Retirement
IRMAA
IRMAA, the income-related monthly adjustment amount, is an extra charge on Medicare Part B and drug coverage premiums for people whose income is above set limits.
IRMAA stands for income-related monthly adjustment amount. It is an extra charge added to your Medicare Part B and prescription drug premiums if your income is above set limits. The SSA sets it using your modified adjusted gross income (MAGI) from an earlier tax return, generally from two years back.
A round example. For 2026, the SSA says a married couple filing jointly pays higher premiums if MAGI is above $218,000. Limits change each year, so check the current table. For example, one large sale that lifts income over a limit can move you into a higher premium tier.
What can push income up. Roth conversions, large capital gains, required minimum distributions and the sale of a business or property can all count. The SSA says you can ask for a new decision if income drops after a life-changing event, such as you or your spouse stopping work.
Why it matters to your plan. Tax planning in your 60s should look at premium tiers as well as tax brackets. Ask your CPA about timing. See our Roth conversion guide.
Related terms
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