Medicare, IRMAA and poverty-level reference data

The standard monthly premium is $202.90, or $2,435 a year. Most people pay this; roughly 8% pay more because of IRMAA.

How we checked it: Every IRMAA tier divided by its statutory multiple implies 202.88-202.93, which is this figure. The tables and the standard premium corroborate each other.

Source: SSA — POMS HI 01101.031 — How IRMAA is Calculated and How IRMAA Affects the Total Medicare Premium. Effective 2026. Reviewed annual.

IRMAA is a surcharge on Medicare Part B and Part D for higher incomes. Two things about it catch people out. First, it is set from your tax return from 2 years earlier — a Roth conversion or a large required distribution today raises your premium two years from now, long after the decision can be undone. Second, every tier is a cliff, not a taper: one dollar over a threshold raises your premium for the entire year.

Single filers

Married filing jointly

Worth knowing: Every threshold doubles for joint filers EXCEPT the highest: $500,000 single vs $750,000 married, not $1,000,000. Easy to get wrong, and it puts a joint filer at $800,000 in the top tier when naive doubling would not.

The Part B figures above are the total monthly premium at each tier, not the surcharge on its own.

Source: SSA — POMS HI 01101.020 — IRMAA Sliding Scale Tables. Effective 2026. Reviewed annual.

48 contiguous states and DC. These drive ACA marketplace subsidies — and note the timing: 2026 marketplace coverage — an ACA coverage year uses the guidelines published in the PRIOR calendar year. Alaska and Hawaii have higher guidelines, which we do not list.

Each additional person adds $5,500. The 400% column matters because it is the ACA subsidy cliff: above it the premium tax credit is lost entirely, not reduced.

Source: HHS / ASPE — Annual Update of the HHS Poverty Guidelines (Federal Register 2025-01377). Effective 2025. Reviewed annual.

What this costs in practice

A single retiree whose modified AGI two years ago was $90,000 pays $2,435 a year for Parts B and D. The same retiree at $250,000 pays $8,790 — a difference of $6,355 a year, decided by a tax return filed 2 years earlier.

That is why the lookback matters when you plan a conversion. Model it against your own numbers and the engine will show the surcharge in the year it actually lands.

Key facts

• The standard monthly Medicare Part B premium for 2026 is $202.90, per SSA (POMS HI 01101.031 — How IRMAA is Calculated and How IRMAA Affects the Total Medicare Premium).
• IRMAA — the Medicare surcharge for higher incomes — is set from the income on your tax return from 2 years earlier, so a Roth conversion today can raise your Medicare premium two years from now.
• A single filer with modified AGI above $109,000 pays an IRMAA surcharge; for married filing jointly the threshold is $218,000.
• The 2025 federal poverty guideline for the 48 contiguous states is $15,650 for one person and $32,150 for a household of four, rising $5,500 per additional person.
• An ACA coverage year uses the poverty guidelines published in the PRIOR calendar year, so 2025 guidelines govern 2026 marketplace subsidies.
• Every IRMAA income threshold is double for joint filers except the highest, which is $500,000 for a single filer and $750,000 for a couple — not double.

How we keep this current

Each figure carries the date it was last read at its source, shown above. A scheduled job re-checks them: where the publishing agency offers a machine-readable feed — as HHS does for the poverty guidelines — the value is compared exactly and any change is flagged. Where the figure lives in a fact sheet or a PDF, the job confirms the source still resolves and flags the entry for a human to re-read.

Deliberately, it does not scrape a number out of a table and publish it. A misread table is worse than an old one, because it arrives wearing a citation. And a source it cannot reach is reported as broken, never as unchanged — those look identical and mean opposite things.