Medicare Premium Estimator 2026

Understanding Medicare Parts

| Part | What It Covers | Premium | |------|---------------|---------| | Part A | Hospital inpatient, skilled nursing, hospice | Free (if 40+ quarters of FICA taxes) | | Part B | Doctor visits, outpatient, preventive care | Based on income (IRMAA) | | Part C | Medicare Advantage (private plans bundling A+B+D) | Varies by plan | | Part D | Prescription drugs | Varies; IRMAA applies to higher earners |

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2026 Medicare Part B Premium by Income

Medicare uses your MAGI from 2 years prior (2024 income determines 2026 premiums). IRMAA surcharges are applied in tiers:

| Annual MAGI (Single) | Annual MAGI (MFJ) | Monthly Part B Premium | |----------------------|-------------------|----------------------| | ≤ $103,000 | ≤ $206,000 | $185.00 | | $103,001 – $129,000 | $206,001 – $258,000 | $259.00 | | $129,001 – $161,000 | $258,001 – $322,000 | $370.00 | | $161,001 – $193,000 | $322,001 – $386,000 | $480.00 | | $193,001 – $499,999 | $386,001 – $749,999 | $591.00 | | ≥ $500,000 | ≥ $750,000 | $628.00 |

A single retiree in the $129K–$161K MAGI tier pays $370/month — $2,220/year more than the base premium. Managing income in the 2 years before Medicare enrollment (especially Roth conversions and capital gains timing) can permanently reduce premiums.

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Part D IRMAA Surcharges

Part D prescription drug premiums also carry IRMAA surcharges (paid in addition to the base plan premium):

| Annual MAGI (Single) | Monthly Part D IRMAA | |----------------------|---------------------| | ≤ $103,000 | $0 | | $103,001 – $129,000 | $13.70 | | $129,001 – $161,000 | $35.30 | | $161,001 – $193,000 | $57.00 | | $193,001 – $499,999 | $78.60 | | ≥ $500,000 | $85.00 |

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The "IRMAA Cliff" and Income Management

IRMAA thresholds are sharp cliffs — earning $1 over the $103,000 threshold triggers $888/year in extra premiums (for a couple, $1,776/year). Strategies to stay below a threshold:

• Time capital gains realizations across years to avoid surges
• Avoid large Roth conversions in the 2 years before Medicare eligibility
• Qualified Charitable Distributions (QCDs) from IRAs reduce MAGI without going through AGI
• Harvest tax losses to offset gains that would push income into a higher tier

How to Appeal IRMAA

If your income dropped significantly since the base year (retirement, divorce, death of spouse, loss of income-producing property, reduction in pension), you can appeal using Form SSA-44 — Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event.

The SSA will use a more recent tax year. Approved appeals are retroactive to the month IRMAA began.