Medicare Part D
2026 IRMAA Brackets: When Higher Income Raises Your Medicare Bill
If your income has climbed in the last couple of years — maybe you sold a house, took a large IRA withdrawal, or converted funds to a Roth — you could open a Medicare letter in the mail this winter and see a surprise. It's called IRMAA, short for the Income-Related Monthly Adjustment Amount, and it's an extra charge added on top of your regular Part B and Part D premiums.
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Click to call 855-729-3240Key takeaways
- IRMAA is an extra charge added to Part B and Part D premiums for people with higher income, and it's based on your tax return from two years ago, so your 2027 surcharge depends on your 2025 income.
- For 2026, the surcharge starts once a single filer's income tops $109,000, or a married couple filing jointly tops $218,000, with the highest tier hitting single filers at $500,000 or more (or $750,000 for joint filers).
- If your income dropped due to a "life-changing event" like retirement, a spouse's death, divorce, or losing a pension, you can file form SSA-44 to ask Social Security to use more recent income instead.
- Social Security sends a letter about the charge, and if the numbers look wrong, you have a limited window to appeal, so don't ignore that mail.
Springfield, Mo. — Why this matters right before Dec. 7
With the Annual Enrollment Period running Oct. 15 through Dec. 7, this is the time of year Springfield readers most often ask us about it. CMS typically publishes the 2027 IRMAA brackets later this fall, alongside the Part B figures. Here's how the structure works, and how to avoid the most common mistakes.
What IRMAA actually is
IRMAA isn't a separate bill you can shop around. It's an extra amount the Social Security Administration adds to two things:
- Your Part B premium (doctor visits, outpatient care).
- Your Part D premium (prescription drug coverage), even if your drug plan is bundled inside a Medicare Advantage plan.
Social Security determines whether you owe IRMAA by looking at your Modified Adjusted Gross Income (MAGI) from two years ago. So your 2027 surcharge is based on your 2025 tax return. That two-year lookback is where most surprises come from.
The 2026 income thresholds
For 2026, IRMAA kicks in once a single filer's MAGI goes above $109,000, or a married couple filing jointly goes above $218,000. Below those numbers, you pay the standard Part B and Part D premiums — no surcharge.
Above those numbers, there are several tiers. The higher your income, the higher the surcharge on both Part B and Part D. The very top tier applies to single filers with MAGI at or above $500,000 (or $750,000 for joint filers). Medicare.gov publishes the full bracket chart each fall — always check the current figures there before you plan around a number.
A few quick points worth knowing:
- IRMAA is a cliff, not a phase-in. Going one dollar over a bracket puts you in the next tier for the whole year.
- It's recalculated every year. A one-time income spike in 2024 doesn't follow you forever.
- Married-filing-separately has its own (much tighter) thresholds.
How you'll find out you owe it
You won't get a bill from your plan. Social Security mails an initial determination letter, usually late in the year, showing the income they used and the amount you'll owe. If you get Social Security benefits, the surcharge is pulled from your monthly check. If you don't, Medicare bills you directly.
If that letter arrives and the numbers look wrong, don't ignore it — you have appeal rights, which we'll get to below.
The mistakes we see most often in Greene County
Springfield is in Greene County, where — like everywhere else — the IRMAA rules are federal, not local. But the mistakes are very human:
1. Assuming this year's income is what counts. It isn't. It's your income from two years back. 2. Not filing a "life-changing event" appeal when you qualify. Retirement, the death of a spouse, divorce, loss of pension income, or a work stoppage can all be grounds to ask Social Security to use more recent income instead. The form is SSA-44. 3. Roth conversions and big one-time withdrawals that quietly push you over a bracket. Talk to a tax professional before the conversion, not after. 4. Forgetting that IRMAA applies to Part D too, even if you have a Medicare Advantage plan that includes drug coverage. 5. Not opening the Social Security envelope. The window to appeal is limited.
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 Greene County
(MA penetration in Greene 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.
What's changing around IRMAA in 2027
The surcharge rules themselves are the same structure you've seen before, but the drug side of Medicare continues to evolve in 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 maximum deductible is $615 in 2026 and $700 in 2027.
- The old "donut hole" coverage gap is gone — Part D now has three phases (deductible, initial coverage, catastrophic).
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter. It's optional and free to opt into.
None of those changes remove IRMAA, but they do change the full picture of what higher-income beneficiaries pay each year.
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 is based on your 2025 tax return. CMS publishes the 2027 brackets and Part B figures later this fall.
| 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 retired this year and my income dropped a lot. Do I still have to pay IRMAA based on 2024?
Q: Does IRMAA apply if I have a Medicare Advantage plan?
Q: If I switch plans during AEP, does that change my IRMAA?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.