income tax on $300,000 of conversions?

This is where spreadsheets break down and purpose-built planning tools become necessary. Comprehensive platforms like eMoney handle tax modeling broadly; for how Income Lab’s approach differs, see our Income Lab vs. eMoney comparison. The interactions between conversion amounts, bracket changes (OBBBA impact), IRMAA lookback timing, and surviving spouse scenarios create a multi-dimensional optimization problem.

---

How Income Lab Approaches IRMAA Planning

Income Lab’s guardrails-based approach to retirement income planning naturally integrates IRMAA considerations into the distribution strategy. Because the system models income from every source (Social Security, pensions, IRA distributions, Roth conversions) and tracks bracket boundaries, advisors can see how each income decision affects the overall plan, including IRMAA implications.

Key capabilities for IRMAA-conscious planning:
– Tax Lab models Roth conversion scenarios with bracket awareness, helping advisors size conversions that optimize tax savings without unnecessarily triggering higher IRMAA tiers
– Social Security Optimizer evaluates claiming strategies that account for how SS income interacts with other income sources to affect total MAGI
– Retirement GPS provides ongoing monitoring, alerting advisors when plan changes could push clients toward IRMAA tier boundaries

The integrated approach matters because IRMAA, federal tax, state tax, and Social Security taxation are not separate problems. They interact at every level. Optimizing one in isolation can create costs in another. Income Lab’s retirement income framework considers them together.

Income Lab is continuously expanding its tax planning capabilities. Schedule a demo to see the current feature set.

---

Key Takeaways

1. IRMAA cliff effects are severe. A single dollar over a tier boundary costs $1,052 to $3,181 per year per couple. Calculate IRMAA room before any income decision.

2. The two-year lookback creates planning opportunities. Any years in the late 50s/early 60s between retirement and Medicare are the most valuable Roth conversion window because conversions happen before IRMAA applies.

3. The widow/widower trap is real and underplanned. Single-filer IRMAA brackets are half the MFJ brackets. Model the surviving spouse scenario.

4. IRMAA and retirement income planning are inseparable. Withdrawal sequence, Roth conversion strategy, and Social Security timing all affect IRMAA. A comprehensive retirement cash flow plan must account for all of these together. Optimizing any of these in isolation can create IRMAA costs that offset the benefit.

5. The OBBBA changes require reanalysis. New bracket structures, SALT cap changes, and the senior standard deduction all shift MAGI levels. Every Medicare-eligible client’s IRMAA exposure needs fresh modeling under the new law.

---

Next Steps

See how IRMAA planning works in a live demo. Income Lab’s integrated tax and retirement income engine models IRMAA alongside every other income-dependent provision, so you can show clients exactly how their decisions today affect their Medicare costs for years to come.

Schedule a Demo →

Download the 2026 IRMAA Planning Quick Reference. A one-page bracket table with planning thresholds and the most common strategies, formatted for your client files.

Get the Reference Guide →

---

Sources:
– CMS 2026 Medicare Parts A & B Premiums and Deductibles: Official 2026 Part B premium and IRMAA surcharge amounts
– SSA IRMAA Overview: Medicare premium adjustment details and appeal process
– IRS Revenue Procedure 2025-32: 2026 tax bracket thresholds used in IRMAA MAGI projections
– Medicare.gov Part B Costs: Beneficiary-facing premium tables and surcharge explanations
– SSA Form SSA-44: Life-Changing Event form for IRMAA appeals
– Kitces: IRMAA Planning Strategies: In-depth analysis of IRMAA bracket management and Roth conversion interactions

Continue Reading

• TCJA Sunset and OBBBA: What Every Retirement Plan Needs Now
• State Taxes in Retirement: The Complete Advisor Guide
• Book a demo to see IRMAA-aware planning in action

Frequently Asked Questions

What are the 2026 IRMAA bracket thresholds?

For 2026, IRMAA surcharges begin at $109,000 MAGI for single filers and $218,000 for married filing jointly. There are five surcharge tiers, with the highest tier starting at $500,000 (single) or $750,000 (MFJ). The surcharges range from $1,148 to $6,936 per person per year for Part B and Part D combined.

How does the two-year lookback affect IRMAA planning?

IRMAA uses your client’s modified adjusted gross income from two years prior. Income decisions made in 2026 affect Medicare premiums in 2028. This creates a planning window: the years between retirement and Medicare (typically the late 50s to early 60s) are the most valuable for Roth conversions because those conversions happen before IRMAA applies.

Can you appeal an IRMAA surcharge?

Yes. The SSA allows IRMAA appeals using Form SSA-44 when a qualifying life-changing event causes income to drop. Qualifying events include retirement, marriage, divorce, death of a spouse, or loss of income-producing property. If your client retired recently and their lookback year reflects full employment income, filing an SSA-44 with current income documentation can reduce or eliminate the surcharge.

How do Roth conversions interact with IRMAA brackets?

Roth conversions increase MAGI in the conversion year, which flows through to IRMAA premiums two years later. The optimal approach is to calculate the client’s IRMAA room to the next tier before sizing the conversion. In many cases, converting up to the tier boundary is cost-free from an IRMAA perspective, while larger conversions may still be net positive if the long-term tax savings exceed the one-year surcharge.

What is the IRMAA widow/widower trap?

When a spouse dies, the surviving spouse files as Single, where IRMAA brackets are roughly half the married filing jointly thresholds. A couple comfortably in Tier 1 as MFJ filers can suddenly land in Tier 3 as a single filer with no actual change in income. Planning for this means modeling the surviving spouse scenario and considering Roth conversions while both spouses are alive to reduce future income exposure.