What Income Counts for Medicare IRMAA? Check the Rules for 2026

Income for Medicare IRMAA 2026: Medicare bills can come with a surprise when your income crosses a certain limit. This extra charge is called IRMAA, or Income-Related Monthly Adjustment Amount. It can increase what you pay each month for Medicare Part B and Part D.

But Medicare doesn’t just check your salary or the money you make from work. It uses a special income number called modified adjusted gross income (MAGI). For IRMAA, this means your adjusted gross income (AGI) plus tax-exempt interest. The Social Security Administration (SSA) explains it simply: “Modified Adjusted Gross Income (MAGI) is the sum of” AGI and tax-exempt interest income.

Medicare IRMAA Brackets 2027: Income Limits and Premiums

Which Income Counts for Medicare IRMAA?

IRMAA uses information from your federal tax return. In most cases, Medicare uses tax information from two years earlier. The IRMAA charged for 2026 is generally based on income from your 2024 tax return. SSA normally uses the newest IRS information available and won’t use tax information that’s more than three years old. Here are the main types of income that can raise your IRMAA income level:

Wages and job income

Money earned from a regular job is part of AGI, so it can count toward IRMAA. Self-employment earnings can also count because they can be included in AGI.

Retirement income

Pensions, taxable IRA withdrawals and taxable 401(k) distributions can increase MAGI. A large withdrawal from a traditional IRA can therefore push someone into a higher IRMAA bracket. A rollover that isn’t treated as taxable income is different and generally isn’t added to AGI.

Investment income

Capital gains, dividends and taxable interest can all matter. This includes gains from selling stocks, mutual funds or property when those gains are included in AGI. SSA also notes that one-time income such as capital gains, property sales and IRA withdrawals can affect IRMAA for one year.

Rental income

Income from rental property can count when the taxable amount is included in AGI. What matters for IRMAA isn’t simply the total rent collected. The amount that becomes part of your federal AGI is what can affect the calculation.

Medicare IRMAA Brackets 2026: Income Limits and Monthly Premiums Explained

Social Security Income Has an Important Catch

Social Security is a common area of confusion. The full amount of your Social Security benefit isn’t automatically added to IRMAA income. Only the portion that’s taxable is included in AGI. The IRS says Social Security benefits can have up to 85% included in taxable income depending on a person’s income and filing status.

This means someone receiving $30,000 in Social Security benefits won’t necessarily have the full $30,000 counted in their IRMAA MAGI. The taxable amount reported on the federal tax return is what can become part of AGI. Social Security benefits that aren’t taxable generally aren’t part of AGI. SSI is different. Supplemental Security Income isn’t taxable, so it isn’t included in this IRMAA income calculation.

Tax-exempt interest is another important detail. It may not be taxable for regular federal income tax purposes, but Medicare still adds it to AGI when calculating IRMAA. This can include certain interest earned from municipal bonds and other tax-exempt investments.

What Are the 2026 IRMAA Income Limits?

IRMAA starts when MAGI is above $109,000 for an individual or $218,000 for a married couple filing jointly. The amount you pay rises as your income moves into higher brackets.

These IRMAA amounts are added to the standard 2026 Part B premium of $202.90 per month. Part D also has its own IRMAA charges for people above the income limits.

A person can also have a higher IRMAA because of a one-time event. For example, selling an investment property or having a large capital gain can raise income for that tax year. That higher income can then affect Medicare premiums two years later. SSA says one-time income can affect Medicare premiums for one year.

How to Check the Income Medicare Used

The easiest place to start is your tax return from two years earlier. Look at your AGI on Form 1040 and then add your tax-exempt interest. That’s the basic MAGI figure SSA uses for IRMAA.

Like if your 2024 AGI was $105,000 and you had $8,000 in tax-exempt interest, your IRMAA MAGI would be $113,000. For 2026, that would put an individual above the first IRMAA threshold.

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Income isn’t the only thing that can matter after the original tax return is used. When certain major life-changing events lower income, such as retirement, marriage, divorce or the death of a spouse, a beneficiary may ask SSA to reconsider the IRMAA decision.

FAQs

1. Does Social Security count for IRMAA?

Taxable Social Security benefits can count because they’re included in AGI. Nontaxable benefits generally aren’t included in the IRMAA MAGI calculation.

2. Does a Roth IRA withdrawal count as IRMAA income?

A qualified Roth IRA withdrawal generally isn’t included in AGI, so it generally won’t increase IRMAA. Taxable retirement withdrawals from traditional accounts are different.

3. Does tax-exempt interest count for IRMAA?

Yes, even tho the interest may be tax-free for federal income tax, Medicare adds tax-exempt interest to AGI when calculating IRMAA.

4. Which tax year is used for 2026 IRMAA?

Medicare uses your 2024 tax return to determine your 2026 IRMAA.