IRMAA for 2027: higher Medicare premiums for higher incomes
If your income is above a set limit, you pay more than the standard Medicare premium. The extra is called the income-related monthly adjustment amount, or IRMAA. For 2027 it’s based on your 2025 tax return.
At a glance
- Which income counts: modified adjusted gross income (MAGI) from two years earlier: your adjusted gross income plus tax-exempt interest. 2027 premiums use 2025 income.
- 2026 starting point: above $109,000 for a single filer, $218,000 for a joint return
- What it adds: a higher Part B premium and an extra amount on top of your Part D plan premium
- No hold-harmless protection: the full premium increase comes out of your check
- 2027 limits and amounts: usually announced in November
The tiers
| Income, single filer | Income, joint filers | 2026 Part B total (official) | 2026 Part D add-on (official) | 2027 Part B total (projection) |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 | $209.50 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | $14.50 | $293.34 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | $37.50 | $419.00 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | $60.40 | $544.66 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.20 | $83.30 | $670.32 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 | $712.34 |
2026 amounts: CMS 2026 Medicare Parts A & B fact sheet. 2026 tiers are based on 2024 income. The 2027 column scales each 2026 total by the projected change in the standard premium; official 2027 amounts and income limits, based on 2025 income, come in November.
Married people filing separately who lived with their spouse at any time during the year have a different scale: in 2026, $109,000 or less pays the standard premium, $109,001 to $390,999 pays $649.20, and $391,000 or more pays $689.90 (CMS).
How it shows up on your check
If your premiums come out of Social Security, SSA takes out the full income-related Part B premium and the Part D add-on. The Part D add-on is separate from your drug plan’s own premium, which you pay to the plan.
| December 2026 | January 2027 | |
|---|---|---|
| Benefit before deductions | $3,800.00 | $3,936.00 |
| Part B premium taken out | −$405.80 | −$419.00 |
| Part D income-related amount | −$37.50 | −$37.50 |
| Deposit | $3,356.70 | $3,479.50 |
Because the hold-harmless rule doesn’t apply, a higher premium comes out in full even if it’s bigger than your COLA raise.
If your income has dropped: appealing
Two years is a long lag. If your income went down because of a life-changing event, you can ask SSA to use a more recent year instead, with form SSA-44. Qualifying events are:
- Marriage, divorce or annulment
- Death of your spouse
- You or your spouse stopped working or cut back work hours
- Loss of income-producing property through no fault of your own (for example, a disaster)
- Loss or reduction of a pension
- An employer settlement payment
Retiring is the most common reason. A one-time spike in income that isn’t one of these events, such as selling a house or a large IRA withdrawal, can’t be appealed this way, but it only affects premiums for one year.
If you disagree with the income figure itself, for example because the IRS data is wrong or you filed an amended return, you can ask for a reconsideration. SSA explains both routes on its IRMAA page.
When you’ll hear
SSA sends a letter to people who will pay an income-related amount before the new premiums start. Your COLA notice also lists your Medicare deductions for 2027.
Figures last checked against official sources: