2026 Medicare Premium & IRMAA Changes — What Business Owners & High Earners Need to Know
Medicare costs are rising in 2026, and recent updates from the Centers for Medicare & Medicaid Services (CMS) and Social Security are causing financial concern for many beneficiaries — especially those with higher incomes. These changes affect not only retirees but also high‑earning business owners, creators, and professionals who may soon enroll in Medicare or are planning for future healthcare costs.
In this article, Velin & Associates, Inc. explains the latest premium updates, the Income‑Related Monthly Adjustment Amount (IRMAA) rules, and how these might impact your personal and business tax strategy.
📈 1. Medicare Premiums & Deductibles for 2026
For 2026, CMS officially announced the new Medicare premium and deductible amounts:
- Part B (Medical Insurance) Monthly Premium: $202.90 for most enrollees — up from $185.00 in 2025.
⠀ - Part B Annual Deductible: $283 in 2026, up from $257 in 2025.
⠀ - Part A (Hospital Coverage) Deductible: $1,736 per benefit period.
These changes are part of broader annual adjustments that reflect rising medical costs and utilization trends in the U.S. healthcare system.
💰 2. What Is IRMAA & Why It Matters
IRMAA stands for Income‑Related Monthly Adjustment Amount. It’s a surcharge added to your standard Medicare Part B and Part D (prescription drug) premiums if your Modified Adjusted Gross Income (MAGI) from two years prior exceeds certain thresholds as reported on your tax return.
📊 2026 IRMAA Income Tiers
Here’s how higher incomes affect Medicare costs in 2026:
|
MAGI (Individual) |
MAGI (Married Filing Jointly) | Part B Monthly Premium | Part D Monthly Surcharge |
| ≤ $109,000 | ≤ $218,000 | $202.90 | $0 + plan premium |
| Above $109k – $137k | Above $218k – $274k | ~$284.10 | ~$14.50 |
| Above $137k – $171k | Above $274k – $342k | ~$405.80 | ~$37.50 |
| Above $171k – $205k | Above $342k – $410k | ~$527.50 | ~$60.40 |
| Above $205k – $500k | Above $410k – $750k | ~$649.20 | ~$83.30 |
| Over $500k | Over $750k | ~$689.90 | ~$91.00 |
|
(Figures approximate based on CMS published tables) |
These IRMAA brackets mean that higher‑earning individuals and couples can see substantially larger Medicare premiums than the standard amount.
🧠 3. Why This Matters for Your Business & Taxes
📍 Creators & Influencers (YouTubers, TikTokers, Filmmakers)
As creators scale their revenue through brand deals or ad monetization:
- If your MAGI grows past $109,000 or more due to YouTube ad revenue, sponsorships, or TikTok monetization, you could pay significantly higher Medicare premiums in retirement.
Example: If 2024 MAGI was $150,000 due to high‑traffic content, your Part B premium in 2026 could rise to ~$405.80 — double the base rate.
That’s an extra annual cost of over $2,400+ compared to the standard premium.
👉 Strategic tax planning now can help smooth taxable income to potentially avoid steeper brackets later.
🛍️ eCommerce Sellers (Shopify Store Owners & Amazon Businesses)
Online commerce owners often have fluctuating incomes due to product launches, seasonality, and inventory costs:
- A high‑grossing Shopify Store owner with MAGI of $300,000 in 2024 might see IRMAA surcharges catapulting their Part B premium to ~$527.50/month.
⠀ - If not anticipated, these elevated healthcare costs in retirement could disrupt your planned cash flows — especially after ceasing active business income.
🩺 Healthcare Professionals (Doctors & Dentists)
Doctors and dental practice owners often earn high incomes early in their careers, potentially triggering IRMAA:
- Example: A dentist with MAGI of $425,000 from a busy practice isn’t just paying business taxes — in retirement, their Medicare Part B + IRMAA could approach ~$649+ monthly.
Optimizing retirement account contributions, shifting income timing, or using qualified plans can materially impact IRMAA brackets.
📆 4. Medicare & Social Security Interaction
Social Security also uses your 2024 tax return to determine IRMAA in 2026. Reductions in income due to retirement or business transitions might qualify you to file an SSA‑44 appeal to request IRMAA reconsideration if a life‑changing event occurred.
✅ 5. How Velin & Associates, Inc. Can Help
At Velin & Associates, Inc., we specialize in helping business owners and high‑earning professionals strategically plan for tax and retirement outcomes:
- YouTube & TikTok creators: We help optimize your income reporting and retirement planning so you can reduce future Medicare premium burdens.
- Shopify Store & Amazon Business owners: E‑commerce business tax planning that considers IRMAA and Social Security strategies.
- Doctors & Dental Practices: Custom healthcare and practice tax strategies, including optimizing retirement contributions that influence Medicare costs.
- Online Commerce: Tailored tax and retirement insights for creators and online sellers nationwide.
Example:
A filmmaker client earned $180,000 in 2024. Without planning, their projected Medicare Part B premium plus IRMAA for 2026 would have been over $400 per month. With proper planning, we could shift the timing of certain income and maximize retirement contributions, helping reduce taxable income and potentially lower the client’s projected IRMAA bracket as part of their long-term retirement strategy.
📞 Get Expert Help Today
Understanding Medicare premiums and IRMAA is complex — especially when it intersects with your business income and tax situation.
👉 Contact Velin & Associates, Inc. for personalized tax strategy and retirement planning that considers your future Medicare costs. For more information about our tax planning services, contact us today: visit our website.
Velin & Associates, Inc
8159 Santa Monica Blvd STE 198/200 West Hollywood, CA 90046
323-902-1000
dmitriy@losangelescpa.org
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