Key Takeaways
- The standard 2026 Part B premium is $202.90/month; IRMAA can push it as high as $689.90.
- 2026 IRMAA starts above $109,000 (single) or $218,000 (married), based on 2024 income.
- 2027 brackets are projected near $112,000 (single) and $224,000 (married), up about 3%.
- CMS announces official 2027 numbers in November 2026, based on final 2026 CPI data.
If your income crosses one of six specific lines, Medicare charges you more — sometimes a lot more — for the exact same Part B and Part D coverage everyone else gets. That surcharge is called IRMAA, and I get more confused emails about it than almost any other Medicare topic.
What IRMAA Actually Is
IRMAA stands for Income-Related Monthly Adjustment Amount. It’s a surcharge on top of your regular Medicare Part B and Part D premiums if your income is above certain thresholds.
Congress created it in 2003 for Part B, then expanded it to Part D in 2010. The idea: higher earners cover more of their own Medicare costs instead of splitting everything 75/25 with the government.
Here’s the part that trips people up. IRMAA isn’t based on this year’s income — it’s based on your tax return from two years ago. Your 2026 IRMAA is determined by your 2024 tax return. Your 2027 IRMAA will be based on 2025 income.
That two-year lag is exactly why someone can retire, see their income drop sharply, and still get hit with a surcharge based on the bigger paycheck they earned while still working.
The Income Number That Matters: MAGI
IRMAA doesn’t look at your adjusted gross income (AGI) alone — it uses Modified Adjusted Gross Income (MAGI), which adds back tax-exempt muni bond interest to your AGI. It also includes the taxable portion of your Social Security benefits, but not the untaxed portion.
If you’re doing Roth conversions, harvesting capital gains, or taking a large IRA withdrawal, that shows up in MAGI two years later as a potential IRMAA trigger. I’ve written a full breakdown of how AGI and MAGI differ and why it matters for retirement accounts if you want the mechanics.
2026 IRMAA Brackets
The standard Part B premium in 2026 is $202.90/month. Depending on your MAGI, you could pay anywhere from that standard rate up to more than triple it.
| MAGI (Single) | MAGI (Married Filing Jointly) | Part B Premium (Monthly) |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 (standard) |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.30 |
| $500,000+ | $750,000+ | $689.90 |
Part D IRMAA uses these same six brackets, added on top of your plan’s own premium. The Part D surcharge ranges from about $14.50/month at the lowest tier to roughly $91/month at the top.
Notice how close some of these lines sit to each other. Cross a threshold by even $1 and your premium jumps to the next tier’s flat rate — there’s no smoothing or phase-in. For a married couple where both spouses are on Medicare, that $1 can cost the household more than $2,000/year.
Subscribe or follow us to get updates when CMS confirms the official 2027 numbers this November.
Looking Ahead: 2027 IRMAA Brackets (Projected)
The IRS and Social Security Administration won’t lock in the official 2027 brackets until they have all 12 months of 2026 CPI data — that typically happens in October or November. Based on the data available so far, though, the projected thresholds look like this:
| MAGI (Single) | MAGI (Married Filing Jointly) | Bracket |
|---|---|---|
| Up to ~$112,000 | Up to ~$224,000 | Standard |
| ~$112,000 – $141,000 | ~$224,000 – $282,000 | 1.4x standard |
| ~$141,000 – $176,000 | ~$282,000 – $352,000 | 2.0x standard |
| ~$176,000 – $211,000 | ~$352,000 – $422,000 | 2.6x standard |
| ~$211,000 – $499,999 | ~$422,000 – $749,999 | 3.2x standard |
| $500,000+ | $750,000+ | 3.4x standard (frozen through 2027) |
That’s roughly a 3% increase across the first four brackets — the top bracket is legislatively frozen at $500,000/$750,000 and doesn’t adjust for inflation. I’m watching the September 2026 CPI report closely, since that’s typically the last data point CMS needs before finalizing next year’s numbers. I’ll update this page the moment the official 2027 figures are out.
Worked Examples
Maria, a single retiree, had $195,000 in MAGI on her 2024 return from a mix of pension income, RMDs, and part-time consulting. In 2026, that lands her in the $171,001–$205,000 bracket, so she pays $527.50/month for Part B instead of the standard $202.90 — an extra $3,895/year.
Tom and Linda, a married couple both on Medicare, had a combined 2025 MAGI of $360,000 after Tom did a large Roth conversion. Based on the projected 2027 brackets, that puts them in the ~$352,000–$422,000 range — 2.6x standard for each of them, adding roughly $6,500/year to their household Medicare costs.
Common Issues to Watch Out For
I hear about the same few mistakes over and over on this one.
Assuming this year’s income is what counts. It’s your MAGI from two years ago. If you’re planning a big Roth conversion or asset sale, think about the IRMAA hit two years down the road, not this year’s premium.
Not appealing after a life-changing event. If your income was higher two years ago because you were still working, and you’ve since retired, married, divorced, or lost a spouse, you can appeal using Form SSA-44 with the Social Security Administration.
Missing that both spouses pay separately. If you and your spouse are both on Medicare, IRMAA applies to each of you individually, not once per household — that doubles the total impact when I calculate real numbers for readers.
Forgetting Part D IRMAA is separate but simultaneous. People budget for the Part B surcharge and get surprised when the Part D surcharge shows up too. They’re always assessed together, using the same bracket.
If you’re weighing whether the $6,000 Senior Deduction or other year-end moves might nudge your MAGI in either direction, it’s worth running the numbers before December 31 rather than after you file.
