IRMAA Basics
How IRMAA Affects Medicare Advantage Enrollees
Verified against SSA POMS as of August 26, 2026
The short answer
Income-Related Monthly Adjustment Amount (IRMAA) may affect enrollees of Medicare Advantage plans if they have modified adjusted gross income (MAGI) above certain thresholds. Both Medicare Part B and Part D premiums may include an IRMAA surcharge based on income levels.
IRMAA Overview
Income-Related Monthly Adjustment Amount (IRMAA) applies to certain beneficiaries with modified adjusted gross income (MAGI) above specific thresholds and affects those enrolled in Medicare Part B, a Medicare Advantage Plan with prescription drug coverage (MA-PD), or a Medicare prescription drug plan (PDP). IRMAA is calculated based on MAGI from two years prior to the premium year (PY-2). Tax return information from the IRS, including MAGI, is used to determine the amount of IRMAA surcharges that a beneficiary must pay. Beneficiaries can appeal or ask for a new initial determination under certain circumstances.
HI 01101.001 View source ›How IRMAA Affects Medicare Advantage Plans
For beneficiaries enrolled in a Medicare Advantage Plan with prescription drug coverage, the IRMAA surcharge is an additional cost on top of the monthly premium of the plan. Importantly, IRMAA does not adjust the premium paid for the Medicare Advantage policy itself. Instead, IRMAA impacts the costs associated with Part B and Part D. To enroll in a Medicare Advantage plan, beneficiaries must first sign up for Medicare Parts A and B. Most Medicare Advantage plans include a drug plan, and if they do, both IRMAA for Part B and Part D will apply if the individual's Modified Adjusted Gross Income (MAGI) exceeds the IRMAA threshold. As a result, beneficiaries may see an increase in their total healthcare costs if their income surpasses certain levels.
HI 01101.001 View source ›Determining IRMAA
The IRS provides tax information to SSA to assist in determining IRMAA obligations. The income is assessed based on the MAGI from the second year prior to the premium year. For example, IRMAA for 2026 is based on income from 2024. There are generally either two or five levels of IRMAA depending on the filing status, with specific income thresholds defining each level as detailed in the guidance. If data from PY-2 is unavailable, data from PY-3 may be used until the more recent data can be assessed.
HI 01101.030 View source ›Medicare Part B Premium and IRMAA
The IRMAA for Medicare Part B beneficiaries who exceed income thresholds results in paying more than the standard premium amount. The Federal government typically subsidizes about 75% of the actual costs of Part B, but those who pay IRMAA cover parts of these costs based on established income brackets. For example, in 2026, the subsidized Part B premium is $202.90. A beneficiary reaching the first IRMAA threshold will pay $284, while those in the highest income bracket may pay up to $689.90, covering 85% of the actual costs.
HI 01101.001 90 FR 52063Related Page
Worked example
Frequently asked
Does IRMAA affect Medicare Advantage plans?
Yes, IRMAA can affect Medicare beneficiaries with Medicare Advantage plans. While IRMAA does not directly impact the premium of the Medicare Advantage plan itself, it does affect the Part B premium. Additionally, if the Medicare Advantage plan includes prescription drug coverage (MA-PD), an IRMAA Part D surcharge may be applied if the beneficiary's income exceeds certain MAGI thresholds.
How is IRMAA determined?
IRMAA is determined based on your modified adjusted gross income (MAGI) provided by the IRS from your tax returns two years prior to the current premium year.
Will IRMAA surcharges decrease or be eliminated if my MAGI goes down in future years?
Yes. IRMAA calculations are performed for each beneficiary every year. The outcome of the annual calculation will determine whether there is an IRMAA surcharge for that premium year.
What happens if I do not pay my IRMAA?
If IRMAA is not paid, CMS may terminate your Part B and D coverage. Termination of Part B, will trigger any linked Medicare Advantage or Medigap plan to also be cancelled.