IRMAA: The Uninvited Retirement Guest
IRMAA has a way of showing up in retirement the same way an unexpected guest appears at your front door an hour before dinner. You did not invite her, you certainly did not plan for her, and yet she still finds a way to increase your Medicare costs. The Income Related Monthly Adjustment Amount known as IRMAA is an added charge to Medicare Part B and Medicare Part D premiums for people whose income is above specific thresholds. It is based on your Modified Adjusted Gross Income from two years earlier which means your 2026 premiums are determined from your 2024 tax return. With thoughtful planning many retirees can reduce or avoid these added charges although pensions withdrawals and investment income can make planning more complex.
Basic Structure
The standard Medicare Part B premium for 2026 is $202.90 per month² (based on CMS data available as of January 2026).
If your 2024 Modified Adjusted Gross Income is above $109,000 for single filers or above $218,000 for joint filers you will owe an IRMAA surcharge.
Medicare Part D premiums can also include added charges for higher income households³.
2026 IRMAA Brackets
| Single Filers | Joint Filers | Income Related Monthly Adjustment Amount | Total Monthly Premium Amount |
|---|---|---|---|
| Less than or equal to $109,000 | Less than or equal to $218,000 | $0.00 | $202.90 |
| Greater than $109,000 and less than or equal to $137,000 | Greater than $218,000 and less than or equal to $274,000 | $81.20 | $284.10 |
| Greater than $137,000 and less than or equal to $171,000 | Greater than $274,000 and less than or equal to $342,000 | $202.90 | $405.80 |
| Greater than $171,000 and less than or equal to $205,000 | Greater than $342,000 and less than or equal to $410,000 | $324.60 | $527.50 |
| Greater than $205,000 and less than $500,000 | Greater than $410,000 and less than $750,000 | $446.30 | $649.20 |
| Greater than or equal to $500,000 | Greater than or equal to $750,000 | $487.00 | $689.90 |
For married people who file separately the thresholds differ and anyone above $109,000 will face IRMAA charges².
Why This Matters for Retirees in O’Fallon Illinois
Many O’Fallon residents retire from Scott Air Force Base or from organizations such as DITCO DISA or Transcom. These retirees often receive a FERS pension and take withdrawals from the Thrift Savings Plan. These income sources count toward Modified Adjusted Gross Income and can trigger IRMAA. Even with Federal Employees Health Benefits in place Medicare becomes your primary coverage at age 65 and IRMAA still applies to Medicare premiums. The Illinois State Health Insurance Assistance Program offers free guidance for Medicare issues⁴.
Common Mistakes That Cause IRMAA Charges
Income spikes
Large capital gains home sales Roth conversions or significant retirement account withdrawals can push income above IRMAA thresholds. Even if the event happens one time IRMAA applies two years later⁵.
Missing the appeal opportunity
If your income has dropped since 2024 you may qualify for a reduced IRMAA level through the Social Security appeal process. Many retirees never file the required form⁶.
Delaying Medicare Part B enrollment
Avoiding Medicare Part B does not prevent IRMAA and can create late enrollment penalties and gaps in coverage.
Overlooking tax exempt interest
Interest from municipal bonds still counts toward Modified Adjusted Gross Income even though it is not federally taxable⁵.
Incorrect coordination with Federal Employees Health Benefits
FEHB does not reduce or eliminate IRMAA. Only income planning can prevent Medicare income related surcharges.
Strategies to Reduce or Avoid IRMAA in 2026
Qualified Charitable Distributions
People age 70 and one half or older can donate directly from an IRA to a qualified charity. This satisfies required minimum distributions without raising income.
Roth conversion timing
For certain individuals converting retirement funds to Roth during lower income years reduces future taxable withdrawals and limits future IRMAA exposure.
Maximizing traditional contributions
Increasing contributions to pretax retirement plans during 2024 may lower Modified Adjusted Gross Income and reduce IRMAA in 2026.
Delaying Social Security benefits
In some cases delaying Social Security can keep income lower in early Medicare years and may help avoid IRMAA for that period.
Appealing with Form SSA 44
If you experienced a qualifying life change such as retirement marriage divorce or the death of a spouse you may request a lower IRMAA determination⁶.
Special Considerations for Federal and Military Retirees
Scott Air Force Base is a major employer in the region, and many retirees have a combination of FERS annuity income TSP withdrawals and sometimes TRICARE. Because pensions and TSP withdrawals increase Modified Adjusted Gross Income planning around withdrawal timing is often essential. The Retiree Activities Office at the base and Illinois SHIP offer helpful local guidance. Learn more about your TSP Rollover Options to maximize retirement savings and reduce future tax impact.
Final Thoughts
IRMAA can create a significant added expense but with proper planning most retirees can reduce or avoid it. Review your 2024 income now and determine which 2026 IRMAA tier may apply to you. Consider strategies such as Qualified Charitable Distributions retirement withdrawal planning or filing an appeal if your income has changed. Retirees in O'Fallon and the Scott Air Force Base region may benefit from guidance that understands federal and military benefit systems.
References
- ¹ https://www.marketwatch.com/story/medicare-part-b-premiums-will-rise-in-2026-wiping-away-a-third-of-social-securitys-cola-abb08324
- ² https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- ³ https://www.kiplinger.com/retirement/medicare/medicare-premiums-2026-irmaa-brackets-and-surcharges-for-parts-b-and-d
- ⁴ https://www2.illinois.gov/aging/ship
- ⁵ https://www.medicareresources.org/blog/four-ways-to-avoid-income-related-medicare-surcharges
- ⁶ https://www.ssa.gov/forms/ssa-44.pdf
Disclosure
This material is provided for informational and educational purposes only and should not be construed as individualized investment, tax, or financial advice. The information is based on sources believed to be reliable as of the publication date; however, accuracy cannot be guaranteed and may change without notice. Any examples provided are hypothetical and for illustrative purposes only. Strategies discussed may not be appropriate for all individuals. Consult a qualified financial professional, tax advisor, or attorney for advice specific to your circumstances. Medicare premiums, IRMAA brackets, and tax rules are subject to change. Clark Wealth Partners is not affiliated with CMS, SSA, the Department of Defense, or any federal agency.