Medicare Part D

2026 IRMAA Brackets: What Higher-Income Enrollees Owe

BEDFORD, N.H. — If your income has climbed in recent years, your Medicare bill for 2027 may look different than a neighbor's, even if you're on the same coverage. That's because Medicare adds an income-related surcharge — called IRMAA — on top of standard Part B and Part D premiums for higher earners. With the fall Annual Enrollment Period running from October 15 through December 7, this is a good time to understand how the extra charge works and where the 2027 income lines will fall once CMS publishes them.

What IRMAA actually is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's not a separate bill you can shop around — it's an extra amount added to your Part B premium and, if you have drug coverage, your Part D premium. Most people on Medicare pay the standard Part B premium and no Part D adjustment. IRMAA only applies to enrollees whose income is above a set threshold.

The Social Security Administration handles IRMAA determinations. If a surcharge applies, you'll get a letter explaining the amount and how it was calculated.

The 2027 income thresholds

For 2026, IRMAA starts kicking in above $109,000 for a single filer and above $218,000 for a married couple filing jointly. Income below those lines means you pay the standard Part B premium with no adjustment.

Above those first thresholds, IRMAA is tiered — the surcharge grows in steps as income rises, with separate brackets for individuals and joint filers. The highest tier applies to single filers with income at or above $500,000 and joint filers at or above $750,000. Married people who file separately have their own, narrower set of brackets.

Because the exact dollar amount of each tier is tied to the standard Part B premium (which is finalized each year by CMS), the surest place to see the current chart is medicare.gov, under "Costs."

Which year's income Medicare uses

Here's the part that surprises people: your 2027 IRMAA will be based on your 2025 tax return — the most recent one the IRS has on file. Medicare looks back two years.

That two-year lag matters. If you had a one-time bump in 2025 — from selling a home, taking a large IRA withdrawal, or cashing out stock — it can push you into an IRMAA bracket in 2027 even if your current income is much lower.

Life changes let you appeal

You don't have to just accept a surcharge tied to old income if your situation has changed. Social Security allows you to request a new IRMAA determination after certain "life-changing events," including:

• Marriage, divorce, or the death of a spouse
• Stopping work or reducing hours
• Loss of pension income
• Loss of income-producing property due to a disaster or other event beyond your control

You file Form SSA-44 with documentation. If approved, Social Security will recalculate your surcharge based on your more current income.

Why 2027 is worth a closer look

A few big changes to Part D — the drug benefit — take effect or continue in 2027 alongside IRMAA:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your out-of-pocket spending on covered drugs hits that amount, you pay nothing more for covered drugs the rest of the year.
• The Part D deductible maximum is $615 in 2026 and $700 in 2027.
• The old coverage gap ("donut hole") is gone as of 2025; the drug benefit now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying at the pharmacy counter.

None of these changes remove IRMAA for higher earners, but they do change the overall math of what Medicare costs across the year.

A note on local plan choices

Bedford is in Hillsborough County, where Medicare Advantage and stand-alone Part D plans are set at the county level. IRMAA applies the same way regardless of which plan you pick — it's charged on top of the Part B premium (and, for drug coverage, in addition to the plan's own Part D premium). Choosing a different plan doesn't make IRMAA go away.