The Rogues’ Gallery · A trap, personified
The IRMAA Cliff
The real thing: Medicare Part B and Part D income-related surcharges.
“It isn’t a slope. It’s a step. One dollar.”
— Max
A note on who Max is. Max is a cartoon owl. He is not a financial advisor, insurance agent, or tax professional, and nothing here is personalized advice. When a question turns personal, he does not answer it — he teaches the general version and points you to a licensed conversation, which is automated and says so before it says anything else.
How Max draws The IRMAA Cliff: A sheer chalk cliff with a tiny, cheerful figure one step from the edge, holding a Roth conversion form.
What it really is: IRMAA — the income-related monthly adjustment amount — is a surcharge Medicare adds on top of the standard Part B and Part D premiums for beneficiaries above a set income line. The standard Part B premium is $202.90 a month for 2026; IRMAA sits on top of that for higher incomes.
Why it is a cliff and not a slope: the surcharge does not phase in gradually. Cross the income line by a single dollar and the entire higher amount applies for the whole year. And the income it measures is your modified adjusted gross income from two years prior — the premium you pay this year was decided by a tax return you already filed.
The 2026 income tiers were not yet confirmed when this was written, so this page does not state them. That is deliberate: a number you would have to take back is worse than no number. What is stable is the shape — a step, measured two years in arrears — and you can plan around a step you can see.
The way out: a genuine life-changing event (retirement, a spouse's death, marriage, divorce, a lost pension) can be appealed with Social Security form SSA-44, which asks Medicare to use a more recent, lower year. Filing it is free.
Figures on this page are for tax year 2026 and were last verified 2026-07-25. Tax and benefit numbers change every year — check the current-year figure before acting on any of them. The 2026 Medicare IRMAA income tiers were not yet confirmed when this was written; where they matter, they are named but not stated as fact.
Where it bites
Let me circle the part that bites.
Desk’s open.
— Max