2026 Medicare Premium and IRMAA Changes: What Taxpayers Need to Know
2026 Medicare Premium and IRMAA Changes: What Taxpayers Need to Know
The Centers for Medicare and Medicaid Services announced the 2026 premiums, deductibles, and income related adjustments for Medicare Parts A, B, and D. These changes affect taxpayers across a wide range of income levels, with the most significant planning impacts tied to modified adjusted gross income thresholds that increase Part B and Part D costs. Understanding the 2026 numbers helps taxpayers manage income, withdrawals, and capital gains decisions that may influence what they pay for Medicare.
Key 2026 Medicare Income Thresholds and Premiums
The 2026 Medicare tables below summarize standard and higher income premiums for Part B coverage, immunosuppressive drug coverage, and Part D income related adjustments, along with the updated Part A deductibles and premiums. Taxpayers and advisers can use these figures to coordinate Roth conversions, capital gain recognition, retirement account withdrawals, and other actions that affect modified adjusted gross income.
Medicare Part B Standard Coverage: 2026 IRMAA and Total Monthly Premium
| MAGI – Individual Return | MAGI – Joint Return | IRMAA (Monthly) | Total Part B Premium (Monthly) |
|---|---|---|---|
| Less than $109,000 | Less than $218,000 | $0.00 | $202.90 |
| More than $109,000 up to $137,000 | More than $218,000 up to $274,000 | $81.20 | $284.10 |
| More than $137,000 up to $171,000 | More than $274,000 up to $342,000 | $202.90 | $405.80 |
| More than $171,000 up to $205,000 | More than $342,000 up to $410,000 | $324.60 | $527.50 |
| More than $205,000 up to $500,000 | More than $410,000 up to $750,000 | $446.30 | $649.20 |
| More than $500,000 | More than $750,000 | $487.00 | $689.90 |
The standard Part B premium for 2026 is $202.90 with an annual deductible of $283. A relatively small portion of enrollees pay the income related amounts shown in the higher tiers.
Medicare Part B Standard Coverage: 2026 Premiums for Married Separate Filers
| MAGI – Separate Return | IRMAA (Monthly) | Total Part B Premium (Monthly) |
|---|---|---|
| Less than $109,000 | $0.00 | $202.90 |
| More than $109,000 up to $391,000 | $446.30 | $649.20 |
| More than $391,000 | $487.00 | $689.90 |
For additional context on how these thresholds interact with retirement savings strategies, see my overview of 2026 retirement plan limit increases .
Medicare Part B Immunosuppressive Drug Coverage Only: 2026 IRMAA and Premium
Certain individuals whose full Medicare coverage ended 36 months after a kidney transplant may elect Part B immunosuppressive drug coverage only. The standard 2026 premium for this coverage is $121.60 per month.
| MAGI – Individual Return | MAGI – Joint Return | IRMAA (Monthly) | Total Premium (Monthly) |
|---|---|---|---|
| Less than $109,000 | Less than $218,000 | $0.00 | $121.60 |
| More than $109,000 up to $137,000 | More than $218,000 up to $274,000 | $81.10 | $202.70 |
| More than $137,000 up to $171,000 | More than $274,000 up to $342,000 | $202.70 | $324.30 |
| More than $171,000 up to $205,000 | More than $342,000 up to $410,000 | $324.30 | $445.90 |
| More than $205,000 up to $500,000 | More than $410,000 up to $750,000 | $445.90 | $567.50 |
| More than $500,000 | More than $750,000 | $486.50 | $608.10 |
Immunosuppressive Drug Coverage Only: 2026 Premiums for Married Separate Filers
| MAGI – Separate Return | IRMAA (Monthly) | Total Premium (Monthly) |
|---|---|---|
| Less than $109,000 | $0.00 | $121.60 |
| More than $109,000 up to $391,000 | $445.90 | $567.50 |
| More than $391,000 | $486.50 | $608.10 |
Medicare Part D: 2026 Income Related Monthly Adjustment Amounts
Part D income related monthly adjustment amounts are paid in addition to the plan premium. The following tables summarize the 2026 adjustments.
Part D IRMAA for Standard Filers
| MAGI – Individual Return | MAGI – Joint Return | Part D IRMAA (Monthly) |
|---|---|---|
| Less than $109,000 | Less than $218,000 | $0.00 |
| More than $109,000 up to $137,000 | More than $218,000 up to $274,000 | $14.50 |
| More than $137,000 up to $171,000 | More than $274,000 up to $342,000 | $37.50 |
| More than $171,000 up to $205,000 | More than $342,000 up to $410,000 | $60.40 |
| More than $205,000 up to $500,000 | More than $410,000 up to $750,000 | $83.30 |
| More than $500,000 | More than $750,000 | $91.00 |
Part D IRMAA for Married Separate Filers
| MAGI – Separate Return | Part D IRMAA (Monthly) |
|---|---|
| Less than $109,000 | $0.00 |
| More than $109,000 up to $391,000 | $83.30 |
| More than $391,000 | $91.00 |
Medicare Part A: 2026 Deductibles, Coinsurance, and Premiums
Many Medicare beneficiaries pay no Part A premium due to at least 40 quarters of Medicare covered employment. For those who do pay, and for all beneficiaries using inpatient and skilled nursing benefits, the 2026 deductibles and coinsurance amounts are important planning figures.
Part A Deductibles and Coinsurance for 2026
| Benefit | 2026 Amount |
|---|---|
| Inpatient hospital deductible per benefit period | $1,736 |
| Daily hospital coinsurance, days 61 through 90 | $434 |
| Daily hospital coinsurance for lifetime reserve days | $868 |
| Skilled nursing facility coinsurance, days 21 through 100 | $217.00 |
Part A Monthly Premiums for Voluntary Enrollees
| Coverage Situation | 2026 Monthly Premium |
|---|---|
| At least 30 quarters of coverage, or spouse with at least 30 quarters | $311 |
| Fewer than 30 quarters of coverage | $565 |
Final Takeaway
The 2026 Medicare premium and IRMAA tables place clear dollar amounts on the cost of crossing key income thresholds. Taxpayers who expect higher income in retirement, or who are planning Roth conversions, asset sales, or large distributions, should evaluate how those decisions affect modified adjusted gross income relative to the Medicare brackets. Careful planning can help reduce exposure to higher Medicare premiums and align health care costs with long term financial goals.
See current federal rates on the Economic Dashboard .
