IRMAA Calculator

IRMAA works differently from how most people expect. It looks at your income from two years ago, so your 2026 premium is based on your 2024 tax return, not your current income. This catches people off guard, especially around retirement, when a large one-time event like a Roth conversion or capital gains sale in an earlier year can trigger a higher premium years later even if current income has dropped. IRMAA is also a cliff system rather than a gradual increase. Crossing a threshold by even one dollar moves your entire premium into the next tier, not just the amount over the line. For married couples where both spouses are on Medicare, it's worth understanding that IRMAA isn't split between you. The income threshold considers your combined income if you file jointly, but each spouse individually pays the full premium for whatever tier that income falls into. If your income has dropped significantly due to a specific life event, retirement, divorce, or the death of a spouse among others, you can request a reconsideration using Form SSA-44 rather than waiting two years for the surcharge to catch up to your current situation.