Updated November 2026. CMS has not yet released the 2027 figures; this page will be updated when it does. IRMAA (Income-Related Monthly Adjustment Amount) is an extra charge that higher-income people with Medicare pay on top of the standard Part B and Part D premiums. It applies to individuals with modified adjusted gross income (MAGI) above $109,000 and married couples filing jointly above $218,000 in 2026, based on the tax return from two years earlier.
The standard Part B premium is $202.90 a month in 2026, and the highest IRMAA bracket raises it to $689.90, according to the Centers for Medicare & Medicaid Services (CMS). The Part B deductible is $283.
2026 IRMAA Brackets
Brackets are based on 2024 MAGI, as reported on the 2024 federal tax return.
| Individual tax return | Joint tax return | Total Part B monthly premium | Part D monthly IRMAA (added to plan premium) |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 | $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 | $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 | $60.40 |
| Above $205,000 and below $500,000 | Above $410,000 and below $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Married people who file separately and lived with their spouse during the year face only three tiers: $202.90 up to $109,000, $649.20 above $109,000 and below $391,000, and $689.90 at $391,000 or more.
What To Expect for 2027
CMS usually announces the next year’s Part B premium, deductible and IRMAA brackets in November. The 2026 Medicare Trustees Report projected a 2027 standard premium of about $209.50 a month; the final figure can differ. IRMAA thresholds are indexed to inflation, so the 2027 brackets, based on 2025 tax returns, are expected to start somewhat higher than $109,000 and $218,000.
How IRMAA Is Calculated
- The Social Security Administration (SSA) uses your MAGI from two years earlier: adjusted gross income plus tax-exempt interest.
- One dollar over a threshold triggers the full surcharge for that bracket; there is no phase-in.
- The surcharge is deducted from Social Security benefits or billed separately.
- Part D IRMAA also applies to people in Medicare Advantage plans with drug coverage.
How To Appeal an IRMAA Determination
If your income dropped after a “life-changing event,” you can ask SSA to use a more recent year’s income with Form SSA-44. Qualifying events include:
- Retirement or reduced work hours.
- Marriage, divorce or the death of a spouse.
- Loss of income-producing property.
- Loss or reduction of an employer pension.
- An employer settlement payment.
A one-time capital gain, such as selling a house or a Roth conversion, does not qualify. Planning those transactions around the brackets is a common strategy for retirees; talk with a tax adviser before you act.
Ways To Reduce IRMAA
- Time large capital gains and Roth conversions to stay under a bracket.
- Use qualified charitable distributions from an IRA after age 70½, which do not count toward MAGI.
- Contribute to a health savings account (HSA) before enrolling in Medicare; see our HSA and FSA limits guide.
- File Form SSA-44 soon after retirement if your income fell.
For choosing coverage on top of Part B, see our Medigap vs Medicare Advantage guide and Medicare Advantage plans by state for 2027. Follow our Medicare hub for the 2027 premium announcement.
Sources
CMS, 2026 Medicare Parts A and B Premiums and Deductibles fact sheet (November 2025); Social Security Administration, Form SSA-44; 2026 Medicare Trustees Report.