Complete 2026 Medicare IRMAA premium surcharge brackets for MFJ and Single filers. How a big capital-gains sale year creates a 2-year-forward IRMAA hit, and how to structure to avoid it.
By Hans Goldstein, EA, Tax & Exit Planning · Updated
Admitted to practice before the IRS.
Send me the sale price and rough basis. Within one business day I'll email you the actual number and the Seller's Guide to §453. If it doesn't fit your deal, I'll tell you that plainly.
No retainer · no obligation. Hans Goldstein, a licensed insurance agent (CA Insurance License #4273294), will contact you and may discuss insurance products, including annuities.
IRMAA (Income-Related Monthly Adjustment Amount) is the Medicare premium surcharge tied to your income from two years prior. If your modified adjusted gross income (MAGI) in 2026 lands above certain thresholds, you'll pay higher Part B and Part D premiums in 2028. For California sellers age 63+, a single big-gain year can push you into the maximum IRMAA tier for one year, costing $5,000-$14,000 per couple on Medicare.
| 2024 MAGI (MFJ), sets 2026 premiums | Part B surcharge/mo | Part D surcharge/mo | Annual cost/couple |
|---|---|---|---|
| Under $218,000 | $0 | $0 | $0 |
| $218,000 to $274,000 | +$81.20 | +$14.50 | ~$2,297 |
| $274,000 to $342,000 | +$202.90 | +$37.50 | ~$5,770 |
| $342,000 to $410,000 | +$324.60 | +$60.40 | ~$9,240 |
| $410,000 to $750,000 | +$446.30 | +$83.30 | ~$12,710 |
| Over $750,000 | +$487.00 | +$91.00 | ~$13,870 |
The IRS uses your MAGI from 2 years prior to set your current-year Medicare premium. So:
The structured installment sale spreads your gain recognition across 5-40 years. Each year's recognition is small, often staying below the $218K MFJ no-surcharge threshold entirely. On a $4M sale spread over 30 years, annual MAGI might be $90K ordinary + $130K gain + $40K interest = $260K → Tier 2 instead of Tier 6. The IRMAA cost difference can be $100,000+ over the term.
For a 63+ California seller with a $1M+ gain, IRMAA is often the cost that sinks the cash-sale option. The 2-year lookback means the bill arrives long after the seller stops thinking about the tax consequences.
The installment sale calculator on this site models the 2-year IRMAA lookback automatically, comparing your cash-sale IRMAA hit against the spread-out installment sale path.
Run the calculator → 213-414-2808
A plain-English guide for sellers on how a structured installment sale can help you net more after tax when you sell a business, practice, or property. It covers the math, the alternatives, and how to tell if your deal fits.
Leave your details and the PDF downloads right away. Within one business day Hans will email a preliminary read on which structure fits your deal. No retainer. On a funded structure, the insurer pays a one-time commission of about 4% of the amount structured to the brokerage firm that places it (Hans’s share is about 2.4%; no trail). It is built into the annuity pricing, not a separate fee.
📞 Hans Goldstein · 213-414-2808 · CA Insurance License #4273294 · Independent §453 specialist · Goldstein & Co. LLC
Hans Goldstein, a licensed insurance agent (CA Insurance License #4273294), will contact you and may discuss insurance products, including annuities.
2026 monthly surcharge per person, set by 2024 modified AGI
| Joint MAGI (2024) | Single MAGI (2024) | Part B surcharge | Part D surcharge |
|---|---|---|---|
| $218,000 or less | $109,000 or less | $0 | $0 |
| $218,001 to $274,000 | $109,001 to $137,000 | $81.20 | $14.50 |
| $274,001 to $342,000 | $137,001 to $171,000 | $202.90 | $37.50 |
| $342,001 to $410,000 | $171,001 to $205,000 | $324.60 | $60.40 |
| $410,001 to $749,999 | $205,001 to $499,999 | $446.30 | $83.30 |
| $750,000 and up | $500,000 and up | $487.00 | $91.00 |
Source: CMS, 2026 Medicare Parts A and B Premiums and Deductibles fact sheet (standard Part B premium $202.90), checked October 3, 2026. Surcharges are added to the standard Part B premium and to your Part D plan premium.
Keep modified AGI two years earlier under the next threshold: spread a large gain with an installment sale, time Roth conversions, use qualified charitable distributions from an IRA after 70½, and harvest losses. If your income dropped because of a life-changing event such as retirement or loss of a spouse, file Form SSA-44 to ask Social Security to use a more recent year.
Not as of October 3, 2026. CMS usually announces the next year's Part B premium and IRMAA amounts in October or November. The 2027 brackets will apply to 2025 modified AGI, and the thresholds are inflation-indexed, so they are expected to start a little above the 2026 levels of $109,000 single and $218,000 joint.
Yes, each spouse on Medicare pays the surcharge on their own premium, based on the couple's joint modified AGI if you file jointly. So a married couple in the top 2026 tier pays $487.00 a month each for Part B on top of the standard premium, plus each person's Part D surcharge. Married filing separately uses much lower thresholds and is usually worse.
Joint filers: $218,000 to $274,000, $274,000 to $342,000, $342,000 to $410,000, $410,000 to $750,000, and over $750,000. Single filers: $109,000 to $137,000, $137,000 to $171,000, $171,000 to $205,000, $205,000 to $500,000, and over $500,000. The table on this page lists the Part B and Part D surcharge for each tier.
Sources: CMS 2026 Medicare Parts A and B premiums; SSA-44 life-changing event form; SSA: Medicare premiums. Checked October 3, 2026.
Hans Goldstein is an Enrolled Agent, admitted to practice before the Internal Revenue Service. Not affiliated with or endorsed by the IRS. General education, not tax or legal advice for your situation.
