If you opened a letter from Social Security and saw a higher Medicare bill than expected, or you’re turning 65 in 2026 and trying to figure out if you’ll pay extra, here’s the truth: IRMAA is triggered by your yearly income, and it can raise your Part B and Part D costs the moment your Medicare starts.
The full video for this topic will be added soon.
Key Takeaways
- 2026 IRMAA begins at $109,001 single / $218,001 joint
- Based on 2024 income
- Current Medicare enrollees get letters in November or December
- New Medicare enrollees get IRMAA right away
- You can appeal IRMAA
- Form SSA-44 is used for Life-Changing Event appeals
- Social Security handles IRMAA, not Medicare agents
- IRMAA help page: PrepareforMedicare.com/IRMAA
The 2026 IRMAA Income Thresholds
IRMAA is an extra charge added to your Medicare Part B and Part D premiums. It has nothing to do with your plan, your doctor, or your coverage decisions. It’s based on your Modified Adjusted Gross Income from two years earlier.
For 2026, the key cutoffs are:
- $109,001 for individuals
- $218,001 for married couples filing jointly
Below these numbers, you pay the standard premium.
Above them, IRMAA adds an extra charge in one of several tiers.
If you want to see how even a small income change can affect your Medicare bill, the Avoid the IRMAA Medicare Surcharge Trap: How $1 Can Raise Medicare Costs article gives a simple example.
Matt tip: Think of IRMAA as Medicare’s version of a luxury tax. It’s math, not judgment.
How IRMAA Letters Work
If You’re Already on Medicare
Most people receive their updated IRMAA notice in November or December, usually in the same envelope as the Social Security COLA letter.
This is the annual update.
If You’re Starting Medicare in 2026
This part surprises almost everyone.
When you join Medicare for the first time, IRMAA starts immediately.
No waiting. No delay. No two-year cushion.
Your 2024 income decides your IRMAA level on Day 1 of your Medicare coverage.
High-income year in 2024?
Sold property, sold a business, did Roth conversions, took large distributions?
IRMAA shows up right away.
Matt tip: IRMAA doesn’t “wait for retirement.” It shows up the moment you enroll.
Why You Might Get an IRMAA Letter
These are the most common triggers:
- Retirement
- Sale of a business
- Real estate sale
- Large IRA distributions
- Roth conversions
- RMD spikes
- Investment gains
- IRS adjustments
Sometimes it’s a genuine one-time spike. Sometimes it’s simply IRS data catching up.
You Can Appeal IRMAA (And Many People Qualify)
There are two paths:
1. Life-Changing Event Appeal (Form SSA-44)
You may qualify if your income dropped because of:
- Retirement
- Reduced work hours
- Marriage
- Divorce
- Death of a spouse
- Loss of income-producing property
- Pension changes
If today’s income is lower than your 2024 income, you may qualify.
2. Incorrect IRS Data
If the IRS used the wrong year, if your return was amended, or if something doesn’t match, you can request a reconsideration.
Matt tip: Do not assume the first IRMAA letter is final. Many people never appeal, even when they qualify.
Who Handles IRMAA (And Who Doesn’t)
This part causes confusion every season.
IRMAA is handled only by Social Security.
Not Medicare.
Not insurance companies.
Not Medicare agents.
This is why my IRMAA resources are collected in the Prepare for Medicare IRMAA guide for easy reference.
If you need help with brackets, appeals, SSA-44, or Life-Changing Events, start with the IRMAA help and appeal guide.
Medicare Planning Is Separate
IRMAA decisions and Medicare coverage decisions are two different tracks.
For Medicare planning, turning 65, working past 65, deciding on Medigap or Medicare Advantage, or figuring out timing, the Brickhouse Agency can guide you through everything calmly, clearly, and without pressure.
You can reach them through the Brickhouse Agency website for clear, personal Medicare guidance.
What To Do Next
If you want guidance on IRMAA charts, appeals, brackets, or Form SSA-44, you can start with the IRMAA help and appeal guide on the Prepare for Medicare site.
If you need help comparing Medicare Advantage and Medigap, planning for retirement in 2026, or reviewing your choices, you can schedule a conversation with the Brickhouse Agency.
FAQs
Is IRMAA a penalty?
No. It’s an income-based adjustment tied to your tax return from two years earlier.
Can IRMAA be removed?
Yes. If your income has dropped or the IRS data was incorrect, you can appeal.
Does IRMAA affect my plan choices?
No. IRMAA affects what you pay for Part B and Part D, not your plan type.
Do insurance agents handle IRMAA?
No. Only Social Security processes IRMAA and appeals.
Schedule Your FREE Medicare Consultation
Whether you’re new to Medicare, turning 65, retiring, or looking to change plans, the licensed agents at Brickhouse Agency offer free, no-obligation consultations to walk you through your options.
Required Medicare Disclaimer: No obligation to enroll. Brickhouse Agency does not offer every plan available in your area. For information on all your options, visit Medicare.gov or call 1-800-MEDICARE.
