How much extra is IRMAA per month?
In 2026, IRMAA adds between $95.70 and $578.00 per month, per person, on top of your regular Medicare premiums — if you have both Part B and Part D coverage. The Part B surcharge alone runs from $81.20 to $487.00 a month, and the Part D surcharge adds $14.50 to $91.00 more. Which amount applies to you depends entirely on which income tier your MAGI (adjusted gross income plus tax-exempt interest, from your tax return of two years earlier) falls into. The table below is the complete 2026 picture, with the monthly figures combined and multiplied out to a full year, because the yearly numbers are what make the tiers worth fighting over.
The 2026 IRMAA surcharges, tier by tier
| 2026 tier | MAGI — single filer | MAGI — married filing jointly | Part B extra / month | Part D extra / month | Combined extra / month | Combined extra / year |
|---|---|---|---|---|---|---|
| No IRMAA | $109,000 or less | $218,000 or less | $0 | $0 | $0 | $0 |
| Tier 1 | Over $109,000 up to $137,000 | Over $218,000 up to $274,000 | $81.20 | $14.50 | $95.70 | $1,148.40 |
| Tier 2 | Over $137,000 up to $171,000 | Over $274,000 up to $342,000 | $202.90 | $37.50 | $240.40 | $2,884.80 |
| Tier 3 | Over $171,000 up to $205,000 | Over $342,000 up to $410,000 | $324.60 | $60.40 | $385.00 | $4,620.00 |
| Tier 4 | Over $205,000 and under $500,000 | Over $410,000 and under $750,000 | $446.30 | $83.30 | $529.60 | $6,355.20 |
| Tier 5 (highest) | $500,000 or more | $750,000 or more | $487.00 | $91.00 | $578.00 | $6,936.00 |
Source: CMS 2026 fact sheet, "2026 Medicare Parts A & B Premiums and Deductibles"; table checked October 2026. Combined and yearly columns are arithmetic from the CMS monthly surcharges. The full official tables for every filing status are on the brackets page.
What "extra" means on your actual bill
The surcharges in the table are added to what everyone already pays. In 2026 the standard Part B premium is $202.90 a month. A single filer in Tier 2 therefore pays $202.90 + $202.90 = $405.80 a month for Part B in total — the standard premium plus a Part B surcharge that happens to equal it. The Part D surcharge works differently: it is not folded into your drug plan's own premium, and it only applies if you actually have Part D coverage (including a Medicare Advantage plan with drug coverage). No Part D, no Part D surcharge — but the Part B surcharge stands either way.
Everything above is per person. A married couple filing jointly shares one MAGI, lands in one tier, and then each spouse on Medicare pays that tier's surcharge. A couple in Tier 2 with Part D coverage pays the combined extra twice: $240.40 × 2 = $480.80 a month, or $5,769.60 a year, above their standard premiums. When people say IRMAA caught them by surprise, it is usually this doubling — or the cliff below — that did it.
Married filing separately: different, harsher table
The tiers above do not apply if you are married, lived with your spouse, and file separately. That table has almost no steps: at $109,000 or less of MAGI there is no surcharge, but over $109,000 and under $391,000 the surcharge jumps straight to the Tier 4 rates — $446.30 a month for Part B and $83.30 for Part D — and at $391,000 or more the top rates of $487.00 and $91.00 apply. Filing separately for other tax reasons can quietly become the most expensive choice on the return once IRMAA is priced in.
If the amount on your notice looks wrong for your life now
The surcharge is priced off the tax return from two years earlier, so a correct-looking amount can still be priced off a life you no longer live. If your income dropped because of a listed life-changing event — retirement is the most common — Form SSA-44 is how you ask Social Security to reprice you off a more recent year. If Social Security refuses, or used incorrect data, the formal appeal ladder is separate, and its first deadline is 60 days — our denial guide lays out all four levels. Either way, start from your tier in the table above: the difference between your current tier's yearly cost and the tier your income belongs in now is the amount actually at stake.
Questions people ask
How much extra is IRMAA per month in 2026?
From $95.70 to $578.00 a month per person if you have both Part B and Part D — that is the Part B surcharge ($81.20 to $487.00) plus the Part D surcharge ($14.50 to $91.00) for your tier. Over a full year, the combined extra runs from $1,148.40 in Tier 1 to $6,936.00 in Tier 5.
Is IRMAA charged on top of the standard Part B premium?
Yes. The 2026 standard Part B premium is $202.90 a month, and the IRMAA Part B surcharge is added to it. In Tier 2, for example, the total Part B premium is $405.80 a month. The Part D surcharge is a separate add-on that applies only if you have Part D coverage.
Do both spouses have to pay IRMAA?
Yes, if both are on Medicare. Joint MAGI sets one tier for the household, and each spouse pays that tier's surcharge individually. A couple's combined extra is double the per-person figure in the table.
What happens if my income is $1 over an IRMAA bracket line?
The full next tier applies. IRMAA has no gradual phase-in: $1 over a threshold moves you into the higher tier for the entire year, at that tier's full monthly surcharge. Being just over a line is the most common reason people look for a way to reprice — and the reason exact MAGI arithmetic matters before a tax year closes.
Not financial or legal advice. If a figure here ever disagrees with your notice, your notice controls.