If your 2025 income crossed $112,000 as a single filer — or $224,000 on a joint return — Medicare will charge you extra in 2027. That extra charge is called IRMAA, the Income-Related Monthly Adjustment Amount, and it is added to your Part B and Part D premiums for the whole year.
One thing to be clear about up front: the 2027 brackets are projected, not final. CMS has not announced the official 2027 figures yet. Last year the announcement came on November 14, and nothing has landed in the CMS newsroom as of today. The table below is the best available projection, built from the Medicare Trustees Report and the inflation formula written into federal law — the same formula that reproduces every CMS threshold for 2024, 2025 and 2026 exactly.
The projected 2027 IRMAA table
Your 2027 surcharge is set by your modified adjusted gross income — MAGI — on your 2025 tax return. Here is the full projected table, single filers and married couples filing jointly:
Standard — $112,000 or less single / $224,000 or less joint — Part B $209.50 a month, Part D add-on $0.
Tier 1 — $112,001 to $141,000 single / $224,001 to $282,000 joint — Part B $293.30 a month, Part D add-on $15.40.
Tier 2 — $141,001 to $176,000 single / $282,001 to $352,000 joint — Part B $419.00 a month, Part D add-on $39.70.
Tier 3 — $176,001 to $211,000 single / $352,001 to $422,000 joint — Part B $544.70 a month, Part D add-on $64.00.
Tier 4 — $211,001 to $499,999 single / $422,001 to $749,999 joint — Part B $670.40 a month, Part D add-on $88.30.
Top tier — $500,000 or more single / $750,000 or more joint — Part B $712.30 a month, Part D add-on $96.40.
The Part D add-on sits on top of whatever your drug plan charges. The standard Part B premium itself is projected at $209.50 a month, up $6.60 from $202.90 in 2026, with the annual deductible projected at $292, up from $283.
A small honesty note on the middle three boundaries: they could come in $1,000 higher than shown. The Bureau of Labor Statistics published no inflation index for October 2025, during the lapse in appropriations, and how CMS treats that missing month moves those three lines by $1,000. The first threshold ($112,000 / $224,000) and the top tier ($500,000 / $750,000) are the same under every treatment.
What each tier actually costs you
IRMAA is a cliff, not a slope. Cross a threshold by a single dollar and you pay the full tier for all 12 months — on Part B and Part D, per person. A married couple where both spouses are on Medicare pays each tier twice.
At the first tier, the surcharge is $83.80 a month on Part B plus $15.40 on Part D — $99.20 a month per person, or $1,190.40 a year. For a couple both on Medicare, that is $2,380.80 a year on top of the standard premiums.
At the top tier, the extra is $502.80 a month on Part B plus $96.40 on Part D — $599.20 a month per person, or $7,190.40 a year above what a standard enrollee pays. Part B alone runs $712.30 a month at the top, $8,547.60 a year.
Your 2025 tax return already decided it
This is the part that catches people off guard. Medicare does not look at this year’s income. It looks back two years, so your 2027 surcharge rests on the return you filed in early 2026 for tax year 2025. Nothing you do with 2025 income now can change it.
MAGI here means your adjusted gross income plus any tax-exempt interest. A few things do not count toward it: Roth IRA withdrawals, qualified HSA distributions used for medical expenses, the return of your own cost basis from a brokerage account, and loan proceeds. Nontaxable Social Security is not added either.
What you can still influence is 2026 income, which sets your 2028 IRMAA. A Roth conversion done in 2026, for example, is ordinary income and will land in the MAGI that decides your 2028 surcharge. If you are planning a conversion, size it against the 2028 thresholds, not the 2027 ones.
The 2026 baseline, for comparison
For reference, here are the confirmed 2026 figures from CMS, set by your 2024 return. The standard Part B premium is $202.90 a month with a $283 deductible, and surcharges start above $109,000 single or $218,000 joint. Part B runs $202.90 to $689.90 a month across the six tiers, and the Part D surcharge runs $0 to $91.00.
So the first threshold rises about 2.8% into 2027 ($109,000 to $112,000) and the standard premium about 3.25% ($202.90 to $209.50). One trap to watch: some guides list $106,000 and $212,000 as the 2026 thresholds. Those are the 2025 figures, not 2026 — the 2026 lines are $109,000 and $218,000.
Can you appeal? Yes, with Form SSA-44
A surcharge built on income you no longer earn is not something you have to accept. Social Security calls the remedy a new initial determination, and you request it with Form SSA-44. You name the qualifying event, give the date it happened, estimate your lower income, and attach proof. Most decisions land in roughly 30 to 90 days.
Social Security recognizes eight qualifying life-changing events, and the list is closed: work stoppage including full retirement, work reduction, loss of income-producing property through disaster, fraud or theft, loss of pension income, an employer settlement payment after bankruptcy or reorganization, marriage, divorce or annulment, and the death of a spouse.
One-time income spikes do not qualify on their own. A Roth conversion, a large withdrawal, a capital gain or a business sale is a spike, not a life change. If your work status changed alongside a sale, file under work stoppage or work reduction instead. If Social Security says no, you have 60 days to ask for reconsideration on Form SSA-561-U2.
Married filing separately costs far more
If you filed married filing separately and lived with your spouse at any time during the year, the single-filer table does not apply. The structure is compressed into three levels. In 2026, income above $109,000 and below $391,000 pays $649.20 a month for Part B plus $83.30 for Part D, and $391,000 or more pays $689.90 plus $91.00. The projected 2027 version is $670.40 plus $88.30 above $112,000, and $712.30 plus $96.40 at $388,000 or more. Filing separately, in other words, can cost far more than filing jointly. If you lived apart from your spouse all year, the single column applies instead.
When the official numbers land
CMS announces the final 2027 Part B premium, deductible and IRMAA thresholds in November — last year it was November 14. Your determination letter from Social Security should arrive in late November or December, and the figure will also show in your my Social Security account. Open enrollment ends December 7, 2026, so if you are still choosing a plan, do it with the projected surcharge in mind: IRMAA does not change which plan you pick, but it does change what the year costs in total.
For the typical retiree, none of this applies — the standard $209.50 premium is the whole story. But if your 2025 income was near a line, check the exact figure now. A dollar over a threshold costs roughly $1,190 a year at the first tier, and the time to appeal, or to plan 2026 income for 2028, is now.
FAQ: IRMAA brackets 2027
What are the IRMAA brackets for 2027?
The projected 2027 IRMAA brackets start above $112,000 of 2025 MAGI for single filers and $224,000 for married couples filing jointly. Higher tiers start above $141,000, $176,000 and $211,000 single ($282,000, $352,000 and $422,000 joint), with the top tier at $500,000 or more single and $750,000 or more joint. These are projections — CMS has not announced the official 2027 figures yet, and the middle three boundaries could come in $1,000 higher depending on how CMS treats a missing October 2025 inflation reading.
What income counts for IRMAA in 2027?
Your modified adjusted gross income on your 2025 federal tax return — adjusted gross income plus tax-exempt interest. Medicare uses a two-year lookback, so the return you filed in early 2026 decides your 2027 surcharge. Roth IRA withdrawals and nontaxable Social Security do not count toward MAGI.
How much extra will I pay at the first IRMAA tier in 2027?
A projected $99.20 a month per person — $83.80 on Part B and $15.40 on Part D — or $1,190.40 a year. A married couple where both spouses are on Medicare pays double, $2,380.80 a year. At the top tier the extra is a projected $599.20 a month per person.
Can I appeal IRMAA?
Yes, with Form SSA-44, if you had one of eight qualifying life-changing events — including retirement, work reduction, divorce or the death of a spouse — that lowered your income. File with proof of the event and your estimated lower income; most decisions take 30 to 90 days. A one-time income spike, like a Roth conversion or a capital gain, does not qualify on its own.
Does a Roth conversion raise my Medicare premium?
Yes. A conversion is ordinary income and lands in the MAGI Medicare uses two years later. A conversion done in 2025 already set your 2027 surcharge; a conversion done in 2026 will affect your 2028 IRMAA. Size conversions against the tier thresholds, because IRMAA is a cliff — one dollar over a line applies the whole tier for the year.
Sources
- 2026 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (projected 2027 Part B premium $209.50, deductible $292)
- CMS, 2026 Medicare Parts A & B Premiums and Deductibles fact sheet, November 14, 2025 (confirmed 2026 figures)
- CMS, Calendar Year 2027 Rate Announcement, April 6, 2026 (Part D deductible $700, out-of-pocket cap $2,400); CMS Part D base beneficiary premium announcement, July 28, 2026 ($41.33)
- 42 U.S.C. §1395r(i)(5) (IRMAA threshold indexing formula)
- Social Security Administration, Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event)
- CMS newsroom check, November 11, 2026 (no 2027 Part B premium / IRMAA announcement published yet)