Newsroom · Moab
Medicare IRMAA in 2026: A Moab & Grand County 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 Moab retirees do not — but a one-time income spike, like selling property into Moab's hot market, 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.
Read the full transcript
Hi, it's Emma with Medicare On Main in Moab. Let's talk about IRMAA — the Income-Related Monthly Adjustment Amount. It's an extra charge Medicare adds to your Part B and Part D premiums when your income is high enough. Here's the catch: it uses a two-year lookback, so your 2026 surcharge is based on your 2024 tax return. In 2026, if you're single with income of $109,000 or less, or a couple at $218,000 or less, you pay the standard Part B premium of $202.90, with no surcharge. Above that, it climbs in tiers. The good news? Only about 8% of people pay it — most folks here in Grand County never cross the line. But a one-time income spike can trigger it: selling a Spanish Valley home into Moab's hot market, a Roth conversion, or a big retirement withdrawal. And if your income has dropped since 2024 — say you retired or lost a spouse — you can appeal with form SSA-44 and often get it lowered. Don't just accept a surprise surcharge. Let's check where you land. Call Medicare On Main at 435-260-3200. Free, local, no pressure.
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 Grand County — fall under the threshold and pay the standard 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 premium | Part 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 short-term-rental 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.
Review my Medicare costs →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, cabin, or short-term rental that produced a large capital gain in 2024 — a live risk in Grand County's tight, high-value housing market.
- 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:
- Work stoppage or reduction — retiring or cutting back hours (very common right at 65, and common for Moab's self-employed and seasonal workers).
- Marriage, divorce, or the death of a spouse.
- 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.
Why does IRMAA matter in Moab?
Moab is a small-business and self-employed town wrapped around a high-value real-estate market, and that combination is exactly where IRMAA surprises turn up. Most people we help across Grand County never cross the threshold — they pay the standard $202.90. But the retiree who sold a Spanish Valley home or a nightly rental into a strong market, the rancher or shop owner who cashed out a business, and the couple doing Roth conversions before required withdrawals kick in are all worth a second look. 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.
Source: CDC PLACES, 2023 — via the Medicare On Main Data Desk. Model-based prevalence among Grand 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 Grand 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. Medicare On Main does not offer every plan available in your area, and takes 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. In a place like Moab, a single big real-estate sale in 2024 is the classic trigger.
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 Moab pay IRMAA?
No. IRMAA is designed to affect only higher-income households — about 8% of Part B enrollees nationally — and most retirees in Moab and Grand 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 in a year with a large capital gain — for example, selling a Spanish Valley home or a short-term rental into Moab's hot market, a Roth conversion, or the sale of a small 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 with more than 22 years of experience — 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. Our Moab office is at 880 S Main St, inside Central Utah Insurance Agency.
Sources
- CMS: 2026 Medicare Parts A & B Premiums and Deductibles (Nov 14, 2025) — official 2026 Part B & Part D IRMAA brackets and premiums.
- Social Security Administration — Medicare Premiums — how income affects Medicare premiums.
- SSA-44 — Medicare IRMAA Life-Changing Event form — appeal IRMAA after a life-changing event.
- CDC PLACES: Local Data for Better Health, County 2023 — Grand County chronic-condition prevalence (2023).