Medicare IRMAA in Tennessee: 2026 Overview
| IRMAA Starts At | $103,000/year individual income (from 2024 tax return) |
|---|---|
| Maximum Part B Surcharge | $384.30/month above standard premium |
| Maximum Part D Surcharge | $81.00/month above plan premium |
| Income Used | Your 2024 Modified Adjusted Gross Income (MAGI) |
| Can You Appeal? | Yes — if your income has decreased since 2024 |
What Is IRMAA?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to your Medicare Part B and Part D premiums if your income exceeds certain thresholds. In Tennessee, as in all states, IRMAA is determined by your Modified Adjusted Gross Income (MAGI) from your federal tax return two years prior. For 2026 premiums, SSA uses your 2024 income. IRMAA affects approximately 7% of Medicare beneficiaries nationally.
2026 IRMAA Brackets for Tennessee Residents
| Individual Income (2024) | Joint Income (2024) | Part B Premium | Part D Surcharge |
|---|---|---|---|
| $103,000 – $129,000 | $206,000 – $258,000 | $174.70/mo | +$0.00/mo |
| $129,000 – $161,000 | $258,000 – $322,000 | $244.60/mo | +$12.90/mo |
| $161,000 – $193,000 | $322,000 – $386,000 | $349.40/mo | +$33.30/mo |
| $193,000 – $500,000 | $386,000 – $750,000 | $454.20/mo | +$53.80/mo |
| Over $500,000 | Over $750,000 | $559.00/mo | +$81.00/mo |
How IRMAA Is Calculated in Tennessee
SSA uses your 2024 federal tax return to determine your 2026 IRMAA. If you had a life-changing event that reduced your income — such as retirement, divorce, death of a spouse, or loss of income-producing property — you can appeal your IRMAA determination and request that SSA use a more recent year’s income instead.
How to Appeal IRMAA in Tennessee
To appeal your IRMAA determination, file Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event) with your local Social Security office. Qualifying life-changing events include: marriage, divorce, death of spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, and employer settlement payment. You must provide documentation of the life-changing event and your estimated current income.
IRMAA and Tennessee State Taxes
IRMAA is a federal surcharge — it applies equally to all Medicare beneficiaries regardless of which state they live in. However, Tennessee residents should be aware that state income taxes may affect their MAGI calculation. Consult a tax advisor or CPA if you are near an IRMAA threshold to explore strategies for managing your Medicare costs through income planning.
Medicare Savings Programs in Tennessee
If your income is below the IRMAA threshold but you still struggle with Medicare costs, Tennessee offers Medicare Savings Programs (MSPs) that can help pay your Part B premium and other costs. The Qualified Medicare Beneficiary (QMB) program, Specified Low-Income Medicare Beneficiary (SLMB) program, and Qualifying Individual (QI) program are available based on income and asset limits. Contact your Tennessee Medicaid office or SHIP counselor for current eligibility limits.