The Hidden Medicare Surcharge That Hits Retirees With Over $109,000 in Income
If your income in retirement is above a certain threshold, you may be paying significantly more for Medicare than your neighbors — and most people don’t find out until they receive their first bill. This extra charge is called the Medicare IRMAA surcharge, and in 2026 it kicks in at $106,000 for single filers. Here’s what it is, how it works, and what you can do about it.
What Is the Medicare IRMAA Surcharge?
IRMAA stands for Income-Related Monthly Adjustment Amount. It’s an additional premium that higher-income Medicare beneficiaries pay on top of standard Part B and Part D premiums. The Medicare IRMAA surcharge is determined by Medicare.gov and adjusted annually.
In 2026, the standard Medicare Part B premium is $185.00 per month. However, if your income exceeds the threshold, you pay considerably more — potentially hundreds of dollars more per month.
Who Gets Hit by the Medicare IRMAA Surcharge?
The Medicare IRMAA surcharge is based on your Modified Adjusted Gross Income (MAGI) from two years prior. So your 2026 Medicare premiums are based on your 2024 tax return. That two-year lag catches many retirees off guard — especially those who had a high-income year due to:
- Selling a home or investment property
- Large capital gains from selling stocks or a business
- Required Minimum Distributions (RMDs) from retirement accounts
- Roth IRA conversions
- A final year of high employment income before retiring
2026 Medicare IRMAA Surcharge Brackets
Here are the 2026 IRMAA thresholds and the resulting Part B premiums:
| Individual Income | Joint Income | Monthly Part B Premium |
|---|---|---|
| Up to $106,000 | Up to $212,000 | $185.00 |
| $106,001–$133,000 | $212,001–$266,000 | $259.00 |
| $133,001–$167,000 | $266,001–$334,000 | $370.00 |
| $167,001–$200,000 | $334,001–$400,000 | $480.90 |
| Above $200,000 | Above $400,000 | $591.90 |
At the highest bracket, a married couple could each pay $591.90/month — over $14,000 per year combined just for Part B alone, before any other Medicare costs.
Can You Appeal the Medicare IRMAA Surcharge?
Yes. If your income has dropped significantly since the year Social Security is using to calculate your surcharge, you can file a Life-Changing Event appeal with the Social Security Administration. Qualifying events include:
- Retirement or reduction in work hours
- Death of a spouse
- Divorce or annulment
- Loss of income-producing property
If your income dropped for any of these reasons, you may be able to reduce or eliminate the surcharge immediately rather than waiting for Social Security to use a more recent tax year.
How Medicare Supplement Plan G Protects You
The Medicare IRMAA surcharge increases your Part B premium — but it doesn’t change what Medicare covers or what you owe for services. That’s where a Medicare Supplement Plan G comes in.
With Plan G, once you pay the annual Part B deductible ($257 in 2026), you pay nothing out of pocket for covered Medicare services for the rest of the year. If you’re already paying higher premiums due to IRMAA, the last thing you want is additional copays and coinsurance on top. Plan G eliminates that exposure entirely.
Questions About Your Medicare Costs?
I’m Andy Orlikoff, an independent Medicare broker based in Surprise, AZ. I help Arizona retirees understand their Medicare costs — including the Medicare IRMAA surcharge — and choose the right supplement plan. My help costs you nothing extra.
Call or text: (623) 742-3878
Email: andy@azhealth.us
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