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IRMAA tier 5 (2026): income thresholds and cost

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Tier 5 thresholds and surcharges

Filing status MAGI from MAGI up to Monthly surcharge / person Annual surcharge / person
Single / HoH $500,000 and above $578.00 $6,936.00
Married filing jointly $750,000 and above $578.00 $6,936.00

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 5

Tier 5 is a cliff threshold: one dollar of MAGI above $500,000 (single) or $750,000 (MFJ) triggers the full tier-5 surcharge, not a proportional amount. The step up from the previous tier costs $48.40/month per person ($580.80/year). Because IRMAA uses a two-year lookback, the income that lands you in this tier was earned two years before the premiums hit.

Headroom before tier 5

Headroom is the gap between a starting MAGI and the tier-5 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 5 (single) Room before tier 5 (MFJ)
$80,000 $420,000 $670,000
$120,000 $380,000 $630,000
$180,000 $320,000 $570,000
$250,000 $250,000 $500,000

Escape hatches

Model IRMAA tier 5 in the calculator