Medicare IRMAA in New York: What Triggers the Surcharge and How to Get Out of It

If you live in New York and your income is above $109,000 as a single filer or $218,000 filing jointly, you pay more than the standard Medicare premium in 2026. That extra charge is IRMAA, the Income-Related Monthly Adjustment Amount, and it lands on both your Part B and your Part D premium.

The timing is what catches people. Social Security sets your 2026 IRMAA using the tax return you filed for 2024. The income you had two years ago decides what you pay this year.

One thing to get out of the way: the IRMAA brackets are federal. A NY retiree and a retiree three states over with identical income pay identical surcharges. What does change by state is the Part D plan premium the surcharge gets added to, and the Medigap premium sitting alongside it.

How IRMAA actually works

The standard Medicare Part B premium is $202.90 a month in 2026, which is one piece of what Medicare costs this year. Most New York residents pay exactly that.

If you don't, Social Security has pulled your modified adjusted gross income from IRS records, matched it against six income tiers, and billed you for the tier you landed in. MAGI is your adjusted gross income plus tax-exempt interest. Municipal bond income counts here even though you don't pay tax on it, including New York bonds.

Two details do most of the damage:

• IRMAA is charged per person. If you and your spouse are both on Medicare and your joint income clears a threshold, you each pay the surcharge. Two premiums, two surcharges.
• The brackets are cliffs. One dollar over a threshold puts you in the full next tier. There's no partial credit, no phase-in.

That second one stings. A single filer at $109,001 pays $81.20 more per month for Part B than a single filer at $109,000, plus $14.50 more for Part D. Call it $1,148 over the year for one extra dollar of income.

The 2026 IRMAA brackets

All of these are based on your 2024 MAGI, and they apply the same way in New York as everywhere else. The Part B column is your total monthly premium. The Part D column is a surcharge added on top of whatever your New York drug plan charges.

Married and filing separately gets its own treatment, and it's rough. Over $109,000 you jump straight to $649.20 for Part B. At $391,000 and up it's $689.90.

At the top bracket you're paying about $6,936 more per year than someone on the standard premium. Per person. That lands on top of whatever Medigap plan you carry, and Plan G pricing swings hard by state, so two retirees with the same surcharge can still have very different total bills.

What actually pushes New York retirees over the line

Most people who open an IRMAA notice weren't pulling a big salary in 2024. They had one unusual year.

"Many people may have an unexpected IRMAA if they aren't aware of what can cause it," says Mark Bilgere, a licensed Medicare agent in Bedford, Texas. "In addition to a high salary, the sale of a business, the sale of a second home or a large distribution from a qualified account could cause an IRMAA."

The usual suspects:

• A Roth conversion
• Required minimum distributions, especially the first one
• Capital gains from selling a rental or a second home, which hits New York residents who downsized or sold property in 2024
• A lawsuit or insurance settlement
• Interest from CDs and savings accounts, which caught a lot of retirees off guard once rates climbed
• Inherited IRA distributions

Run the math before you pull a large withdrawal. An extra $2,000 of income that trips you into the next bracket can cost more in premiums than the withdrawal was worth. Medicare is full of that kind of math, and a few plan and withdrawal choices can quietly raise your tax bill in ways that never show up on a notice. The same goes for running the numbers before you pick a plan in the first place.

How long does IRMAA last in New York?

One year at a time. It is not permanent and it does not follow you around, in New York or anywhere else.

Social Security re-runs the calculation every fall for the coming year, always reaching back two tax years. Your 2026 surcharge came from 2024. Your 2027 surcharge will come from 2025. If your income dropped back to normal, the surcharge drops off on its own. You don't file anything.

So a one-time spike doesn't lock you in. It costs you for twelve months, two years later, and then it's gone.

The brackets themselves also move. They're indexed to inflation, which is why the single-filer threshold went from $106,000 for 2025 to $109,000 for 2026.

Worth knowing: an IRMAA surcharge is a separate animal from the Part B late enrollment penalty and the Part D late enrollment penalty. Those two really can stick with you for life. IRMAA won't.

Getting out early with Form SSA-44

You don't always have to wait for the two-year lag to catch up. If a specific event cut your income, you can ask Social Security to use a current-year estimate instead of the old tax return.

There are 8 qualifying life-changing events:

1. Marriage
2. Divorce or annulment
3. Death of a spouse
4. You or your spouse stopped working
5. You or your spouse reduced work hours
6. Loss of income-producing property through something outside your control, like a disaster or fraud
7. Loss or reduction of pension income
8. An employer settlement payment after bankruptcy or reorganization

Retirement is the big one. If you retired in 2025 and your 2024 return still shows a full working salary, SSA-44 is how you fix 2026 instead of overpaying all year. This comes up constantly for people who stayed on employer coverage past 65 and then finally stopped working.

"If that life event reduces your modified adjusted gross income to a lower level or completely removes you from IRMAA charges, it is well worth your time to submit that form," says Kevin Chaikin, a licensed Medicare agent in Reston, Virginia. "You may need documentation depending on the life changing event. Expect up to 8 weeks for the appeal to be processed."

Bring proof. A retirement letter, a death certificate, a pension termination notice, whatever matches the event you're claiming. An estimate of your new income helps too. You can mail the form or take it to a Social Security field office in New York, and dropping it off in person tends to be faster than mailing it.

What doesn't qualify: a Roth conversion, a large RMD, selling stock, or capital gains from a home you chose to sell. Those were your decisions. SSA-44 covers income you lost. Income you chose to realize doesn't count.

When the numbers themselves are wrong

Different problem, different fix. If Social Security used a return you later amended, or the IRS data is simply wrong, you request a new initial determination and hand over the corrected return or an IRS transcript. No SSA-44 needed for that one. Call Social Security at 1-800-772-1213 or take it to your local NY office.

This happens more than you'd think with corrected 1099s and reclassified distributions.

Staying under the threshold on purpose

If you're close to a bracket line, a few moves help:

• Spread withdrawals across tax years rather than taking one big distribution. Two $40,000 withdrawals in different years can keep you under a line that one $80,000 withdrawal blows past.
• Use qualified charitable distributions. After 70 and a half, giving directly from an IRA to charity satisfies your RMD without adding a dollar to MAGI.
• Do Roth conversions early. Because of the two-year lookback, a conversion at 62 never touches your Medicare premiums. A conversion at 64 shows up on your first Medicare bill, so this is worth sorting out while you're still working through the turning-65 checklist.
• Harvest losses to offset gains in a year you're already near a line.
• Watch your HSA. Contributions have to stop once you enroll in Medicare, but the balance you already built can pay Part B premiums tax-free, surcharge included.

Worth looping in a tax professional if you're within a few thousand dollars of a threshold. The brackets are published every fall for the following year, so you usually have time to plan. A local New York agent can tell you how the surcharge stacks on the specific plans sold in your county, which is where the state-level differences actually show up.

The Part D side of the surcharge

The Part D piece works differently from Part B. Social Security bills it separately, even though your Part D plan premium itself goes to your insurer. You can get a bill from Social Security for a surcharge on a plan you pay someone else for, which confuses almost everyone the first time.

The surcharge doesn't change your benefits. Your $2,000 out-of-pocket cap and your formulary stay exactly the same. If the combined cost is squeezing you, shopping Part D plans available in your New York county during open enrollment is the lever you actually control, and the Medicare Prescription Payment Plan can spread the drug costs across the year even if it can't touch the surcharge.

Open enrollment runs October 15 through December 7, which lines up neatly with when IRMAA notices arrive.

If your income runs the other way

IRMAA only pushes premiums up. On the low end there's a separate set of programs that push them down. Extra Help with Part D costs and the Medicare Savings Programs can cover premiums, deductibles, and copays outright if you qualify, and the income limits are higher than most New York residents assume. Some New York Medicare Advantage plans also offer a Part B give back benefit that knocks a chunk off the standard premium.

Free one-on-one counseling is available through New York's State Health Insurance Assistance Program (SHIP) if you want help sorting out which bucket you're in.

What to do when the notice shows up

IRMAA determination letters go out in the fall, usually November or December, for the year ahead. When yours arrives:

1. Check which tax year it used and confirm the income figure matches your return.
2. If the figure is wrong, request a new initial determination with documentation.
3. If the figure is right but your situation changed because of one of the 8 life events, file Form SSA-44.
4. If the figure is right and nothing changed, budget for it and look at whether you can keep next year's MAGI lower.

You have 60 days from the date of the notice to request a formal appeal through Social Security, though a new initial determination request has no such deadline.

And if you're moving into or out of NY, the surcharge travels with you. Changing your plan when you relocate is a separate process that has nothing to do with IRMAA.