Medicare Part D
2026 IRMAA Brackets: When Medicare Costs More at $109K
FONTANA, Calif. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-earning retirees are getting a fresh look at something that catches many people off guard: the income-related monthly adjustment amount, better known as IRMAA. For 2026, the surcharge kicks in once a single filer's income tops $109,000, or $218,000 for a married couple filing jointly. If that's you, your Part B and Part D premiums won't look like your neighbor's — and it's worth understanding why before the mail from Social Security arrives.
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Key takeaways
- For 2026, Medicare's IRMAA surcharge starts when a single filer's income is above $109,000 or a married couple's joint income is above $218,000.
- Social Security figures IRMAA using your tax return from two years earlier, so 2027 premiums will usually be based on 2025 income, and about 8% of people with Medicare pay this extra amount.
- If you've had a life-changing event like retirement, a spouse's death, or divorce, you can file Form SSA-44 to ask Social Security to use more recent income instead of waiting on the normal two-year lookback.
- Starting in 2025, the Part D coverage gap was eliminated, and for 2027 there are further changes to drug costs that apply no matter your income level.
Fontana seniors, here's what the 2027 IRMAA brackets will mean for you
What IRMAA actually is
IRMAA isn't a separate bill or a penalty. It's an extra amount added to your standard Medicare Part B premium and, if you have drug coverage, your Part D premium. Social Security calculates it automatically using your most recent tax return on file with the IRS — usually your 2025 return for 2027 premiums. That two-year lookback is why a recent retiree can be surprised: the income that triggers the surcharge may be from a year you were still working full-time.
About 8% of people with Medicare pay IRMAA in a given year, according to CMS. Everyone else pays the standard Part B premium and whatever their Part D plan charges.
The 2026 income thresholds
Here's where the brackets begin for 2026, based on modified adjusted gross income (MAGI) from your 2024 tax return. CMS publishes the 2027 brackets later in the fall:
- Single filer: surcharges begin above $109,000
- Married filing jointly: surcharges begin above $218,000
- Married filing separately: a separate, tighter schedule applies
The surcharge climbs in tiers. The higher your income, the higher the add-on to both Part B and Part D. The very top tier applies to single filers with income at or above $500,000, and married-joint filers at $750,000. Exact dollar amounts for each tier are posted on medicare.gov once CMS finalizes them for the year.
Why Fontana readers are asking about this now
Fontana is in San Bernardino County, home to a large and growing population of Medicare-eligible residents. With home values, pensions, required minimum distributions from retirement accounts, and part-time consulting income all in the mix, plenty of local retirees find themselves brushing up against — or crossing — that $109,000 line without realizing it.
A few common local triggers:
- Selling a home in a rising market (capital gains count toward MAGI)
- Roth conversions done in 2025
- A working spouse's W-2 income the year before both retire
- Required minimum distributions starting at age 73
The result: a one-time income spike in 2025 can raise your Medicare costs for all of 2027.
What to do if your income has dropped
If you had a life-changing event — retirement, the death of a spouse, divorce, loss of a pension, or reduced work hours — you can ask Social Security to recalculate using more recent income. This is done using Form SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event."
You'll need documentation, such as a letter from a former employer or a signed statement about your retirement date. If approved, Social Security adjusts your premium without waiting for the tax cycle to catch up.
Selling a house or taking a large one-time withdrawal is not on the list of qualifying life-changing events. Those income spikes work their way through the normal two-year lookback.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in San Bernardino County
(MA penetration in San Bernardino County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
How IRMAA fits with other 2027 changes
There's some good news layered into the coming year. The Part D landscape continues to reshape after the coverage gap was eliminated in 2025. For 2027:
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027 — once you hit it, you pay nothing for covered drugs the rest of the year.
- The Part D deductible maxes out at $615 in 2026 and $700 in 2027.
- The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments instead of paying big pharmacy bills up front.
These changes apply regardless of income. IRMAA affects what you pay in premiums; the cap and smoothing plan affect what you pay at the pharmacy counter.
Higher-income surcharges
2026 IRMAA income brackets
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. Your 2027 surcharge will be based on your 2025 tax return. CMS publishes the 2027 brackets and surcharge amounts later in the fall; the 2026 figures are shown below for reference.
| Income — single filer | Income — married, joint | Part B monthly premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | Plan premium only |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | + $14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | + $37.40 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | + $60.40 |
| $205,001 – $500,000 | $410,001 – $750,000 | $649.30 | + $83.30 |
| Above $500,000 | Above $750,000 | $689.90 | + $91.00 |
Standard Part B premium is $202.90/month. Part D surcharges are added to your drug plan’s premium. Married-filing-separately uses a different, compressed schedule. Confirm current amounts at Medicare.gov.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Q: I just got a letter from Social Security about a higher premium. Can I appeal?
Q: Does IRMAA go away once my income drops?
Q: Do Medicare Advantage enrollees pay IRMAA too?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.