Medicare IRMAA 2026: The Part B Income Line Veterans Miss
Medicare IRMAA can add up to $8,279 a year to your Part B premium in 2026. Not because you are sick. Not because you used more health care. Because your income crossed a line you did not know existed.
It is called IRMAA, the Income-Related Monthly Adjustment Amount. My business partner Jeff takes calls from veterans every day who had no idea this surcharge was coming.
By the end of this article, you will know exactly where the line is, why Medicare uses income from two years ago to decide what you pay today, and the one form that fixes it if you have been overcharged.
What Is the Standard Medicare Part B Premium in 2026?
The standard Medicare Part B premium in 2026 is $202.90 a month. If you collect Social Security, it comes straight out of your check. If you are not collecting Social Security yet, Medicare bills you directly and you pay it yourself.
Either way, that is about $2,435 a year.
Most veterans think that is what everybody pays. Same number across the board. That is not how it works.
And before we get to how it does work, know this. There is language on Page 11 of the Medicare handbook that makes sure you are not overpaying for your Part B premium. More on that below.
What Is IRMAA and How Does the Medicare Part B Surcharge Work?
Medicare has a surcharge. If your income is above a certain level, your Part B premium does not go up gradually. It jumps all at once.
It is a cliff. One dollar over the line and your premium increases immediately. Nobody told you about the line.
IRMAA stands for the Income-Related Monthly Adjustment Amount. It is an extra charge added to your Part B premium when your income crosses certain thresholds.
What Are the 2026 IRMAA Brackets?
These come straight from CMS, the Centers for Medicare and Medicaid Services. Watch what one dollar does. If a single filer earns $109,000, they pay the standard $202.90. Earn $109,001, and the premium jumps to $284.10 a month. That is an extra $81 a month, an extra $974 a year, from one dollar.
| Your 2024 income (single filer) | Your 2024 income (joint filers) | 2026 Part B premium | Extra per year over standard |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 / month | Standard |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 / month | About $974 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 / month | About $2,435 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 / month | About $3,895 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 / month | About $5,356 |
| $500,000 or more | $750,000 or more | $689.90 / month | $8,279 a year total |
And Part D. If you have Medicare Part D prescription drug coverage, IRMAA hits that too. Depending on your income, IRMAA adds an extra amount, ranging from roughly $14.50 to about $91 a month, on top of your Part D plan premium.
Five cliffs. Five lines. Nobody told you about any of them.
What Income Counts Toward IRMAA (Your MAGI)?
Medicare looks at your modified adjusted gross income, your MAGI. That is the number from your tax return.
Your pension counts. Your Social Security counts. IRA withdrawals count. Thrift Savings Plan (TSP) distributions count. Capital gains count. Rental income counts. Even tax-exempt interest from municipal bonds counts.
If it is on your tax return, it goes into your MAGI. And one dollar over any of those five lines triggers the full surcharge for that tier.
Does VA Disability Compensation Count Toward IRMAA?
Here is the one exception veterans need to know. VA disability compensation is tax-free. It does not show up on your tax return. So VA disability does not count toward your MAGI.
That is the good news. Remember it. But everything else counts.
Why Does Medicare Use Income From Two Years Ago?
Your 2026 IRMAA is not based on what you earn in 2026. It is based on your MAGI from 2024, two years ago. Medicare looks at your tax return from two years prior and uses that number to set your premium today.
Think about what that means for a veteran. You served 20 years. You retired from the military. Then you went to work in the private sector, maybe as a defense contractor, and earned $140,000 in 2024. You earned every dollar of it.
Then you fully retired from civilian work in 2025. Now you live on your military pension and Social Security, maybe $50,000 a year.
But Medicare does not look at 2025. Medicare looks at 2024. $140,000. That puts you in Tier 2. Your Part B premium is $405.80 a month instead of $202.90. That is an extra $202.90 a month. An extra $2,435 a year.
You live on $50,000 but pay a Medicare premium based on $140,000 you earned two years ago from a job you no longer have. Nobody told you about the line. And nobody told you Medicare would use income from two years ago to draw it.
How Does One IRA or TSP Withdrawal Trigger Three Hits?
If a withdrawal pushes your MAGI over one of those IRMAA thresholds, it does more than trigger taxes. It inflates your Medicare premium too. Not this year. Two years later, because IRMAA uses a two-year lookback.
A $20,000 IRA withdrawal in 2024 could mean a higher Part B premium in 2026. A $30,000 TSP distribution could do the same thing. And you will not find out until the notice arrives from Social Security.
One withdrawal. Three hits. Taxes on the withdrawal itself. Taxes on your Social Security from the combined income formula. And a Medicare premium surcharge two years later.
That is why you need to know your numbers before you make any moves, not after.
My business partner Jeff and I have been friends for over 30 years. Jeff takes calls from veterans every single day. A veteran sees the Part B premium on their Social Security statement and thinks it is a mistake. $284. $405. Sometimes higher. They call expecting us to fix an error.
It is not an error. It is IRMAA. And they had no idea it existed. Same reaction every time. Why did nobody tell me this? That is why we make these videos and write these guides. This information should have been free from the start.
Can You Lower Your IRMAA With the SSA-44 Form?
Here is the part that changes everything. You are not stuck.
If your income has dropped since the year Medicare is using, there is a form. It is the SSA-44. You can download it from our Medicare forms library for veterans.
If you have had what Social Security calls a life-changing event, you can ask them to use your current income instead of the income from two years ago. Life-changing events include:
- Retirement or work stoppage
- A reduction in work hours
- The death of a spouse
- Divorce
- The loss of a pension
- The loss of income-producing property
You fill out the SSA-44, provide proof of your life-changing event and your current income, and Social Security recalculates your IRMAA.
That veteran living on $50,000 but paying a premium based on $140,000 files the SSA-44 and shows he retired in 2025. Social Security recalculates based on his current income. His premium drops back to the standard $202.90. He saves the $2,435 a year.
Most veterans do not know this form exists. Now you do.
What Does Page 11 of the Medicare Handbook Say About Your Part B Premium?
Do not panic, because help is likely available through Medicare Part C.
On Page 11 of the 2026 Medicare and You handbook, Medicare says this about Medicare Part C plans: “Some plans may have a $0 premium and may help pay all or part of your Part B premium.”
That is Medicare’s own language. Options exist for your Part B premium, whether you pay the standard premium or the IRMAA premium. So even if you are paying an IRMAA surcharge, a Part C plan can still make Medicare work harder for you.
$0 premium. Medicare rules allow Part C plans to have a monthly premium as low as $0. Benefits and costs vary by county and plan. Part C is allowed to fill gaps the others cannot.
Do You Need Medicare Part A and Part B to Enroll in Part C?
Here is what you need to know before you go looking. To be eligible for Part C, you must have Medicare Part A and Medicare Part B. You cannot skip Part B and enroll in Part C. Part A and Part B are the foundation.
What Do the VA, Original Medicare, and TRICARE for Life Not Cover?
Does the VA cover routine dental? Unless you have a 100% rating, no. Vision? Sometimes. Hearing? Sometimes. And most veterans do not have a 100% rating.
Original Medicare does not cover routine dental, vision, or hearing. TRICARE for Life does not cover routine dental, vision, or hearing either.
What about a gym membership? An over-the-counter allowance? None of them provide those. And none of them pay any part of your Part B premium on your behalf.
Medicare Advantage, also called Part C, is allowed to provide benefits going beyond what the VA, Original Medicare, and TRICARE for Life provide on their own.
And Part C plans are not allowed to change your VA health benefits in any way. Your VA benefits stay exactly the same.
If you have TRICARE for Life, you are required to have at least Medicare Part A and Part B to keep your TRICARE for Life benefit. And TRICARE for Life wraps around Part C the same way TRICARE for Life wraps around Original Medicare.
Three Veterans, Same Income Drop, Three Different Premiums
Three veterans. Same retirement. Same income drop. Same two-year lookback.
Veteran One does not know about IRMAA. He sees the inflated premium on his Social Security statement and thinks it is a mistake. He calls Social Security and gets told that is the correct amount. He pays an extra $2,435 a year because nobody told him about the line.
Veteran Two knows about IRMAA but does not know about the SSA-44. He assumes he is stuck. He pays the surcharge for an entire year before someone finally mentions the form.
Veteran Three knows about the line. He knows about the two-year lookback. He files the SSA-44 and gets his premium recalculated based on current income. He pays the standard $202.90. And his VA benefits did not change. They cannot.
Same retirement. Same income drop. Three completely different premiums.
Which veteran are you going to be?
How Do You Check and Fix Your IRMAA Status?
If you are approaching 65, or if your income has changed since you enrolled in Medicare, check your IRMAA status.
Know where the lines are. $109,000 for single filers. $218,000 for joint filers. And remember that IRA withdrawals, TSP distributions, and required minimum distributions (RMDs) all count toward your MAGI.
If your income has dropped because of retirement, work stoppage, or any qualifying life-changing event, file the SSA-44. Do not pay a premium based on income you no longer earn.
Run your own numbers with our IRMAA calculator.
I am not a tax advisor, and this is not tax advice. Every situation is different. Talk to a qualified tax professional or financial professional who understands your complete income picture before making any changes.
2026 IRMAA and Part B Quick Reference
| Item | 2026 Amount |
|---|---|
| Standard Medicare Part B premium | $202.90 per month |
| Annual standard Part B cost | About $2,435 |
| IRMAA threshold, single filer | $109,000 MAGI |
| IRMAA threshold, joint filers | $218,000 MAGI |
| IRMAA Tier 1 premium | $284.10 per month |
| IRMAA Tier 2 premium | $405.80 per month |
| IRMAA Tier 3 premium | $527.50 per month |
| IRMAA Tier 4 premium | $649.20 per month |
| IRMAA Tier 5 premium (top bracket) | $689.90 per month, about $8,279 a year |
| IRMAA lookback period | Income from 2 years prior (2024 for 2026) |
| Form to request a recalculation | SSA-44 (life-changing event) |
| Counts toward MAGI | Pension, Social Security, IRA/TSP withdrawals, capital gains, rental income, tax-exempt interest |
| Does NOT count toward MAGI | VA disability compensation (tax-free) |
Sources: CMS 2026 Parts A & B Premiums and Deductibles, SSA-44 Life-Changing Event Form
Watch: How IRMAA Raises Your Medicare Part B Premium
The full video sits at the top of this page. Watch it on YouTube for the complete breakdown of the two-year lookback, the SSA-44, and the three veterans.
Read Medicare for Veterans: The Complete Field Guide Free
I wrote Medicare for Veterans: The Complete Field Guide. You can read it free at freevetsbook.com or buy a copy on Amazon.
You earned Medicare. The SSA-44 lowers your premium. Part C makes Medicare work harder for you.
Official Sources on Medicare IRMAA
- CMS 2026 Premiums and Deductibles: cms.gov
- SSA-44 Medicare IRMAA Life-Changing Event Form: ssa.gov/forms/ssa-44.pdf
- SSA Medicare Premiums and IRMAA: ssa.gov
- Medicare & You 2026 Handbook: medicare.gov
- KFF Medicare Advantage 2026 Spotlight: kff.org
Disclaimer
I am not affiliated with or endorsed by Social Security, Medicare, the VA, TRICARE, or any government agency. Nor would I want to be.
This is general education, not personal advice. I am not a tax advisor and this is not tax advice. Benefits and costs vary by county and plan. Always review your own situation before making changes.