If you are new to Medicare in California or you just received a letter from Social Security that adjusted your premium, there is a good chance the three letters confusing you are IRMAA. The Income Related Monthly Adjustment Amount is one of the most misunderstood parts of Medicare. It is not a penalty and it is not a separate plan. It is an income-based surcharge on top of the Part B premium, and for a growing number of Californians it shows up as a surprise the first year on Medicare. This guide walks through the 2026 brackets, how Social Security decides what you pay, and how to appeal if your situation has changed.
The Standard Part B Premium in 2026
The standard Medicare Part B premium for 2026 is $206.50 per month. The annual Part B deductible is $257. Every Californian on Medicare pays this baseline unless their income is low enough to qualify for a Medicare Savings Program, or high enough to trigger IRMAA. The premium is usually deducted directly from your Social Security benefit, so you may never see a bill at all.
Because Medicare is a federal program, the $206.50 does not change depending on whether you live in Los Angeles, Fresno, or Humboldt County. What changes by ZIP code is the Medicare Advantage and Medigap landscape. For help understanding how those plans layer on top of Part B, see our guide to Medicare Supplement plans in California.
What IRMAA Is and How It Works
IRMAA is a monthly surcharge that kicks in when your modified adjusted gross income (MAGI) crosses a federal threshold. MAGI is your adjusted gross income plus any tax-exempt interest. The Social Security Administration pulls this number from your tax return two years before the premium year. So your 2026 IRMAA is based on your 2024 tax return.
That two-year lookback is the part that surprises most people. A California professional who retired in 2025 could still be paying IRMAA in 2026 based on the year they were still earning a full salary. The good news is that this is fixable with a simple appeal, which we cover below.
2026 Part B IRMAA Brackets
| Single Filer (2024 MAGI) | Joint Filer (2024 MAGI) | Total Monthly Part B Premium |
|---|---|---|
| $109,000 or less | $218,000 or less | $206.50 |
| $109,001 to $137,000 | $218,001 to $274,000 | $289.10 |
| $137,001 to $171,000 | $274,001 to $342,000 | $412.90 |
| $171,001 to $205,000 | $342,001 to $410,000 | $536.70 |
| $205,001 to $499,999 | $410,001 to $749,999 | $660.50 |
| $500,000 and above | $750,000 and above | $701.80 |
The Part D IRMAA is a separate, smaller surcharge added on top of whatever Part D plan premium you choose. It ranges from about $13.70 per month at the first bracket to $85.80 at the highest bracket in 2026.
Why California Hits IRMAA More Often Than Most States
California is the state with the largest share of new Medicare enrollees paying IRMAA. Three reasons drive this. First, salary levels in metro California push retirees into higher brackets in their final working years. Second, real estate sales, especially a long-held home in the Bay Area or Los Angeles, can add hundreds of thousands in capital gains to a single tax year. Third, Roth conversions and required minimum distributions from large retirement accounts can bump MAGI higher than expected.
None of these situations is permanent. Selling a home is usually a one-time event. Earning a full salary ends at retirement. That is why the appeal process exists.
How to Appeal IRMAA with Form SSA-44
If you had a qualifying life changing event, you can ask Social Security to use a more recent income estimate instead of your two-year-old tax return. Events that qualify include marriage, divorce, the death of a spouse, stopping or reducing work, loss of a pension, or the loss of income-producing property that was not a voluntary sale.
Steps to File the Appeal
First, download Form SSA-44 from the Social Security website. Second, complete the event section and attach proof: a marriage certificate, a divorce decree, a death certificate, a retirement letter from your employer, or documentation that the pension ended. Third, provide an estimate of your expected MAGI for the current year based on your new situation. Fourth, submit the form in person at a California Social Security office or by mail. Social Security usually decides within 30 to 60 days and will refund overpaid months if the decision is in your favor.
Help for Lower Income Californians
On the other end of the spectrum, California offers Medicare Savings Programs through Medi-Cal that can pay your Part B premium entirely. Income limits for 2026 are roughly $1,325 per month for the QMB program and $1,585 for SLMB for a single person, with higher limits for couples. These programs also pay cost sharing and, in the case of QMB, eliminate most out-of-pocket hospital and doctor charges. If your income is near those limits, it is worth applying. For a closer look at how Medicare and Medi-Cal work together, see our guide on dual Medi-Cal and Medicare benefits.
What to Do Next
If you are new to Medicare, check the bracket table above with your 2024 tax return before your first premium is deducted. If you are already paying IRMAA and had a recent life change, start the SSA-44 appeal sooner rather than later. And if you are shopping for Part D or Medicare Advantage plans, remember that the Part D IRMAA follows you no matter which plan you pick, so choosing a slightly cheaper Part D plan does not reduce the surcharge.
For Spanish-speaking family members managing their parents' Medicare, our sister site BeneficiosMedicare.com covers these rules in Spanish with California-specific detail.
Frequently Asked Questions
How much is Medicare Part B in California in 2026?
$206.50 per month is the standard premium. Higher income filers pay an IRMAA surcharge on top.
What income counts toward IRMAA?
Modified adjusted gross income, which is your AGI plus tax-exempt interest. Social Security uses the tax return filed two years earlier.
Can I appeal IRMAA?
Yes, using Form SSA-44, if you had a qualifying life changing event like retirement, divorce, or the death of a spouse.
Does selling my California home trigger IRMAA?
It can. Capital gains from a home sale count as income and can push you into a higher bracket for two years. A home sale is not a qualifying event for an SSA-44 appeal.
Worried about a Medicare premium surprise in 2026? A free 15-minute review with a licensed California Medicare agent can map your 2024 income against the brackets and flag any appeal opportunities before your first bill.
Share this with someone you love. A parent or friend about to turn 65 in California deserves to see the IRMAA brackets before their first Part B letter arrives.