Any high income causes the premiums to skyrocket for two years. Had a client that it cost him and his wife over $16,000 per year each for 2 years.
The income-related monthly adjustment amount (IRMAA) applies to individuals with modified adjusted gross incomes exceeding $109,000 and couples exceeding $218,000.
The IRMAA is calculated on a sliding scale with five income brackets, topping out at $500,000 for individual filing and $750,000 for married, filing jointly. These figures, except for the top bracket, are inflation-adjusted annually. For 2026, these inflation-adjusted brackets range from $109,000 to $205,000 for single tax filers and $218,000 to $410,000 for joint filers.
IRMAA calculations have a two-year lag. Whether you pay an IRMAA in a given year depends on your tax returns from two years ago.
In other words, your 2026 IRMAA liability is based on your MAGI from 2024.
My clients Medicare Part B premiums went to $690 per month for each husband and wife or $1,380 for both. It costs them $16,560 per year for Medicare Part B!
This was due to liquidating some stock.
His wife was really pissed and he had to reimburse her for her lost Social Security benefits as that was her spending money.
Actually the Premium grid goes up up and away to the last bracket at above $500,000 for Single filers and above $750K for joint filers, the top bracket paying $629.90 per month each of joint Part B premium and $85.80 for single Part D.