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How are Medicare Part B/D IRMAA (Income-Related Monthly Adjustment Amount) surcharges handled?

Remember that Medicare Premiums use a two-year lookback.

Medicare looks at income (in the form of MAGI - Modified Adjusted Gross Income) from two tax years prior to determine the Part B/D Premium IRMAA adjustments. There are multiple calculations for MAGI based on the planning application, but for Medicare Part B/D Premium purposes, MAGI is equal to:

Adjusted Gross Income (AGI) + Tax-Exempt Interest


A taxpayer's MAGI from 2026 will impact Medicare Part B/D Premiums in 2028. That impact will only apply for one tax year and is reassessed annually. For example, 2026 income only affects 2028 Medicare Part B/D Premiums and 2027 income only affects 2029 premiums. This can be challenging to plan around, since income this year affects Medicare Part B/D Premiums two years in the future, and those Premiums and MAGI thresholds have yet to be published. 

Reminder: Even though clients may not be eligible for Medicare, their income this year could impact Medicare Premiums in the future if they are within two years from becoming a Medicare participant. Therefore, generally beginning at age 63, advisors will want to pay attention to their client's income to gauge if any planning done in that year will impact the amount they pay for Medicare Part B/D Premiums.


These IRMAA income thresholds and associated IRMAA surcharges for Medicare Parts B and D can be seen on the Tax Report, within the MAGI section of Scenario Analysis, or within our Range Calc tool. 

Although MAGI brackets and surcharge amounts are not yet published for tax years beyond 2026, Holistiplan defaults to applying the most recent officially released brackets and surcharges to remain conservative. This is because even exceeding a given threshold by a single dollar will subject the taxpayer to increased surcharges for the year. 

To elect to have MAGI brackets and surcharge amounts inflate, check the Inflate MAGI Thresholds in Tax Report and Range Calc box. This will inflate bot the bracket and surcharges by the inflation assumption provided in the line above. 


Caution: This checkbox does not impact the tax calculation itself. It will only impact the MAGI bracket and surcharge amounts displayed on the Tax Report, Scenario Analysis, and Range Calc.


The Centers for Medicare and Medicaid Services publishes Medicare values for the following year in each calendar year, generally in October or November. The 2026 brackets impacted by 2024 income were published on November 14, 2025. When new values are published, those updated numbers are  incorporated into Holistiplan.