2027 IRMAA brackets: the Medicare surcharge projection

The short answer. Your 2027 Medicare income-related monthly adjustment amount (IRMAA) is decided by the income on your 2025 tax return, because Medicare uses a two-year lookback. The official 2027 brackets are not yet published — the Centers for Medicare & Medicaid Services typically announces them around November 2026 — so any 2027 number here is a clearly labeled projection. What is confirmed is the 2026 structure, and that is enough to plan with: the first surcharge tier for 2026 begins at modified adjusted gross income (MAGI) over $109,000 single or $218,000 married filing jointly.

What IRMAA actually is

IRMAA is a surcharge bolted onto your Medicare Part B and Part D premiums once your income clears certain thresholds. The detail that catches people off guard is that it is a cliff, not a gentle ramp. A single dollar of income over a bracket threshold does not nudge your premium up slightly — it moves you into the next surcharge tier in full. Two retirees whose incomes differ by one dollar can pay meaningfully different Medicare premiums for an entire year, which is why the thresholds deserve real attention rather than a glance.

For 2026, the figures are settled. The standard Medicare Part B premium is $202.90 per month, paid by everyone on Part B. Above the first threshold, the confirmed 2026 Part B surcharges run from $81.20 to $487.00 per month depending on the tier, and the Part D surcharges run from $14.50 to $91.00 per month. Those figures come from the Centers for Medicare & Medicaid Services notice “Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rates, and Annual Deductible Beginning January 1, 2026”, published in the Federal Register on November 19, 2025. Those surcharges are stacked on top of your underlying premiums, so a high earner in the top tier is paying the standard premium plus the surcharge, every month, for the year.

That standard premium is also the figure that interacts directly with your Social Security check, since most beneficiaries have Part B deducted straight from their monthly deposit. How that $202.90 premium plays against the annual cost-of-living adjustment — including the provision that can cap the deduction so a premium increase does not shrink your net check — is covered in our Social Security COLA tracker.

The two-year lookback is the whole game

Here is the mechanism that makes this page worth reading in mid-2026 rather than in late 2027: your IRMAA is based on your MAGI from two years earlier. Your 2026 surcharge is built from your 2024 return. And your 2027 surcharge will be built from your 2025 MAGI — the income on the return you file in 2026. The decision is already in motion.

That lag is the reason a Medicare premium can feel like it arrived out of nowhere. A beneficiary remembers a single strong income year — a property sale, a large capital gain, a one-time distribution — and only feels the surcharge two years later, long after the cause has faded from memory. The flip side is the good news. Because 2027 keys off 2025, you still have room in 2025 to manage the income that sets it.

What counts toward MAGI for IRMAA

The income measure that triggers a surcharge is a specific one. For IRMAA, MAGI is your adjusted gross income (AGI) plus tax-exempt interest, such as the interest from municipal bonds. Municipal bond interest is famously free of federal income tax, but it is not invisible to Medicare — it climbs back in for this calculation. (For the broader definition, see our explainer on MAGI.)

The components are wide-ranging. MAGI for IRMAA counts wages, interest, dividends, capital gains, distributions from traditional retirement accounts, rental income, and the taxable portion of your Social Security benefits. Because AGI sits at the heart of it, it helps to understand how that figure is built up from a W-2 and your other income before tax-exempt interest is added back. The takeaway is that a single large realization event — selling an appreciated stock, taking a big traditional-IRA withdrawal, converting to a Roth — flows straight into the number that decides your premium.

How the 2027 brackets are projected

The 2027 figures are not yet known, and it matters that we say so plainly. The official 2027 IRMAA brackets and premiums are set by the Centers for Medicare & Medicaid Services and are typically announced around November 2026. Until then, every 2027 number is a projection, and we will update this page when the agency publishes the real ones.

We can still describe the direction of travel, because the mechanism is defined. The IRMAA thresholds are adjusted annually for inflation using the Consumer Price Index (CPI-U), so they drift upward modestly each year. The 2026 thresholds themselves rose from 2025 — the first single tier moved from $106,000 to $109,000, and the married threshold from $212,000 to $218,000 — which shows the indexing in action.

To make this concrete without overstating it: if the thresholds rise with inflation of roughly 2.5%, the first single tier would begin near $112,000 in 2027. Treat that strictly as an illustration. It is an estimate based on a hypothetical inflation assumption, not a confirmed figure, and the official number will come from the agency in the fall of 2026. Do not file a return or skip a conversion on the strength of a projected bracket — use it only to understand roughly where the line might sit.

Why this is a 2025 planning problem

The practical reason to read a 2027 projection in 2026 is that the levers are pulled now. Because 2027 IRMAA keys off 2025 MAGI, any action that raises your 2025 income can tip you over a 2027 cliff: a large Roth conversion, realizing a substantial capital gain, or taking a lump-sum distribution in 2025 all land in the figure that sets the surcharge. Conversely, spreading income across years, timing a conversion to fill a bracket rather than overflow it, or deferring a sale into a lower-income year keeps you under the line.

The cliff structure raises the stakes on these decisions. Because crossing a threshold by a dollar triggers the full surcharge for the next tier, the cost of a slightly-too-large conversion is not a few dollars — it can be a full step up in your Part B and Part D premiums for all of 2027. That asymmetry is exactly why the modeling belongs in your 2025 tax planning, before the year closes, rather than in your 2027 budget after the bill arrives. Keep an eye out for the official Centers for Medicare & Medicaid Services figures around November 2026; this page will be updated to reflect them.