What is IRMAA?
IRMAA stands for income-related monthly adjustment amount. It's an extra amount added to the standard Part B premium ($202.90 a month in 2026) and to your Part D premium when your modified adjusted gross income (MAGI) is above certain thresholds. It can affect Washington retirees whose income is lifted in a single year by stock vesting, deferred compensation, a home sale or a Roth conversion, as well as people with steady high income.
The 2026 IRMAA brackets
IRMAA uses a two-year lookback: your 2026 IRMAA is based on your 2024 tax return (the one filed in 2025). Social Security applies it automatically using IRS data. You don't apply for it; Social Security mails you a notice, and the amount appears with your premium.
2026 IRMAA structure
| 2024 MAGI (single) | 2024 MAGI (joint) | Total Part B premium | Part D amount |
|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $202.90 (standard) | None |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | +$14.50 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 | +$37.50 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 | +$60.40 |
| $205,001–$499,999 | $410,001–$749,999 | $649.20 | +$83.30 |
| $500,000 or more | $750,000 or more | $689.90 | +$91 |
Married filing separately and lived with your spouse at any time during the year: there are only three levels. Your Part B premium is $202.90 with MAGI up to $109,000, $649.20 above that and below $391,000, and $689.90 at $391,000 or more, so the first step up is a steep cliff. Check your own notice and the CMS fact sheet for the exact amounts. For 2027, IRMAA will use your 2025 tax return; see Medicare costs in 2027.
The cliff problem
IRMAA is a cliff, not a phase-in. If your MAGI is even one dollar over a threshold, you pay the full amount for that tier. A single filer with 2024 MAGI of $109,000 pays the standard premium; at $109,001, the first IRMAA tier adds {{(irmaa.tiers.1.part_b - irmaa.tiers.0.part_b + irmaa.tiers.1.part_d_surcharge) * 12:.2f}} a year in Part B and Part D amounts. For a married couple both on Medicare, that is {{(irmaa.tiers.1.part_b - irmaa.tiers.0.part_b + irmaa.tiers.1.part_d_surcharge) * 24:.2f}}. That's why year-end income planning matters for anyone near a bracket edge. Try the IRMAA calculator.
What counts as MAGI for IRMAA?
For IRMAA, MAGI is your adjusted gross income (AGI) from your tax return plus tax-exempt interest. Common sources that raise it:
- Roth conversions (the converted amount counts as income that year)
- Capital gains from selling stock, including shares from vested stock awards
- Required minimum distributions (RMDs) from traditional IRAs and 401(k)s, which generally start at age 73
- Pension income and the taxable part of Social Security
- Tax-exempt municipal bond interest
- Gain on the sale of your home above the federal home-sale exclusion
Generally not counted: qualified Roth IRA withdrawals, HSA withdrawals for qualified medical expenses, and life insurance proceeds.
Asking for a lower IRMAA: Form SSA-44
If your income has dropped because of a life-changing event, you can ask Social Security to use a more recent year's income with Form SSA-44. Social Security accepts these events:
- Marriage
- Divorce or annulment
- Death of your spouse
- Work stoppage (retirement), the most common reason for new retirees
- Work reduction (for example, moving to part-time)
- Loss of income-producing property because of a disaster or other event beyond your control, such as a wildfire
- Loss or reduction of certain pension income because of plan termination or reorganization
- An employer settlement payment because of the employer's closure, bankruptcy or reorganization
Include proof of the event (such as a marriage or death certificate, or a letter from your employer confirming your retirement date) and an estimate of your income for the current year. If Social Security approves the request, it recalculates IRMAA using the more recent income. If it doesn't, you can appeal.
Get Form SSA-44 at ssa.gov/forms/ssa-44.pdf. You can mail it or bring it to a local Social Security office; find offices and numbers on our Washington Medicare phone numbers and offices page.
Common Washington IRMAA scenarios
The recently retired tech or aerospace employee
You retired in 2025 after a high salary plus stock awards. Your 2024 MAGI was high, so IRMAA applies in 2026, even though your income now is much lower. File Form SSA-44 citing work stoppage, with your retirement date and an estimate of your current-year income.
The Roth conversion trap
You converted a large traditional IRA balance to a Roth in 2024 to manage future tax brackets. Two years later, that conversion pushes your 2026 IRMAA into a higher tier. This can't be fixed with Form SSA-44, because a Roth conversion isn't a life-changing event. The lesson: check the IRMAA effect before a large conversion, especially if you are 63 or older, since income from that year sets IRMAA two years later.
The widow or widower trap
After a spouse dies, the surviving spouse eventually files as single. The single thresholds are about half the joint thresholds, so income that was below IRMAA on a joint return may now trigger it. Form SSA-44 with death of spouse as the event can help if your income dropped as a result; it won't help if your income stays the same and only your filing status changed.
Help in Washington
Social Security decides IRMAA and handles Form SSA-44 requests and appeals: call 1-800-772-1213 (TTY 1-800-325-0778) or visit a local office. For multi-year tax and income planning, a CPA or fee-only financial planner who works on retirement income can model strategies.
A licensed insurance agent with Benefits Life can explain how IRMAA fits with your Medicare coverage choices, at no cost to you. Call (206) SENIORS (206-736-4677), TTY 711, or see plans in your ZIP code. See also Medicare costs by income in Washington.
Sources
- CMS — 2026 Medicare Parts A & B premiums and deductibles (IRMAA tables)
- Social Security — Premiums: rules for higher-income beneficiaries
- Social Security — Form SSA-44, Medicare Income-Related Monthly Adjustment Amount: Life-Changing Event
- Social Security POMS HI 01101.010 — Modified adjusted gross income and the tax year used
- Social Security POMS HI 01101.020 — IRMAA sliding scale tables
- Medicare.gov — Medicare costs
Frequently asked questions
What is the 2026 IRMAA threshold?
For 2026, IRMAA starts above $109,000 of modified adjusted gross income for single filers and above $218,000 for married couples filing jointly, based on your 2024 tax return. At or below those amounts, you pay the standard Part B premium of $202.90.
How do I ask for a lower IRMAA after retirement?
File Form SSA-44 with Social Security, choosing work stoppage as the life-changing event. Include proof such as a letter from your employer showing your retirement date, and an estimate of your income for the current year. If Social Security approves it, it recalculates IRMAA using the more recent income instead of the two-year lookback. If it denies the request, you can appeal.
Does a Roth conversion affect IRMAA?
Yes. The converted amount counts as income in the year you convert and is included in your modified adjusted gross income, so it can raise your IRMAA two years later. A Roth conversion is not one of the life-changing events Social Security accepts on Form SSA-44.
How is IRMAA collected?
Part B IRMAA is added to your Part B premium and taken from your Social Security benefit, or billed by Medicare if you don't get benefits yet. Part D IRMAA is paid to Medicare, not to your drug plan or employer, even if your plan premium is paid another way.
Where can I get help with IRMAA in Washington?
Social Security decides IRMAA and handles Form SSA-44 and appeals: call 1-800-772-1213 or visit a local Social Security office. For multi-year tax and income planning, a CPA or fee-only financial planner can model options. A licensed insurance agent with Benefits Life can explain how IRMAA works with your Medicare coverage choices.
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