Medicare Part D
2026 Medicare IRMAA Brackets: Who Pays More at $109K+
CLEVELAND — If your income has crept up in recent years, your Medicare bill in 2027 might look bigger than a neighbor's — even if you have the exact same coverage. That is IRMAA at work, and this fall's Annual Enrollment Period (Oct. 15 – Dec. 7) is a good time to understand it.
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Key takeaways
- IRMAA is an extra charge added to Part B and Part D premiums for higher-income Medicare beneficiaries, not a penalty.
- In 2026, the surcharge starts above $109,000 in yearly income for single filers or $218,000 for married couples filing jointly, based on Medicare's published information.
- Social Security bases your IRMAA on your tax return from two years earlier, so your 2025 return determines your 2027 costs, but a one-time income spike can temporarily raise what you owe.
- If a life-changing event lowered your income, you can file Form SSA-44 with Social Security to ask for a lower or removed IRMAA instead of assuming the surcharge is permanent.
IRMAA stands for the Income-Related Monthly Adjustment Amount. It is an extra charge that higher-income beneficiaries pay on top of the standard Part B premium and their Part D drug plan premium. It is not a penalty for doing anything wrong — it is simply how Medicare asks people with higher incomes to pay a larger share.
Here is what Cleveland-area readers should know about the IRMAA thresholds, how Social Security decides who owes IRMAA, and what to do if your income has recently dropped. CMS publishes the 2027 Part B premium and the 2027 IRMAA brackets later this fall, usually in November.
What IRMAA is — and what it isn't
IRMAA is an income-based surcharge, not a separate plan. If you owe it, it is added to:
- Your Part B monthly premium (medical insurance), and
- Your Part D monthly premium (prescription drug coverage), whether that Part D coverage is standalone or built into a Medicare Advantage plan.
Most people on Medicare do not pay IRMAA. It only kicks in above set income levels. In 2026, the first bracket begins above $109,000 for a single filer (and above $218,000 for a married couple filing jointly), according to Medicare.
Two important points:
1. IRMAA is recalculated every year. Being in a higher bracket one year doesn't lock you in for life. 2. The surcharge is billed by Medicare/Social Security, not by your plan. Even if you switch Medicare Advantage or Part D plans during AEP, your IRMAA amount does not change.
How Social Security decides what you owe
Social Security looks at your modified adjusted gross income (MAGI) from your tax return two years ago. For 2027 premiums, that means your 2025 federal tax return.
That two-year lookback catches a lot of people off guard, especially:
- Retirees who sold a home or rental property in 2024.
- People who took a large IRA or 401(k) withdrawal.
- Workers who had a strong final year before retiring.
- Anyone who did a Roth conversion.
A one-time income spike in 2025 can raise your 2027 Medicare costs, even if your current income is much lower.
The IRMAA income brackets, in plain English
The thresholds below are drawn from Medicare's published cost information. There are five surcharge tiers above the base level. The higher your MAGI, the higher the surcharge on both Part B and Part D.
- Single filer at or below $109,000 / joint at or below $218,000: no IRMAA. You pay the standard Part B premium and your plan's standard Part D premium.
- Above those amounts: IRMAA is added, in steps, on both Part B and Part D. The top tier applies to single filers with MAGI of $500,000 or more (and married couples at $750,000 or more).
For the exact dollar amount at each tier, check the "Costs" page at Medicare.gov — CMS publishes the full 2027 chart later this fall, and it is the authoritative source.
What to do if your income has gone down
This is the part many Cleveland retirees miss. If you had a life-changing event that reduced your income, you can ask Social Security to use more recent numbers instead of your 2024 return.
Qualifying events include:
- Retirement or reduced work hours
- Death of a spouse
- Marriage or divorce
- Loss of pension income
- Loss of income-producing property (not due to a sale)
You file Form SSA-44 ("Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event") with documentation. If approved, Social Security will lower — or remove — your IRMAA for the year. It is worth doing; do not assume the surcharge is set in stone.
How this fits with the rest of 2027 Medicare
Even with IRMAA in the picture, 2027 brings some meaningful program-wide changes on the drug side:
- Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your covered drug spending reaches that amount, you pay nothing for covered drugs the rest of the year.
- Part D maximum deductible: up to $615 in 2026 and up to $700 in 2027, depending on the plan.
- The coverage gap ("donut hole") is gone. Since 2025, Part D has three phases instead of four.
- Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments, rather than paying big bills at the pharmacy counter.
None of those features are affected by whether you owe IRMAA. The cap is the cap; the payment plan is available to anyone with Part D.
A quick note for Cleveland readers
Cleveland is in Cuyahoga County, where Medicare beneficiaries have a wide range of Medicare Advantage and standalone Part D options during AEP. Plan availability is set at the county level, so what's offered in Cleveland is generally what's offered across Cuyahoga County. Your county's local SHIP counselor (Ohio's is called OSHIIP — the Ohio Senior Health Insurance Information Program) can walk you through the specifics for free.
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 Cuyahoga County
(MA penetration in Cuyahoga 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.
Higher-income surcharges
2027 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 bracket amounts 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: If I appeal IRMAA using Form SSA-44, how long does it take?
Q: Does IRMAA apply if I have a Medicare Advantage plan instead of Original Medicare?
Q: I'm still working at 68 and have employer coverage. Do I owe IRMAA?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.