Utah · Medicare · 2026
Medicare IRMAA in 2026: A Utah Guide for Higher Earners
For most retirees Medicare Part B costs $202.90 a month in 2026. For higher-income Utah households, a two-year-old tax return can more than triple that — and add a Part D surcharge on top.
The bottom line
- The standard 2026 Part B premium is $202.90/month; IRMAA is an extra charge only on higher incomes (CMS).
- IRMAA starts above $109,000 (single) or $218,000 (married filing jointly) in 2026 MAGI (SSA).
- It's based on your 2024 income — a two-year look-back — so one big year can raise your premiums later.
- At the top bracket, Part B runs $689.90/month (about $487 extra) plus a $91.00 Part D add-on — and each spouse pays their own.
If you're a higher-income retiree in Utah — whether you're in Salt Lake County, a Park City professional winding down a career, or a business owner who sold a property — Medicare's IRMAA can be an unpleasant surprise. Most people pay the standard Part B premium of $202.90 a month in 2026. But once your income crosses a threshold, Medicare adds an income-related surcharge to both your Part B and Part D premiums, and it's tied to a tax return from two years earlier. Here's exactly how the 2026 brackets work, and how Utah households plan around them — with the official numbers.
What is IRMAA, and who actually pays it?
IRMAA stands for income-related monthly adjustment amount. It's an extra amount added on top of your standard Medicare Part B (doctor and outpatient) and Part D (prescription drug) premiums when your income is above a set level. It is not a separate bill you can opt out of — if you owe it and you're on Social Security, it comes straight out of your monthly check.
The key reassurance: most people never pay it. CMS estimates IRMAA affects only about 8% of people with Medicare Part B (CMS). The other roughly 92% pay just the standard $202.90. IRMAA is a high-income surcharge, so if your retirement income is modest, this article is mostly a "good to know" — not a bill you'll see.
Sources: CMS, "2026 Medicare Parts A & B Premiums and Deductibles" — cms.gov; SSA POMS HI 01101.020 — secure.ssa.gov.
The 2026 IRMAA income brackets
IRMAA uses your modified adjusted gross income (MAGI) — roughly your adjusted gross income plus any tax-exempt interest. The tiers below take effect in 2026 and are based on the income reported on your 2024 tax return. The Part B column is the total premium at that bracket (standard plus surcharge); the Part D column is added on top of whatever your drug plan charges.
| 2024 MAGI — single | 2024 MAGI — married/joint | Total Part B (2026) | Part D add-on |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | — |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | +$14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | +$37.50 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | +$60.40 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.20 | +$83.30 |
| $500,000 or more | $750,000 or more | $689.90 | +$91.00 |
Source: SSA POMS HI 01101.020, "IRMAA Sliding Scale Tables," effective Dec. 2, 2025 — secure.ssa.gov. Married-filing-separately brackets differ; see SSA. Part D add-on is in addition to your plan's premium.
Total monthly Part B premium by 2026 IRMAA bracket. Source: SSA POMS HI 01101.020.
How a two-year-old tax return raises your 2026 premium
This is the part that catches Utah retirees off guard. Your 2026 IRMAA is set from the 2024 tax return Social Security has on file (SSA). So a one-time income spike two years ago can raise this year's Medicare cost even if your income has since dropped. Common triggers:
- A large IRA or 401(k) withdrawal — including a required minimum distribution — that pushed your 2024 MAGI over a threshold.
- A Roth conversion done in 2024, which counts as ordinary income the year you convert.
- Selling a home, land, or a business — capital gains above the exclusion can spike MAGI for that one year.
- The loss of a spouse, which can move a surviving spouse from the joint brackets to the lower single thresholds the following year.
Because the surcharge is based on old data, it usually corrects itself as newer returns replace older ones — but that can take a year or two. You don't have to just wait, though (see below).
What a Utah couple actually pays at each tier
Remember that each person on Medicare pays their own IRMAA. For a married couple where both are enrolled, double the per-person surcharge. Here's the added annual cost per person versus the standard premium, combining Part B and Part D:
| Bracket | Extra Part B/mo | Extra Part D/mo | Extra per person / year |
|---|---|---|---|
| Tier 1 | +$81.20 | +$14.50 | $1,148 |
| Tier 2 | +$202.90 | +$37.50 | $2,885 |
| Tier 3 | +$324.60 | +$60.40 | $4,620 |
| Tier 4 | +$446.30 | +$83.30 | $6,355 |
| Tier 5 | +$487.00 | +$91.00 | $6,936 |
Calculated from the 2026 SSA IRMAA table (standard Part B = $202.90). Part D add-on is in addition to your plan premium; a couple pays these amounts twice. Illustration only.
How Utah households plan around the brackets
Utah's higher-income retirees — think Summit County (Park City) professionals, Salt Lake and Utah County business owners, and physicians across the Wasatch Front — are the households most likely to brush up against IRMAA. A few principles help:
1. Watch the threshold before a big withdrawal
Before taking a large IRA distribution or realizing a gain, check where it leaves your MAGI relative to the next tier. Spreading a withdrawal across two tax years can keep you under a bracket in both.
2. Time Roth conversions with IRMAA in mind
Roth conversions are powerful, but the converted amount counts as income the year you convert — and shows up in your IRMAA math two years later. Many Utah retirees convert in lower-income years (often the gap between retiring and starting Social Security or RMDs) to stay under the brackets.
3. Use Form SSA-44 after a life-changing event
If your income dropped because of retirement, the death of a spouse, marriage, divorce, or the loss of income-producing property, you don't have to wait out the two-year look-back. File Form SSA-44 with Social Security and ask them to use your current, lower income instead (SSA). This is one of the most overlooked ways to cut an unfair surcharge.
We help Utah households coordinate withdrawals, Roth conversions, and Medicare timing so an avoidable IRMAA surcharge doesn't catch you by surprise — in plain English, with no pressure.
Talk to a planner →Frequently asked questions
What is IRMAA and who pays it in 2026?
IRMAA — the income-related monthly adjustment amount — is an extra charge added to your Medicare Part B and Part D premiums when your income is above a set threshold. In 2026 it starts once your modified adjusted gross income (MAGI) tops $109,000 for a single filer or $218,000 for a married couple filing jointly. CMS estimates IRMAA affects roughly 8% of people with Part B; most retirees pay only the standard $202.90 Part B premium.
What income does 2026 IRMAA use?
Social Security uses your most recent tax return on file, which for 2026 is generally your 2024 return (filed in 2025). That is a two-year look-back, so a high-income year in 2024 — a large IRA withdrawal, a Roth conversion, or the sale of a home or business — can raise your Medicare premiums in 2026 even if your income has since dropped.
How much can IRMAA add to my Medicare premiums in 2026?
At the highest bracket, the total Part B premium is $689.90 a month — about $487 above the standard $202.90 — plus a Part D add-on of $91.00 on top of your drug plan's premium. Each spouse on Medicare pays their own IRMAA, so a high-income couple can pay it twice.
Does IRMAA go away if my income drops?
Yes, but usually with a two-year lag as newer tax returns replace older ones. If your income fell because of a specific life-changing event — such as retirement, the death of a spouse, marriage, or divorce — you can ask Social Security to use your current income now by filing Form SSA-44 with proof, rather than waiting for the look-back to catch up.
Can I appeal or reduce my Utah IRMAA charge?
You can request a new determination if Social Security used outdated or incorrect data, or if you had a qualifying life-changing event. File Form SSA-44 or contact Social Security. Beyond appeals, planning ahead — spreading out IRA withdrawals, timing Roth conversions, and managing capital gains — can keep future-year MAGI under the next bracket. This is educational, not tax advice.
Is the IRMAA surcharge automatically taken out?
Yes. If you receive Social Security, both your standard Part B premium and any IRMAA are deducted from your monthly check. The Part D IRMAA is billed separately or deducted from Social Security even though your drug plan premium goes to a private insurer. You do not pay IRMAA to your plan; it goes to Medicare.
Sources
- CMS — 2026 Medicare Parts A & B Premiums and Deductibles (standard Part B $202.90, deductible $283, ~8% pay IRMAA): cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- SSA — POMS HI 01101.020, IRMAA Sliding Scale Tables (2026 brackets, Part B totals, Part D add-ons): secure.ssa.gov/poms.nsf/lnx/0601101020
- SSA — Medicare Premiums & the two-year income look-back: ssa.gov/benefits/medicare/medicare-premiums.html
- SSA — Form SSA-44, Medicare IRMAA Life-Changing Event: ssa.gov/forms/ssa-44.pdf
- U.S. Census Bureau — Utah county income snapshot (QuickFacts): census.gov/quickfacts/UT
About this article. Written by the Utah Retirement Income Data Desk and reviewed by Brian Penner, Retirement income & long-term care planner. Educational only — not financial, tax, or legal advice. Utah Retirement Income is a licensed independent insurance agency (NPN 16493717); we do not offer every plan available in your area, and we are not connected with or endorsed by Medicare, CMS, the Social Security Administration, or any government agency. Medicare rules and figures change; confirm your own numbers at medicare.gov or ssa.gov, or with a licensed professional. Any call or text you request implies your consent to be contacted about your inquiry.