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IRMAA tier 2 (2026): income thresholds and cost

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Tier 2 thresholds and surcharges

Filing status MAGI from MAGI up to Monthly surcharge / person Annual surcharge / person
Single / HoH $137,000 $171,000 $240.40 $2,884.80
Married filing jointly $274,000 $342,000 $240.40 $2,884.80

Surcharges are per enrolled Medicare beneficiary and apply to both Part B and Part D (the Part D figure is the surcharge on top of your plan premium). All premiums are based on your MAGI from two years prior.

Crossing into tier 2

Tier 2 is a cliff threshold: one dollar of MAGI above $137,000 (single) or $274,000 (MFJ) triggers the full tier-2 surcharge, not a proportional amount. The step up from the previous tier costs $144.70/month per person ($1,736.40/year). Because IRMAA uses a two-year lookback, the income that lands you in this tier was earned two years before the premiums hit.

The tier 2 cliff as a tax rate

Because the step is all-or-nothing, the cost of crossing depends on how far you cross. The table divides one premium year of the tier-2 step ($1,736.40 for one enrollee, $3,472.80 for a married couple with both enrolled) by the MAGI above the threshold. A conversion that overshoots by $1,000 pays the step at an effective 174% on those dollars (single), on top of income tax.

MAGI over the tier 2 threshold Effective rate, single Effective rate, couple (both enrolled)
$1,000 174% 347%
$5,000 35% 69%
$10,000 17% 35%
$25,000 6.9% 14%

Filling all of tier 2 ($34,000 wide for single filers, $68,000 for joint) spreads the same step over the whole width: 5.1% single, 5.1% for a couple. The rule that falls out: stop under the threshold, or cross it by enough to dilute the step without reaching the next one. Small overshoots are the expensive case.

Headroom before tier 2

Headroom is the gap between a starting MAGI and the tier-2 threshold. A conversion smaller than the room keeps MAGI below the cliff; a conversion larger than the room crosses it.

Starting MAGI Room before tier 2 (single) Room before tier 2 (MFJ)
$80,000 $57,000 $194,000
$120,000 $17,000 $154,000
$180,000 $0 $94,000
$250,000 $0 $24,000

Escape hatches

Model IRMAA tier 2 in the calculator