If you’re signing up for Medicare and your income is over $108,000 as an individual or $216,000 as a married couple, you may pay higher premiums in 2026. This is due to a rule called IRMAA, or Income-Related Monthly Adjustment Amount.

Medicare uses your tax return from two years earlier to determine if IRMAA applies. So for 2026, they’ll look at your 2024 income. If it’s above the set limits, your monthly premiums for Medicare Part B and Part D will increase.

The higher your income, the more you’ll pay, with several income tiers that affect the total cost. These thresholds are reviewed each year and may adjust with inflation.

If you’ve had a life change that reduced your income, like retirement or the death of a spouse, you may be able to ask Social Security to lower your IRMAA amount.

Understanding how your income affects Medicare costs is key to planning. Knowing where you stand before enrolling can help avoid surprises.