IRMAA 2027: Medicare's High-Income Surcharge Explained
Updated
IRMAA adds to your Medicare Part B and Part D premiums if your income is above $109,000 single or $218,000 joint. Here are the brackets and how to appeal.
IRMAA is an extra charge added to your Medicare Part B and Part D premiums if your income is above a certain level. In 2026 it starts at $109,000 for a single person and $218,000 for a married couple filing jointly. Your 2027 surcharge will be based on your 2025 tax return.
How it works
Social Security looks at your modified adjusted gross income (your AGI plus any tax-exempt interest) from two years back. So a big income year in 2025, like selling a business, cashing out stock or a large IRA withdrawal, can raise your Medicare premiums in 2027.
2026 brackets
| Single income | Joint income | Monthly Part B | Part D add-on |
|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $202.90 | $0 |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | +$14.50 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 | +$37.50 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 | +$60.40 |
| $205,001–$499,999 | $410,001–$749,999 | $649.20 | +$83.30 |
| $500,000 and up | $750,000 and up | $689.90 | +$91.00 |
The Part D add-on comes on top of your drug plan's regular premium.
It's a cliff, not a slope
Go $1 over a line and you pay the full higher amount. A single person with $109,001 in income pays about $81 a month more for Part B and $14.50 more for Part D than someone at $109,000. That's over $1,100 a year for one extra dollar of income, so small planning moves near a line can matter a lot.
What 2027 will look like
Medicare announces the official 2027 brackets in November, with the Part B premium. The income lines usually rise with inflation. Unofficial estimates put the first line at about $112,000 single and $224,000 joint. We'll update this page with the official numbers.
You can appeal if your income dropped
If your income fell because of a life-changing event, you can ask Social Security to use a more recent year. Qualifying events include:
- Marriage, divorce, or the death of a spouse
- Stopping work or cutting your hours
- Losing income-producing property in a disaster
- Losing or having a pension cut
- A settlement from an employer that closed or went bankrupt
Use Form SSA-44 and include proof, like a retirement letter or death certificate, plus your tax return if you filed one. You can upload it online, mail or fax it, or make an appointment.
If the IRS data Social Security used is simply wrong, ask for reconsideration using Form SSA-561 or call 1-800-772-1213.
What to do now
- Check where your 2025 income lands against the brackets.
- If you retired or lost a spouse recently, file Form SSA-44 when you get your notice.
- Talk to a tax pro about timing big withdrawals or sales.
Sources: CMS 2026 premiums, Social Security: Medicare premiums, Social Security: lower IRMAA, The Finance Buff.