If your 2024 MAGI was $380,000 and you file married filing jointly, here's exactly what you pay for Medicare in 2026 — and how close you are to the next bracket.
Quick answer: At $380,000 (married filing jointly), your 2026 Medicare Part B premium is $527.50/mo and Part D IRMAA is $60.40 + plan/mo — about $4,620 extra per year above the standard premium. IRMAA is a per-bracket cliff set by your 2024 MAGI; if your income later dropped from a life-changing event, you can appeal with Social Security form SSA-44.
At $380,000 (married filing jointly), you're in 2026 IRMAA tier 3 of 5, so you pay $527.50/month for Part B — that's $324.60/mo more than the standard $202.90 — plus a $60.40/month Part D IRMAA surcharge added on top of your drug plan. Together that's about $4,620 in extra Medicare cost this year versus someone below the first threshold ($218,000). IRMAA is a cliff, not a slope: one dollar over a bracket triggers the full higher amount.
Your 2024 MAGI of $380,000 sits $37,999 into tier 3 (which begins at $342,001). The next IRMAA cliff is at $410,001 — so you have about $30,001 of headroom before your premium jumps to the next tier. If your income tends to vary year to year, that headroom is the number to watch: cross it on your 2024 return and the higher 2026 premium applies for the full year.
If a life-changing event — retirement, work stoppage, divorce, or the death of a spouse — reduced your 2024 MAGI below $342,001, you'd move down to tier 2 and save roughly $1,735 per year in 2026. You request that recalculation with form SSA-44 and proof of the event; Social Security can use a more recent or estimated year instead of 2024. Even without a qualifying event, income planning (Roth-conversion timing, QCDs from an IRA, harvesting gains in a lower year) is how people manage which side of $342,001 they land on.
This page covers $380,000 (married filing jointly). Use the free calculator for any income and filing status, plus the full bracket table and how to appeal with form SSA-44.
Open the 2026 IRMAA Calculator →Yes. $380,000 (married filing jointly) is over the first 2026 IRMAA threshold ($218,000), so an income surcharge applies on both Part B and Part D.
Your 2024 Modified Adjusted Gross Income (MAGI) — adjusted gross income plus tax-exempt interest. Social Security uses a two-year lookback, so your 2026 premium is set by the income on your 2024 tax return.
Yes. If a life-changing event (retirement, divorce, death of a spouse, loss of income) lowered your income, file form SSA-44 to have IRMAA recalculated — dropping below $342,001 in MAGI would save about $1,735/yr here. You can also manage MAGI with Roth-conversion timing, QCDs, and capital-gains timing.
Run IRMAA for your whole book + print SSA-44 appeal language with the IRMAA Calculator & Appeal Toolkit.
See the agent tools on Etsy →2026 IRMAA figures are verified against U.S. government primary sources: