By Marc Gilman
Questions? Call (800) 927-9326 or email
Key Takeaways
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IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge on Medicare Part B and Part D premiums that applies once modified adjusted gross income (MAGI) crosses set thresholds — $109,000 for individuals or $218,000 for married couples filing jointly, based on 2026 figures.
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IRMAA works as a cliff, not a gradual scale. Crossing a threshold by even $1 triggers the full surcharge for that entire bracket — over $1,100 a year in the lowest tier alone.
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Your IRMAA is based on tax returns from two years earlier, so 2026 premiums are generally determined by 2024 income (or 2023 income if 2024 wasn’t yet available to the Social Security Administration).
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A surviving spouse can jump several IRMAA brackets the year after their spouse dies, simply from switching to single-filer thresholds — even with no actual increase in income.
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If your income has dropped because of a specific life-changing event — retirement, divorce, the death of a spouse, and several others — Form SSA-44 lets you request that a more recent year’s income be used instead of the two-year-old tax return IRMAA would otherwise rely on.
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New Hampshire residents have a specific wrinkle worth knowing: the state’s Interest and Dividends Tax was fully repealed for tax periods beginning on or after January 1, 2025, meaning NH now has no individual income tax of any kind. That doesn’t touch IRMAA at all — IRMAA is a federal calculation based on federal MAGI — but it means NH retirees may hold larger interest- and dividend-producing portfolios than they otherwise would, and that income still counts toward the federal MAGI figure IRMAA is based on.
What Is IRMAA, Exactly?
IRMAA stands for Income-Related Monthly Adjustment Amount — the mechanism Medicare uses to have higher-income beneficiaries cover a larger share of their own Part B and Part D costs. Under standard pricing, the government covers roughly 75% of Part B’s cost, with beneficiaries paying the remaining 25%. If IRMAA applies to you, that split shifts — you cover 35%, 50%, 65%, 80%, or 85% of the total cost, depending on your bracket. Medicare Part A isn’t affected; IRMAA applies only to Part B and Part D.
What Are the 2026 IRMAA Brackets?
These amounts are added on top of the standard Part B premium and your regular Part D plan premium. The top bracket adds up to roughly $6,936 a year, per person, on top of what you’d otherwise pay.
Why Does $1 of Extra Income Cost You Over $1,000?
IRMAA doesn’t work like an income tax bracket, where only the amount above the threshold is taxed at a higher rate. It works like a cliff: cross the line by even a dollar, and your entire premium jumps to the next tier’s rate. Someone with $109,000 in MAGI pays the standard premium; someone with $109,001 pays the full second-tier surcharge — an extra $1,148.40 for the year, triggered by a single dollar of additional income.
IRMAA is also based on a tax return from two years earlier. Your 2026 premiums are generally determined by your 2024 income (the letter from the Social Security Administration will confirm which tax year was actually used). That lag means a high-income year — a large capital gain, a big retirement account withdrawal, the year you sold a business — can trigger a surcharge two years later, well after the income event itself is behind you.
What Income Actually Counts Toward IRMAA?
IRMAA is based on your Modified Adjusted Gross Income (MAGI) — your adjusted gross income (line 11 of Form 1040) plus tax-exempt interest income (line 2a of Form 1040). This includes wages, pensions, the taxable portion of Social Security, interest, dividends, rental income, capital gains, and distributions from traditional 401(k)s, 403(b)s, and IRAs, plus tax-exempt interest from municipal bonds.
What does not count:
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Distributions from Roth accounts
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Distributions from Health Savings Accounts (HSAs)
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Proceeds from life insurance
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Portions of Qualified Longevity Annuity Contract (QLAC) payments
The mix of accounts you draw from in retirement directly affects whether you cross an IRMAA threshold — not just your total income.
What Happens to a Surviving Spouse’s IRMAA?
This is one of the more overlooked consequences of IRMAA. When one spouse dies, the survivor becomes a single tax filer — but often keeps a similar overall income to what the couple had together. Since single-filer thresholds are roughly half the married thresholds, a surviving spouse can jump several IRMAA brackets the following year, even though nothing about their actual income changed. It’s worth planning for specifically if there’s a meaningful income or life-expectancy gap between spouses.
Appealing IRMAA: How Form SSA-44 Actually Works
If your income has dropped since the tax year IRMAA is based on, Form SSA-44 lets you request that the Social Security Administration use more recent income information instead.
Step 1: Confirm You Qualify
Form SSA-44 only applies if you experienced one of these specific life-changing events:
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Marriage
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Divorce or annulment
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Death of your spouse
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Work stoppage or work reduction (you or your spouse)
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Loss of income-producing property not caused by your own choice — including a Presidentially or Gubernatorially declared disaster, destroyed livestock or crops, arson, or investment property lost to fraud or theft
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Loss of pension income due to a scheduled cessation, termination, or reorganization of an employer’s pension plan
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An employer settlement payment tied to that employer’s bankruptcy or reorganization
The life-changing event date must fall in the same year as, or an earlier year than, the tax year you’re asking the SSA to use.
Step 2: Report the Income Reduction That Already Happened
You’ll provide the adjusted gross income and tax-exempt interest for the more recent year, plus your tax filing status for that year. As a rule of thumb: use the current (“premium”) year if your income wasn’t reduced until this year, or use last year if your income was reduced last year and isn’t expected to drop further this year.
Step 3: Report an Anticipated Further Reduction (If Applicable)
If you expect your MAGI to drop even further next year, you can provide an estimate for that year too. If you skip this step, the SSA will simply carry the Step 2 information forward until it receives updated tax data.
Step 4: Gather Your Evidence
You’ll need documentation of both your income and the life-changing event itself:
For income, you’ll generally need a signed copy of your Federal tax return, or an IRS transcript, for the year in question. If you provided an estimate, you’ll need to follow up with your actual return once you file it.
Step 5: Sign, and Submit
You can either mail your original documents (the SSA will return them or certified copies), or bring the originals to a local Social Security office for an SSA employee to review in person. Include a current phone number and mailing address so the SSA can reach you with questions. You can also skip the paper form entirely and request an appointment by calling 1-800-772-1213 (TTY 1-800-325-0778), available 7 a.m. to 7 p.m. on business days.
One detail worth flagging: filing Form SSA-44 doesn’t automatically mean the SSA will use the newer information — it has to be accompanied by evidence of the life-changing event and either a copy of your tax return or other evidence of the more recent year’s MAGI.
A New Hampshire-Specific Note for Bedford-Area Retirees
IRMAA itself is a federal calculation, and it applies identically whether you live in Bedford, NH or anywhere else in the country — New Hampshire’s tax rules don’t change how MAGI is calculated for Medicare purposes. But there’s a real local wrinkle worth understanding.
New Hampshire’s Interest and Dividends Tax was fully repealed for tax periods beginning on or after January 1, 2025, meaning New Hampshire now has no individual income tax of any kind — not on wages, retirement income, capital gains, or interest and dividends. That’s a meaningful reason some NH retirees end up holding larger taxable brokerage positions generating interest and dividend income than they might in a state that still taxes it. The federal IRMAA calculation doesn’t care that New Hampshire no longer taxes that income at the state level — every dollar of interest and dividend income still counts toward federal MAGI exactly the same way it did before the repeal. For Bedford-area retirees who’ve shifted more of their portfolio into taxable brokerage accounts since 2025 specifically because the state stopped taxing that income, it’s worth double-checking where that puts you relative to the IRMAA thresholds above.
Where Does Insurance Planning Fit In?
IRMAA isn’t something Gilman Agency calculates or files appeals for directly — that’s a conversation for your CPA or financial advisor. But how IRMAA affects your total Medicare costs is directly relevant to how we help Bedford-area clients think through Part D and Medicare Advantage coverage decisions, since your actual out-of-pocket Medicare costs depend on both your coverage choices and what you’re paying in surcharges.
Questions Worth Asking
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Which tax year is actually being used to determine your current IRMAA bracket, and does the letter from Social Security confirm it?
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Have you had a marriage, divorce, death of a spouse, work stoppage, or another qualifying life-changing event in the past year or two?
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If you’ve shifted more assets into taxable brokerage accounts since New Hampshire repealed its Interest and Dividends Tax, has anyone checked where that puts your MAGI relative to the IRMAA brackets?
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Do you have the specific documentation Form SSA-44 requires for your situation, or would a phone appointment with SSA be simpler?
What To Do Next
If you’re a Bedford-area resident approaching Medicare eligibility, or you’ve had a life-changing event that dropped your income, don’t assume the IRMAA surcharge will adjust on its own. Reach out and we’ll help you understand how IRMAA fits into your broader Medicare coverage decisions.
Questions? Call (800) 927-9326 or email
Prefer we reach out to you instead? Complete our Permission to Contact form and a licensed Gilman Agency agent will follow up.
Frequently Asked Questions
What is IRMAA? IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to Medicare Part B and Part D premiums for beneficiaries whose modified adjusted gross income exceeds set thresholds — $109,000 for individuals or $218,000 for joint filers in 2026.
How much does IRMAA add to Medicare premiums in 2026? Depending on income bracket, IRMAA adds between roughly $95.70 and $578.00 per month per person, combined across Part B and Part D, on top of standard premiums.
Does IRMAA use my current income or past income? IRMAA is based on tax return information from two years prior. 2026 premiums are generally based on 2024 income.
Can IRMAA be appealed? Yes, using Form SSA-44, but only if you’ve had a qualifying life-changing event — such as marriage, divorce, death of a spouse, work stoppage or reduction, loss of income-producing property, loss of pension income, or an employer settlement payment — that reduced your income since the tax year used to calculate your current IRMAA.
Does New Hampshire’s lack of a state income tax affect IRMAA? No. IRMAA is calculated using federal modified adjusted gross income regardless of state tax law. New Hampshire’s repeal of its Interest and Dividends Tax (effective January 1, 2025) doesn’t change how that income is counted for federal Medicare purposes.
What happens to IRMAA when a spouse dies? The surviving spouse moves to single-filer thresholds, which are roughly half the married thresholds — often pushing the survivor into a higher IRMAA bracket the following year even with no actual change in income.
Sources: Social Security Administration, Form SSA-44 (12-2025), “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event”; Centers for Medicare & Medicaid Services (CMS), 2026 Medicare Parts B Premiums and Deductibles fact sheet; New Hampshire Department of Revenue Administration, Technical Information Release 2025-001 on the repeal of the Interest and Dividends Tax.
This article is for general educational purposes and is not tax, legal, or financial advice. IRMAA determinations depend on individual circumstances and current SSA/CMS guidance, which can change. Consult a licensed advisor, CPA, or the Social Security Administration directly for guidance specific to your situation.
