2027 IRMAA Brackets: Medicare Income Limits, Surcharges and How to Appeal

Most people on Medicare pay the standard Part B premium. But if your income is above a certain level, you pay more, sometimes a lot more. The extra charge is called the Income-Related Monthly Adjustment Amount, or IRMAA, and it applies to both Part B and Part D.

IRMAA surprises people for two reasons. It is based on your income from two years earlier, and it works like a cliff: go one dollar over a threshold and you pay the full surcharge for that tier. This guide shows the official 2026 brackets, the projected 2027 brackets and what you can do if a surcharge does not reflect your current income.

How IRMAA works

What counts: your modified adjusted gross income (MAGI), which is adjusted gross income plus tax-exempt interest.

Which year: two years back. Your 2026 premiums use your 2024 tax return. Your 2027 premiums will use your 2025 tax return.

Who decides: the Social Security Administration determines whether you owe IRMAA, and the surcharge is usually deducted from your Social Security check along with the premium.

What it affects: the Part B premium and a separate monthly surcharge on Part D drug coverage, including the drug coverage in a Medicare Advantage plan.

Official 2026 IRMAA brackets

Income (single)	Income (married filing jointly)	Monthly Part B premium	Part D surcharge
$109,000 or less	$218,000 or less	$202.90	$0
$109,001 to $137,000	$218,001 to $274,000	$284.10	$14.50
$137,001 to $171,000	$274,001 to $342,000	$405.80	Higher tiers
$171,001 to $205,000	$342,001 to $410,000	$527.50	Higher tiers
$205,001 to $499,999	$410,001 to $749,999	$649.20	Higher tiers
$500,000 or more	$750,000 or more	$689.90	$91.00

Source: Centers for Medicare and Medicaid Services, 2026 fact sheet. Part D surcharges range from $14.50 to $91.00 a month depending on the tier.

Married people who file separately and lived with their spouse at any time during the year face a much tougher scale: in 2026, income above $109,000 and below $391,000 means a Part B premium of $649.20, and $391,000 or more means $689.90.

Projected 2027 IRMAA brackets

The income thresholds are adjusted each year for inflation under a formula set in federal law. The top tier, $500,000 for single filers and $750,000 for joint filers, is fixed by law and does not rise.

Several independent projections, including those reported by Kiplinger and The Finance Buff, put the 2027 thresholds at roughly:

Tier	Projected single income	Projected joint income	Projected Part B premium if the standard premium is $209.50
Standard	about $112,000 or less	about $224,000 or less	$209.50
1	about $112,000 to $141,000	about $224,000 to $282,000	about $293.30
2	about $141,000 to $176,000	about $282,000 to $352,000	about $419.00
3	about $176,000 to $211,000	about $352,000 to $422,000	about $544.70
4	about $211,000 to $499,999	about $422,000 to $749,999	about $670.40
5	$500,000 or more	$750,000 or more	about $712.30

These are estimates. The premium column applies the standard multipliers (1.4, 2.0, 2.6, 3.2 and 3.4 times the standard premium) to the Medicare Trustees’ projected 2027 standard premium. Some forecasts put the standard premium higher. CMS usually releases the official figures in mid-November.

What a surcharge costs in a year

Using 2026 numbers, the first tier costs an extra $81.20 a month for Part B plus $14.50 for Part D. For one person, that is about $1,148 a year. For a married couple both on Medicare, it is about $2,297 a year. At the second tier, the Part B surcharge alone is $202.90 a month, or about $2,435 a year per person.

That is why a small amount of extra income can be expensive. If a Roth conversion or a capital gain pushes a couple $1,000 over the first threshold, it could cost them more than $2,000 in Medicare premiums two years later.

An example

Karen and David, both 68, file jointly. Their normal income is about $190,000 a year from pensions, Social Security and IRA withdrawals, comfortably under the $218,000 threshold for 2026. In 2025 they sold a rental property and had a $60,000 taxable gain, pushing their MAGI to $250,000.

That one-year gain puts them in the first IRMAA tier for 2027, when Medicare looks back at their 2025 return. Using 2026 amounts as a guide, it would cost them about $2,300 in extra premiums that year. In 2028, when Medicare looks at their 2026 income, they drop back to the standard premium. A property sale is not a life-changing event under the SSA-44 rules, so they cannot appeal, but they could have reduced the impact by spreading the sale over two tax years with an installment sale.

Common ways people cross a threshold by accident

Selling a home or investment with a large capital gain.

Roth conversions, which count as taxable income in the year you convert.

Required minimum distributions that grow as IRA balances and ages rise.

The last year of work, when a full salary, bonus or severance appears on the return used two years later.

The death of a spouse, which moves the survivor to single thresholds that are half the joint ones.

Interest and municipal bond income, which count toward MAGI even when the interest is tax-free.

How to appeal IRMAA: Form SSA-44

If your income has dropped because of a life-changing event, you can ask Social Security to use a more recent year’s income. Qualifying events include:

Marriage, divorce or annulment

Death of a spouse

Stopping work or reducing work hours

Loss of income-producing property, for example after a disaster

Loss or reduction of a pension

Receiving a settlement payment from a current or former employer

To request a change:

Fill out Form SSA-44, “Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event.”

Include your estimated income for the current year, or a more recent tax return.

Attach proof of the event, such as a letter from your employer showing your retirement date, a death certificate or a divorce decree.

Submit it to your local Social Security office, by mail or as instructed on the form.

If your income on the original tax return was simply reported wrong, or you filed an amended return, you can also ask Social Security to correct the figure.

Retirement itself is the most common reason for a successful appeal. Many people retire at 65 or later with a final year of high salary on their record, which is exactly the income IRMAA uses two years later.

Ways to manage IRMAA

Know your number. Keep track of your MAGI each year and how close you are to the next threshold.

Spread out big income events. Split Roth conversions or asset sales across more than one year when possible.

Use qualified charitable distributions. If you are 70½ or older, donating directly from an IRA can satisfy required distributions without raising MAGI.

Draw from Roth accounts in years when income is close to a threshold. Qualified Roth withdrawals do not count toward MAGI.

Time the sale of a home. The home sale exclusion ($250,000 single, $500,000 married) keeps most gains out of MAGI, but larger gains count.

If you are in your late 50s or early 60s

The tax return you file at 63 sets your Medicare premiums at 65. If you plan a large Roth conversion or asset sale, the years before 63 avoid IRMAA completely, though they may affect ACA health insurance subsidies if you retired early.

Frequently asked questions

What are the IRMAA brackets for 2027? Official 2027 brackets will be announced by CMS, usually in mid-November. Projections put the first threshold at about $112,000 for single filers and $224,000 for joint filers.

What income year is used for 2027 IRMAA? Your 2025 tax return.

Does IRMAA apply to Medicare Advantage? Yes. You still pay the Part B premium, including any IRMAA, and a Part D surcharge applies to the drug coverage in your plan.

Is IRMAA permanent? No. It is recalculated every year based on your income from two years earlier.