Higher-income Medicare beneficiaries face additional surcharges known as IRMAA — Income-Related Monthly Adjustment Amounts — on top of standard Part B and Part D premiums.
For 2026, IRMAA brackets start at $106,000 for individuals and $212,000 for married couples filing jointly, with surcharges increasing across five income tiers.
The top IRMAA tier applies to individuals earning over $500,000, who pay the maximum surcharge on both Part B premiums and Part D coverage.
Beneficiaries can appeal IRMAA determinations if their income has dropped due to life-changing events such as retirement, divorce, or loss of income-producing property.

