What Is Medicare IRMAA? A Guide for Georgia Seniors

You did everything right. You saved, you planned, maybe you sold a property or converted part of a retirement account in a good year. Then a letter arrives from Social Security telling you that your Medicare premium is going up, sometimes by hundreds of dollars a month. The reason is a rule with an unfriendly name: IRMAA.

So let’s answer it plainly: what is Medicare IRMAA, how is it calculated, and what can you do about it?

What Is Medicare IRMAA?

Medicare IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge that higher-income beneficiaries pay on top of their standard Medicare Part B and Part D premiums. In plain terms, if your income is above a certain level, you pay more each month for the same Medicare coverage as everyone else.

It is not a penalty for doing something wrong. It is a tiered adjustment built into Medicare, where people with higher incomes cover a larger share of the program’s cost. Most people never pay it. Only around 8% of people with Medicare Part B are affected, but for those who are, the amounts are significant.

How Is Medicare IRMAA Calculated?

IRMAA is based on your Modified Adjusted Gross Income, or MAGI, and it uses a two-year lookback. That detail catches people off guard more than any other. Your 2026 IRMAA is determined by the income on your 2024 tax return, filed in 2025.

So the income that triggers a surcharge was often earned two years earlier, and by the time the notice arrives, that year is already closed. Social Security calculates the amount automatically from the tax data the IRS provides, and it is usually deducted straight from your monthly Social Security payment.

2026 IRMAA Income Brackets

For 2026, IRMAA begins once your 2024 MAGI exceeds $109,000 as a single filer or $218,000 for a married couple filing jointly. Below those thresholds, you simply pay the standard Part B premium of $202.90 per month.

Above them, the surcharge climbs through five income tiers. At the higher brackets, the total Part B premium can reach up to about $689.90 per month per person in 2026. Part D also carries its own IRMAA surcharge, added on top of whatever your drug plan charges, using the same income brackets. Part D IRMAA is paid to Medicare directly, not to your plan.

The Cliff Effect: Why One Dollar Matters

Here is the part that feels unfair. IRMAA works as a cliff, not a gradual slope. If your income lands just one dollar over a bracket threshold, you owe the entire surcharge for that tier, not a small fraction of it. Crossing from $109,000 to $109,001 as a single filer can move you into the next tier and add roughly $81 per month to your Part B premium.

This is why income planning around retirement matters so much. A large one-time event, such as selling appreciated stock, taking a big retirement account withdrawal, or converting to a Roth, can push your MAGI across a line and raise your premiums for an entire year.

Can You Appeal or Reduce IRMAA?

Yes, in the right circumstances. If your income dropped because of a qualifying life-changing event, such as retirement, the death of a spouse, marriage, or divorce, you do not have to wait two years for IRMAA to catch up. You can file Form SSA-44 with Social Security to request a new determination based on your current income.

Beyond appeals, thoughtful planning can help. Because IRMAA looks back two years, decisions you make today affect premiums later, so spreading out income, timing withdrawals carefully, and understanding where the brackets fall can all reduce future surcharges. This is where coordinating your Medicare planning with your broader retirement picture pays off.

How IRMAA Fits Into the Bigger Picture

IRMAA is one piece of a larger set of decisions that arrive around age 65 and beyond. Understanding it alongside enrollment timing and coverage choices helps you avoid surprises. If you are approaching eligibility, our guide on what happens when you turn 65 walks through the enrollment side, and you can find more plain-language guides across our resource center.

Frequently Asked Questions

A few of the questions people ask most often when they are first working out what is Medicare IRMAA and whether it applies to them.

What income is used to calculate IRMAA?

IRMAA is based on your Modified Adjusted Gross Income from two years prior. For 2026, that means your 2024 tax return. MAGI generally includes your adjusted gross income plus certain items like tax-exempt interest.

At what income does IRMAA start in 2026?

For 2026, IRMAA begins when your 2024 MAGI is above $109,000 for single filers or $218,000 for married couples filing jointly. Below those levels, you pay the standard Part B premium.

Does IRMAA apply to Part D too?

Yes. Higher-income beneficiaries pay an IRMAA surcharge on Part D as well, using the same income brackets. It is added on top of your drug plan’s premium and paid directly to Medicare.

Can I appeal my IRMAA?

Yes, if you had a qualifying life-changing event such as retirement, the loss of a spouse, marriage, or divorce that reduced your income. You file Form SSA-44 with Social Security to request a new determination based on current income.

Plan Ahead, Talk It Through

Understanding what is Medicare IRMAA, and how the two-year lookback works, gives you the chance to plan around it instead of being surprised by it. There is no reason to sort through it alone.

When you are ready, schedule a conversation with Goldway Capital. We will explain your Medicare options in plain language, at a comfortable pace, with no pressure and no obligation. Bring your questions and, if it helps, someone you trust.

This information is for educational purposes only and does not constitute legal, financial, or tax advice. IRMAA brackets and amounts are set by the federal government and change annually. Goldway Capital LLC | NPN 22184664 | Not affiliated with or endorsed by Medicare or any government agency. Please contact Medicare.gov or 1-800-MEDICARE for official information.