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Most people pay $202.90 a month for Part B in 2026. If your income two years ago was above the threshold, you pay an income-related adjustment (IRMAA) on top — taking the Part B premium as high as $689.90 a month, plus a Part D surcharge.
How IRMAA works
Social Security uses your modified adjusted gross income from two years earlier — so 2026 premiums are based on your 2024 tax return. Cross a threshold by a single dollar and the full tier applies; it's a cliff, not a slope.
In 2026 the Part B premium runs from $284.10 to $689.90 a month depending on tier, against the standard $202.90 (CMS).
It applies to Part D too
The Part D income-related adjustment is paid separately to Medicare, not to your plan — so a plan with a low premium still leaves you paying the surcharge. See Social Security.
Appealing after a life-changing event
If your income has dropped because of retirement, widowhood, divorce, loss of a pension, or a work stoppage, you can ask Social Security to use current income instead. File form SSA-44 — start at ssa.gov/medicare/lower-irmaa.
This is one of the most commonly missed savings in Medicare: people retire, their income falls, and they keep paying a surcharge based on their working years.
Planning income around the thresholds
Because IRMAA looks back two years, decisions you make now affect premiums later — Roth conversions, large capital gains, and lump-sum distributions can all push you into a higher tier. See our retirement income page.
If the premium is a hardship
Medicare Savings Programs pay the Part B premium for those who qualify (Medicare.gov), and Extra Help covers Part D costs (Social Security). New Mexicans apply through the NM Health Care Authority.
Estimates only
Social Security determines your actual premium and will notify you in writing.
Not sure which of these fits you? A free 15-minute call with a licensed local advisor sorts it out — no pressure, and no cost to you. We do not offer every plan available in your area. For a complete list of every plan in your county, use Medicare Plan Compare or call 1-800-MEDICARE.
Questions, answered
What income does IRMAA use?
Your modified adjusted gross income from two years earlier — 2026 premiums are based on your 2024 return. It's a cliff, so crossing a threshold by a dollar applies the full tier.
Can I get IRMAA reduced?
Yes, after a life-changing event such as retirement, widowhood, divorce, or loss of a pension. File form SSA-44 with Social Security — it's frequently missed by people who've just retired.
Does IRMAA apply to Part D as well?
Yes, as a separate surcharge paid directly to Medicare rather than to your drug plan.
Sources
- CMS — 2026 Medicare Parts A & B Premiums and Deductibles
- SSA — Request to lower an IRMAA
- Medicare.gov — Medicare Savings Programs
- SSA — Extra Help with Medicare drug costs
- New Mexico Health Care Authority
Figures are for 2026 and come from the official sources above. Plan-specific costs vary by county and carrier — confirm yours on Medicare Plan Compare or with a licensed agent.
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Content reviewed by Brian Penner, Independent Medicare advisor — no pressure.