Medicare glossary
IRMAA
IRMAA — the income-related monthly adjustment amount — is a surcharge added to your Medicare Part B and Part D premiums if your income is above a set threshold. It's based on your tax return from two years earlier.
In 2026, the standard premium applies up to $109,000 (individual) or $218,000 (joint); above that you move into IRMAA tiers that step up with income. The brackets are cliffs, so a dollar over a line moves you up a tier. If a life-changing event lowered your income, you can appeal using Form SSA-44.
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