2026 Medicare IRMAA Brackets, Premiums, and Planning Guide for Federal Retirees

Projections are no longer needed; the official 2026 IRMAA brackets and surcharges have now been finalized, and all numbers below reflect the updated Medicare Part B premium, Part D IRMAA surcharges, and all income thresholds for 2026.

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If you receive a federal annuity, make TSP withdrawals, or draw income from multiple retirement sources, now is the time to review how your 2024 tax return may affect your 2026 Medicare premiums.

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What Is IRMAA?

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IRMAA is an income-based surcharge added to your standard Medicare Part B and/or Part D premiums. It applies to all Medicare beneficiaries including those in Medicare Advantage prescription drug plans (MA-PD) whose Modified Adjusted Gross Income (MAGI) exceeds IRS thresholds.

IRMAA is based on five income brackets, with the top tier frozen until 2028. Your 2026 IRMAA level is determined using your 2024 tax return, due to Medicare's two-year lookback rule.

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What’s New in the 2026 IRMAA Brackets?

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Inflation Adjustments Applied

The first four IRMAA brackets increased slightly based on the CPI-U increase of +1.02% for the 12 months ending August 2025.

2026 Standard Premium Released

• Medicare Part B standard premium (2026): $202.90

IRMAA Surcharges Finalized

• Part B surcharges increased ~3%–9%
  
  
• Part D surcharges increased ~6%
  

2026 Bracket Thresholds

• First surcharge tier starts at:
  $109,000 MAGI (single)
  $218,000 MAGI (married filing jointly)
  
  

Top bracket begins at: $500,000 single / $750,000 married filing jointly

How IRMAA Is Calculated

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IRMAA is determined through a multi‑step process that relies heavily on IRS data, inflation indexing rules, and Medicare’s statutory premium formula. After the IRS processes your tax return for 2024, the Social Security Administration retrieves your MAGI and filing status to determine which of the five IRMAA brackets you fall into for 2026. This is why timing matters: even income you received nearly two years ago can directly affect what you pay next year.

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To calculate IRMAA, Medicare first identifies your MAGI, which includes your AGI plus tax‑exempt interest income such as municipal bond interest. MAGI also includes income from federal pensions, TSP withdrawals, capital gains, Roth conversions, dividends, business income, and rental income, essentially any taxable income source. Once your MAGI is known, SSA compares it to the inflation‑adjusted bracket thresholds for the year.

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Each fall, Medicare updates the first four IRMAA brackets by comparing two CPI‑U averages: one for the 12 months ending in the most recent August and one for the previous 12‑month period. The percentage difference becomes the inflation adjustment. Because CPI‑U increases were modest for the relevant period, bracket increases for 2026 were relatively small, making it easier for retirees to drift into a higher bracket due to portfolio gains, RMDs, or other unplanned taxable events.

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The final step is applying the income‑related surcharge associated with your bracket to your Part B and Part D premiums. These surcharges are set using statutory formulas and Medicare Trustees Report projections, then finalized by CMS in the fall. The result is a precise monthly amount added to your Medicare premiums. This entire system is why IRMAA planning must happen early once your tax year closes, the numbers are locked in. Medicare adjusts the first four brackets annually based on this formula:

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“The percentage by which the average CPI-U for the 12-month period ending August exceeds the prior year’s average.”

Because inflation adjustments were modest, threshold increases for 2026 are small meaning even a slight rise in your MAGI may push you into a higher tier.

The top bracket remains frozen until 2028.

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2026 Medicare Part A Costs

Although IRMAA applies only to Part B and Part D, retirees expect a full annual Medicare update. Here are the finalized 2026 Part A numbers:

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2026 Medicare Part B Costs

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Why the increase?

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CMS noted that without regulatory action lowering spending on skin substitutes through the 2026 Physician Fee Schedule, the Part B premium would have been $11/month higher. Rule changes will reduce spending on skin substitutes by 90%, limiting premium growth without affecting patient care.

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2026 Part B IRMAA Brackets

(For Single Filers ≤ $109,000 and Married Filing Jointly ≤ $218,000)

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Also read - how much will medicare part b cost in 2026

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2026 Part B IRMAA Married Filing Separately (Official Table)

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2026 Part B Immunosuppressive-Only IRMAA Table

(For kidney transplant recipients losing full Medicare after 36 months)

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2026 Medicare Part D IRMAA Surcharges

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Part D IRMAA  Married Filing Separately

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Income Sources That Trigger IRMAA (MAGI Breakdown)

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Why IRMAA Matters for Federal Retirees

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Federal retirees are uniquely exposed to IRMAA because they typically draw income from multiple sources simultaneously FERS or CSRS annuities, TSP withdrawals, Social Security benefits, and often additional investment income. Each of these income streams feeds directly into MAGI, which determines whether you pay an IRMAA surcharge.

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The combination of a lifetime federal pension and required minimum distributions from the TSP is often enough to push retirees into higher IRMAA bands even if they never considered themselves high-income earners. This means an otherwise ordinary retirement income strategy can unexpectedly trigger hundreds or even thousands in additional Medicare costs annually.

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Another factor is the IRMAA “cliff.” Unlike progressive tax brackets where you only pay the higher rate on the income above the threshold, IRMAA applies the full surcharge as soon as you exceed a bracket by even one dollar. This creates planning challenges: a modest year-end capital gain, a one-time distribution, or a poorly timed Roth conversion can push you entirely into the next tier.

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Federal retirees also deal with inflation adjustments in their FERS annuities and variable TSP withdrawals, which can raise MAGI without deliberate planning. Because the IRMAA brackets for 2026 increased only slightly, standard raises and investment performance can push retirees into a higher cost tier unexpectedly.

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This is why proactive planning spreading withdrawals, coordinating pension and TSP income, and monitoring MAGI annually is critical. With the right strategy, retirees can often stay below IRMAA thresholds or minimize how many years they fall into a higher surcharge. Federal retirees often draw from multiple taxable sources, causing:

• Higher MAGI
• Bracket creep
• IRMAA exposure from modest increases

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IRMAA is a cliff:

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If you exceed a threshold by $1, you pay the full surcharge for that tier.

Example: A single retiree with $137,001 MAGI in 2024 owes the same IRMAA as someone with $171,000.

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Also read - opm disability retirement

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How IRMAA Is Paid

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IRMAA is collected differently depending on whether you are already receiving Social Security benefits. For retirees who are drawing Social Security, both the Part B premium and the IRMAA surcharge are automatically deducted from your monthly benefit. This means you may see a lower Social Security payment than expected when IRMAA applies.

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If you have delayed Social Security something many federal retirees do to maximize benefits IRMAA is billed separately by Medicare. You will receive the CMS-500 premium bill, usually on a quarterly basis, and must pay it directly. Failure to pay IRMAA on time can result in delinquency notices, interruptions in coverage, or complications with reinstatement.

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Medicare treats Part B and Part D IRMAA separately. Even if your FEHB or employer plan pays your Part D premium, your IRMAA portion must still be paid directly to Medicare. This surprises many retirees who assume their plan handles everything related to Part D.

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You can pay IRMAA through several methods:

• MyMedicare.gov – the preferred option because it’s fast, secure, and fee-free.
• Bank bill pay – automated from your financial institution.
• Medicare Easy Pay – an automatic monthly withdrawal system.
• Mailed payments – sent to the Medicare Premium Collection Center.

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Because IRMAA is tied to your income from two years earlier, you might continue receiving IRMAA bills even after your income decreases unless you file an SSA-44 for a qualifying life-changing event. Monitoring your mail, MyMedicare account, and payment status helps prevent missed payments or confusion when surcharges change at the start of a new calendar year.

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• If receiving Social Security → IRMAA deducted automatically.
• If delaying Social Security → CMS sends a quarterly bill (Form CMS-500).
• Part D IRMAA is paid directly to Medicare, not the Part D plan.

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Payment options:

• MyMedicare.gov (recommended)
• Bank bill pay
• Mail to CMS premium center

Strategies to Reduce or Avoid IRMAA

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1. Spread Out Roth Conversions

Avoid large, single-year MAGI spikes.

2. Balance Income Across Three Buckets

• Taxable
  
  
• Tax-deferred
  
  
• Tax-free (Roth/HSA)
  

3. Maximize Pre-Tax Contributions (while working)

Reduces MAGI now → reduces IRMAA two years later.

4. Manage Capital Gains Timing

Avoid bunching gains into one tax year.

5. Use QCDs for RMDs

Direct charitable gifts reduce taxable income.

6. File Form SSA-44 for Life-Changing Events

May reduce IRMAA due to:

• Retirement
  
  
• Death of spouse
  
  
• Divorce
  
  
• Work reduction
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• Loss of income-producing property

How Federal Pension Advisors Can Help?

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Planning for Medicare costs is more than just checking a premium table. We specialise in helping federal employees:

• Project future Medicare expenses
  
• Optimise TSP and annuity withdrawals
  
• Lower IRMAA exposure legally and efficiently
  
• Free Pension & Benefits Review
• IRMAA Planning & Tax Strategy
• Medicare Education for Retirees

Take control of your Medicare premiums before they control your retirement.

Ready to protect your retirement from IRMAA surprises?

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Schedule your free review today at Federal Pension Advisors and get clarity on your Medicare future.

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What You Can Do Now

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Medicare will finalise the 2026 IRMAA brackets later this year after the COLA release. Meanwhile:

• Review your 2024 tax return and project your MAGI for 2026.
  
  
• Estimate whether you’ll cross a threshold and consider adjusting withdrawal timing or conversions.
  
  
• Consult your federal benefits advisor to ensure your income strategy aligns with your Medicare/retirement goals.
  
  

Taking a few minutes now to map your income plan can avoid a costly IRMAA surprise later.

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Conclusion

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IRMAA can significantly increase Medicare costs, but it’s not random it’s predictable and manageable. By understanding the finalized 2026 brackets and managing your MAGI strategically, you can stay in control of your healthcare expenses.

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FAQs

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1. What are the IRMAA income brackets for 2026?

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The 2026 IRMAA brackets start at MAGI above $109,000 for single filers and $218,000 for married filing jointly.
There are five tiers, with Part B surcharges ranging from $81.20 to $487.00 and Part D surcharges from $14.50 to $91.00.
Your 2026 IRMAA is based on your 2024 tax return.

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2. How much will Medicare Part B cost in 2026?

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The standard Medicare Part B premium for 2026 is $202.90. If IRMAA applies, the total monthly Part B cost ranges from $284.10 up to $689.90, depending on your income tier.

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3. Who has to pay IRMAA in 2026?

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Anyone whose 2024 MAGI exceeds $109,000 (single) or $218,000 (married filing jointly) must pay IRMAA in 2026. IRMAA applies even if you're enrolled in a Medicare Advantage plan with drug coverage.

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4. What is IRMAA based on?

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IRMAA is based on your Modified Adjusted Gross Income (MAGI) from two years earlier. MAGI includes your AGI plus tax-exempt interest, such as municipal bond income.

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Disclaimer

This article is intended for informational and educational purposes only. It should not be considered financial, legal, or tax advice. Individual circumstances vary, and federal retirees should consult with a qualified tax or financial professional before making decisions regarding IRMAA, income management, or Medicare planning.

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