A Medicare On Main advisor reviewing income and Medicare premium paperwork with a retired couple in Grand Junction, Colorado

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Medicare IRMAA in 2026: A Grand Junction Income Guide

If your income is high enough, Medicare quietly adds a surcharge to your Part B and Part D premiums — based on a tax return from two years ago. Here is exactly how it works in 2026.

The bottom line

  • IRMAA is an income surcharge added to your Medicare Part B and Part D premiums when your income is above a threshold. In 2026 the standard Part B premium is $202.90 a month.
  • It uses a two-year lookback: your 2026 surcharge is based on the income on your 2024 tax return (adjusted gross income plus tax-exempt interest).
  • The 2026 threshold is $109,000 (single) / $218,000 (joint). Below it you pay $0 IRMAA; above it, the total Part B premium climbs to as much as $689.90 a month.
  • Only about 8% of people with Part B pay it — most Grand Junction retirees do not — but a one-time income spike can trigger it.
  • If your income has since dropped due to a life-changing event, you can appeal with form SSA-44. We can help you spot it and plan around it — free and local.

IRMAA — the Income-Related Monthly Adjustment Amount — is an extra charge Medicare adds to your Part B and Part D premiums when your income is above a set limit. In 2026, a single filer with income of $109,000 or less (or $218,000 or less for a couple) pays the standard $202.90 Part B premium and no surcharge. Above those limits, the premium rises in steps. The catch that surprises people most: it is based on your income from two years earlier, so your 2026 premium reflects your 2024 tax return.

What is IRMAA, and who actually pays it?

Since 2007 for Part B (and 2011 for Part D), higher-income Medicare beneficiaries have paid more for the same coverage. The surcharge is not a separate plan or a penalty for doing something wrong — it is simply an income-based add-on to your normal premium. For Part B, it is usually deducted directly from your Social Security payment. For Part D, it is charged on top of whatever your drug plan costs, and paid either from your Social Security check or directly to Medicare.

Importantly, IRMAA is the exception, not the rule. CMS estimates it affects roughly 8% of people with Part B. The large majority — including most retirees across Mesa County — fall under the threshold and pay the standard premium.

$202.90
standard 2026 Part B premium (no IRMAA)
8%
of Part B enrollees pay an IRMAA surcharge
2024
the tax year that sets your 2026 IRMAA
$689.90
top-tier total monthly Part B premium

Figures: CMS: 2026 Medicare Parts A & B Premiums and Deductibles (Nov 14, 2025).

What are the 2026 IRMAA income brackets?

Here is the full 2026 schedule. Find the row that matches your 2024 filing status and modified adjusted gross income (MAGI = adjusted gross income + any tax-exempt interest). The Part B column is your total monthly premium; the Part D column is added on top of your drug plan's premium.

Single filer (2024 MAGI)Married filing jointly (2024 MAGI)Total Part B premiumPart D add-on
$109,000 or less $218,000 or less $202.90 $0.00 Standard
Over $109,000 up to $137,000 Over $218,000 up to $274,000 $284.10 (+$81.20) +$14.50 Tier 1
Over $137,000 up to $171,000 Over $274,000 up to $342,000 $405.80 (+$202.90) +$37.50 Tier 2
Over $171,000 up to $205,000 Over $342,000 up to $410,000 $527.50 (+$324.60) +$60.40 Tier 3
Over $205,000 under $500,000 Over $410,000 under $750,000 $649.20 (+$446.30) +$83.30 Tier 4
$500,000 or more $750,000 or more $689.90 (+$487.00) +$91.00 Tier 5

Source: CMS: 2026 Medicare Parts A & B Premiums and Deductibles (Nov 14, 2025). Different thresholds apply to those who are married but file separately.

How the total Part B premium climbs by income tier (2026)

Source: CMS: 2026 Medicare Parts A & B Premiums and Deductibles (Nov 14, 2025). "Total Part B premium" includes the standard $202.90 plus the IRMAA add-on.

Worried a good year pushed you into IRMAA?

Bring us your situation — a home sale, a Roth conversion, a pension change — and we will walk through where you land in 2026 and whether an appeal makes sense. Free, local, no pressure.

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Why does a two-year-old tax return decide my premium?

Medicare does not have your current income when it sets premiums for the coming year, so it uses the most recent return the IRS has finalized — which is two years back. For 2026, that is your 2024 return. This "two-year lookback" is why a single high-income event can echo forward:

  • Selling a home or business that produced a large capital gain in 2024.
  • A Roth IRA conversion, which counts as income the year you convert.
  • Taking large IRA or 401(k) withdrawals, or a lump-sum pension payout.
  • Investment income — including tax-exempt interest, which is added back into MAGI.

If you crossed a threshold by even one dollar, you move up an entire tier — IRMAA is a series of cliffs, not a gradual slope. That is why some retirees plan withdrawals and conversions with these brackets in mind.

My income has dropped since 2024 — what can I do?

This is one of the most common and fixable IRMAA situations. If a life-changing event lowered your income, Social Security can base your premium on your newer, lower income instead of the 2024 return. Qualifying events include:

  1. Work stoppage or reduction — retiring or cutting back hours (very common right at 65).
  2. Marriage, divorce, or the death of a spouse.
  3. Loss of pension income, or loss of income-producing property outside your control.

To request the change, file form SSA-44 with Social Security and attach proof of the event. If you simply believe the wrong income was used, you can ask for a reconsideration instead. Either way, do not just accept a surprise surcharge — check whether you qualify to have it reduced.

How does this fit the Grand Junction picture?

For most people we help in Mesa County, IRMAA never comes up — their income is below the threshold, so they pay the standard $202.90. Where it matters is the household with a strong investment year or a property sale, and the person still working past 65 whose paycheck plus retirement distributions add up. And whatever your premium, the plan that fits your health matters just as much: here is the local chronic-condition picture that should shape your Part D and Advantage choices.

26.6%
Mesa County adults with high blood pressure
29.8%
adults living with obesity
8.1%
adults with diagnosed diabetes

Source: CDC PLACES, 2023 — via the Medicare On Main Data Desk. Model-based prevalence among Mesa County adults, 2023.

How we know all this: the Medicare On Main Data Desk builds every article on public data — here, the official 2026 IRMAA brackets released by CMS on November 14, 2025, plus Mesa County health figures from CDC PLACES (2023). This is education, not advice; IRMAA determinations and appeals are handled by the Social Security Administration, and you should confirm your plan, costs, and eligibility with a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan.

Frequently asked questions

What is Medicare IRMAA?

IRMAA stands for the Income-Related Monthly Adjustment Amount. It is an extra charge added to your Medicare Part B and Part D premiums when your income is above a set threshold. It is not a separate bill for most people — it is added on top of your regular premium, and the Part B portion is usually taken straight out of your Social Security check. In 2026 the standard Part B premium is $202.90 a month; IRMAA only applies above the income limits, and it affects roughly 8% of people with Part B.

What income sets my 2026 IRMAA, and what is the two-year lookback?

Medicare uses a two-year lookback: your 2026 IRMAA is based on the modified adjusted gross income (MAGI) reported on your 2024 federal tax return. MAGI is your adjusted gross income plus any tax-exempt interest. Because of the two-year delay, a high-income year well before you enrolled can still raise your premium — and an income drop since then is handled through an appeal, not automatically.

How much is the IRMAA surcharge in 2026?

For 2026, a single filer with MAGI of $109,000 or less (or a couple filing jointly at $218,000 or less) pays $0 IRMAA and the standard $202.90 Part B premium. Above that, the total Part B premium rises through five tiers — $284.10, $405.80, $527.50, $649.20, and $689.90 a month at the top. Part D adds a separate income surcharge of $14.50 up to $91.00 a month on top of your drug plan's premium.

Will most people in Grand Junction pay IRMAA?

No. IRMAA is designed to affect only higher-income households — about 8% of Part B enrollees nationally — and most retirees in Grand Junction and Mesa County have incomes below the $109,000 individual / $218,000 joint threshold, so they pay the standard $202.90 premium with no surcharge. It is still worth checking, especially in a year with a large capital gain, a Roth conversion, or the sale of a home or business.

My income dropped since 2024 — can I lower or appeal my IRMAA?

Often, yes. If a life-changing event reduced your income — such as retirement or reduced work hours, the death of a spouse, marriage or divorce, or loss of a pension — you can ask Social Security to use your more recent income instead. File form SSA-44 (Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event) with proof of the change. If you simply disagree with the income used, you can also request a reconsideration. This is a common, fixable situation — do not just accept a surprise surcharge.

Does Medicare On Main charge for help with this?

No. Brian Penner is an independent, licensed Medicare advisor — paid by the carriers, not by you. Reviewing how IRMAA affects your Part B and Part D costs, and pointing you to the right Social Security appeal, is free and there is no pressure to enroll in anything.

Sources

Not sure if IRMAA applies to you? Let's check.

Free, local, no pressure — we will look at where your income lands in the 2026 brackets and whether an appeal fits your situation.

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Medicare On Main is a licensed independent insurance agency. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP) to get information on all of your options. Not connected with or endorsed by the U.S. government or the federal Medicare program.