Why your 2024 tax return sets your 2026 Medicare premium
Medicare looks back two years. A home sale, account withdrawal or Roth conversion in 2024 can affect the premium you pay in 2026.
Your Medicare premium may not reflect what you earn now. The Social Security Administration sets your Part B and Part D premiums using the modified adjusted gross income on your tax return from two years earlier.
For 2026, that is your 2024 return.
The standard premium and IRMAA
The standard Part B premium in 2026 is $202.90 a month, with an annual deductible of $283. This is the base rate before any income-related adjustment.
Above certain income thresholds an extra charge is added, called the income-related monthly adjustment amount, or IRMAA. It applies to both Part B and Part D.
The 2026 brackets
| 2024 income, single | 2024 income, married filing jointly | Part B / month | Part D extra |
|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $202.90 | None |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | $60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
The top bracket starts at $500,000 for a single filer and $750,000 for a couple. Unlike the lower brackets, the limit for couples is not double the limit for single filers.
How the thresholds work
The brackets are not gradual. Going one dollar over a threshold moves you into the higher bracket for the entire year.
A single filer with $109,001 of income in 2024 pays $284.10 a month in 2026. A single filer with $109,000 pays $202.90. One dollar of difference costs $974.40 across the year.
What pushes people over without warning
A one-time taxable event can push your income into a higher bracket:
- Selling a property, where the gain lands in a single tax year
- A Roth conversion
- Cashing out an account, or a large required minimum distribution
- Receiving a lump sum, an inheritance that generates income, or exercising options
Because of the two-year lookback, one of these events can raise your premium after the event itself has passed.
You may be able to appeal. If your income has dropped since that tax year because of a specific life-changing event, Social Security can use more recent figures instead. Recognized events include retirement or reduced work hours, the death of a spouse, marriage or divorce, loss of a pension, and loss of income-producing property.
File form SSA-44, "Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event," with Social Security. Retirement is one of the listed events and may qualify you to use more recent income figures.
What to check
Your actual premium appears on your Medicare statement and in your Social Security account. If it is higher than the standard $202.90, the two-year lookback may explain the difference.
To confirm your figure, call Social Security at 1-800-772-1213 or Medicare at 1-800-MEDICARE. We cannot see your record or tell you what you personally owe.
See what Medicare may cost you in 2026
Sources
- CMS fact sheet, 2026 Medicare Parts A and B Premiums and Deductibles. November 14, 2025. Standard premium, deductible and 2026 IRMAA brackets.
- Social Security Administration, form SSA-44, Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event. Appeal process and recognized life-changing events.
Figures apply to calendar year 2026 and change annually. Spot a problem? See our corrections page.