IRMAA Brackets for 2026 and 2027: Medicare Part B and Part D Surcharge Tables

What are the 2026 IRMAA brackets?

The tables below show the 2026 brackets as CMS published them. Income means modified adjusted gross income on the 2024 return. The Part B premium column is the full monthly amount per person, including the standard $202.90. The Part D surcharge is added to whatever your drug plan charges, whether that is a stand-alone plan or a Medicare Advantage plan with drug coverage. The yearly columns show only the surcharge: the amount paid above the standard premium over twelve months.

Single, head of household or qualifying surviving spouse

Married filing jointly

The couple column assumes both spouses have Part B and Part D. If only one spouse is on Medicare, use the per-person column. The joint thresholds are double the single thresholds in every bracket except the top one, which starts at $750,000 for a couple, not $1,000,000.

Married filing separately, lived with your spouse during the year

This table applies if you were married at the end of the year, filed a separate return and lived with your spouse at any point in the year. There are no middle brackets: one dollar above $109,000 goes straight to the second-highest premium. Married people who file separately and lived apart for the entire year use the single table.

The standard premium is set to cover about a quarter of what Part B costs the program for each enrollee. The five brackets are set so that the enrollee pays 35%, 50%, 65%, 80% and 85% of that cost instead. That is why the Part B surcharges are not round numbers and why they rise whenever the standard premium does. CMS estimates that roughly 8% of people with Part B pay a surcharge. Among retired households with large traditional IRAs and taxable portfolios the share is far higher.

Source: CMS, 2026 Medicare Parts A & B premiums and deductibles, published November 14, 2025. Cost shares: 42 U.S.C. 1395r(i).

What are the 2027 IRMAA brackets and Part B premium?

The announcement comes each autumn, in a CMS fact sheet and a notice in the Federal Register. Over the past five years the date has ranged from late September to mid-November; the 2026 figures were published on November 14, 2025. The release dates for each year are in the history table below.

How the 2027 thresholds will be set

The thresholds are not chosen by CMS each year. The Social Security Act fixes a set of base amounts and requires them to be raised by the change in the Consumer Price Index for All Urban Consumers (CPI-U). The measure is the average of the index over the twelve months ending in August of the year before the premium year, compared with the average over the twelve months ending in August 2018. Each result is rounded to the nearest $1,000. So the 2027 thresholds depend on inflation through August 2026, and in a year of ordinary inflation the first threshold moves up by a few thousand dollars.

The top threshold is the exception. The law holds it at $500,000 for a single filer and $750,000 for a couple through 2027, and begins indexing it in 2028. The joint thresholds are twice the single ones, apart from that top figure. The separate-filer table is derived from the single table by subtracting the first threshold, which is how the $391,000 figure in the 2026 table arises ($500,000 less $109,000).

The dollar surcharges are a second calculation. CMS first sets the standard Part B premium from projected program costs, then computes each bracket's premium as its fixed share of those costs. The Part D surcharges are computed in the same way from the national base beneficiary premium for drug coverage.

What the Medicare Trustees projected

The only government figures available for 2027 before the CMS notice are the projections in the annual Medicare Trustees Report. The report transmitted in June 2026 estimated a standard Part B premium of $209.50 a month for 2027, 3.3% above the 2026 premium, and a Part B deductible of $292. It also estimated the Part B surcharge for each bracket. It does not project the income thresholds or the Part D surcharges.

The right-hand column is a projection made in mid-2026, not an official premium. CMS sets the actual amounts using later cost data, and the final premium has differed from the Trustees' estimate in past years. Source: 2026 Medicare Trustees Report, tables V.E2 and V.E3 (intermediate estimates).

Which tax year sets which premium year?

Premiums for a calendar year are set from the tax return for the year 2 years earlier. The IRS sends the figure to Social Security each autumn, and Social Security mails a notice of the coming year's premium, usually in November or December. Your 2025 return, filed in spring 2026, sets your 2027 premium.

Three things follow from the timing. First, you never know the exact thresholds when you earn the income: money received in 2026 will be tested against 2028 brackets that will not exist for another year. Because the thresholds only move up with inflation, the current table is a cautious guide, and many people plan against it with a margin. Second, the first year on Medicare at 65 is priced from the return for the year you turned 63, often a full working year. Third, if the IRS has not yet processed the return from 2 years back, Social Security uses the return from three years back and corrects the premium once the later return arrives.

The determination is made again every year. A single high-income year raises premiums for one calendar year, and the surcharge drops away by itself when a lower-income return becomes the one being tested.

What counts as income for IRMAA?

IRMAA uses its own definition of modified adjusted gross income: adjusted gross income plus tax-exempt interest. On Form 1040 that is line 11 plus line 2a. A few uncommon exclusions are also added back, including excluded foreign earned income, excluded interest on savings bonds used for education, and excluded income from certain US territories. It is not taxable income, so nothing taken after AGI helps.

Two rows surprise people. Municipal bond interest is free of federal income tax, but it is added back for IRMAA, so moving from taxable bonds to municipal bonds does not lower the figure Medicare looks at. And the standard deduction, the additional deduction at 65 and itemized deductions such as charitable gifts made by check all come off after AGI, so none of them reduces IRMAA income. A qualified charitable distribution does, because it never enters AGI in the first place.

Sources: 42 U.S.C. 1395r(i)(4); 20 CFR part 418, subpart B; SSA POMS HI 01101.010.

How do the cliffs work?

Income tax brackets are marginal: a dollar that crosses into a higher bracket is the only dollar taxed at the higher rate. IRMAA is not. A dollar that crosses a threshold changes the premium on every month of the year, for each person on the return who has Medicare. The table shows what crossing each 2026 line adds to one person's yearly cost.

The steps are uneven. Crossing the first line adds $1,148.40 a year per person. Each of the middle steps costs more, up to $1,736.40. The move into the top bracket adds the least, $580.80, because the premium share rises only from 80% to 85% of cost.

Worked example: a Roth conversion that crosses the first line

Take a hypothetical married couple, both on Medicare with Part B and Part D, whose modified AGI before any conversion is $190,000. They are $28,000 below the first joint threshold of $218,000. Using the 2026 brackets:

• A conversion of $28,000 brings them to exactly $218,000. They stay at the standard premium.
• A conversion of $40,000 brings them to $230,000, which is $12,000 over. Each spouse pays $81.20 more a month for Part B and $14.50 more for Part D.
• The surcharge is $1,148.40 per person for the year, or $2,296.80 for the couple, billed 2 years after the conversion.
• Measured against the $12,000 that went over the line, that is a one-time cost of about 19.1% on top of the income tax on the conversion. Measured against one dollar over the line, it would be the same $2,296.80.

The example is not an argument for or against the larger conversion. Whether $2,296.80 is worth paying depends on the tax rate today, the rate expected later and how long the money will stay in the Roth. The point is only that the surcharge is a fixed amount per bracket, so it weighs heavily on income that lands just over a line and lightly on income that lands far past it. The Roth conversion calculator prices a conversion with the surcharge included.

What pushes people over a threshold?

Most households that pay IRMAA for the first time did not have a higher salary. They had one of the following.

• Roth conversions. The converted amount is ordinary income in that year. Conversions made at 63 or later show up in Medicare premiums 2 years on.
• Capital gains. Selling appreciated stock, a rental property or a business adds the net gain to AGI. So do year-end capital gain distributions from mutual funds, which arrive whether or not you sold anything.
• A home sale. Gain on a main home is excluded up to $250,000 for a single owner and $500,000 for a couple filing jointly who meet the ownership and use tests. Gain above the exclusion counts in full, and long-held homes in expensive areas often exceed it.
• Required minimum distributions. RMDs from traditional IRAs and 401(k)s begin at 73 or 75 and grow as a share of the balance each year. A large pre-tax balance can lift income over a threshold with no decision on the owner's part. Our RMD table shows the percentage required at each age.
• The death of a spouse. A survivor files a joint return for the year of death and a single return after that. Household income usually falls by much less than half, because the IRAs and most investment income pass to the survivor, but the thresholds halve. A survivor with $150,000 of modified AGI is $68,000 under the joint threshold and $41,000 over the single one, which in 2026 is bracket 2 and $2,884.80 a year in surcharges.
• Other one-time income. A lump-sum pension payout taken as cash, deferred compensation paid at retirement, the sale of employer stock, or surrendering an annuity with a large gain.

Home-sale exclusion: IRS Topic 701.

How do people manage income around the thresholds?

The approaches below are the ones commonly used. They are described here for information; whether any of them suits a household depends on its whole tax picture, and a surcharge is sometimes worth paying.

• Sizing Roth conversions to a threshold. Many people convert up to a chosen bracket line and stop, leaving a margin for income they cannot predict, such as fund distributions in December. Others decide that a higher bracket is acceptable and convert well past the line, so that the fixed surcharge is spread over more converted dollars. Roth conversions before RMDs works through a multi-year plan.
• Qualified charitable distributions. From age 70½, money sent directly from an IRA to a charity is left out of AGI and counts toward the year's RMD. For someone who gives anyway, this lowers IRMAA income where a deduction for the same gift would not.
• Timing gains. A sale can sometimes be split across two tax years, moved into a year that is already over a line, or paired with realized losses. Net capital losses offset gains in full and up to $3,000 of other income a year.
• Choosing which account to draw from. Spending from a Roth account or from cash in a taxable account adds little or nothing to AGI, while a traditional IRA withdrawal adds every dollar. Households near a line often cover a large one-off expense from the first two.
• Bunching. Because each bracket is a fixed cost, some people concentrate unavoidable income into one year and keep the neighboring years under the line, so that one year is surcharged and the others are not.
• Converting before 63. Income earned before the year you turn 63 never reaches a Medicare premium, which is one reason conversions are often started in the first years of retirement.

None of these changes the brackets themselves, and all of them have to be done by December 31 of the income year. Once the year has closed, the only route to a lower premium is the appeal described next.

Can IRMAA be reduced after the fact?

Yes, in one situation: your income has fallen since the return being used because of a life-changing event. Form SSA-44 asks Social Security to use a more recent year, including an estimate of the current year, in place of the return from 2 years ago. The events the regulation recognizes are:

• marriage, divorce or annulment;
• the death of a spouse;
• stopping work or reducing work hours;
• loss of income-producing property through events outside your control, such as a disaster;
• loss or reduction of pension income;
• a settlement payment from an employer or former employer because of its closure, bankruptcy or reorganization.

Retirement is the common case. Someone who stops work at 66 would otherwise pay premiums set by a full salary until the lower-income return works its way through, and the form removes that lag. A request needs proof of the event and an estimate of the lower income, and each spouse files separately.

Our Form SSA-44 guide covers the evidence, the estimate, the deadlines and what happens if the estimate turns out too low.

Sources: 20 CFR 418.1205 to 418.1265; SSA POMS HI 01120.005; SSA POMS HI 01140.001.

How is the surcharge collected?

You do not pay IRMAA on your tax return, and you do not pay the Part D surcharge to your drug plan. Social Security decides the bracket and tells you in a notice that shows the income it used, the return year and your appeal rights. From there:

• If you receive Social Security benefits, the Part B premium, the Part B surcharge and the Part D surcharge are all deducted from the monthly benefit. Railroad Retirement and federal civil service annuities work the same way.
• If you are not yet drawing benefits, Medicare sends a bill. Part B is usually billed for three months at a time, and the Part D surcharge is billed monthly. The bill can be paid from a bank account through Medicare Easy Pay, online, or by check or card.
• If the benefit is too small to cover the deduction, Medicare bills the remainder.
• The Part D surcharge is owed to Medicare even if an employer or former employer pays your drug plan premium. Leaving it unpaid can end your drug coverage.

One further point for people in a bracket: the hold-harmless rule, which stops a Part B increase from reducing a Social Security check, does not protect anyone who pays IRMAA. They pay the full premium increase each year.

Source: Medicare.gov, publication 11469 (income and drug premiums); CMS fact sheet.

How have the thresholds and premiums changed?

The first threshold has risen every year since inflation indexing resumed in 2020. Between 2022 and 2026 it rose 20%, from $91,000 to $109,000 for a single filer, while the standard premium rose 19%.

Each year links to the CMS fact sheet the row was taken from. The standard premium fell in 2023 because the 2022 premium had been set with a reserve for a drug cost that turned out lower than expected.

For every other figure that changes each year, including the Part A deductible, Social Security amounts, contribution limits and tax brackets, see this year's retirement numbers.

Frequently asked questions

Sources

• CMS, 2026 Medicare Parts A & B premiums and deductibles (fact sheet, November 14, 2025): all 2026 brackets, premiums and surcharges.
• Federal Register, Medicare Part B monthly actuarial rates, premium rates and annual deductible beginning January 1, 2026: the formal notice behind the fact sheet.
• 42 U.S.C. 1395r(i): the definition of modified adjusted gross income, the cost shares, the indexing rule and the frozen top threshold.
• 20 CFR part 418, subpart B: how Social Security determines the adjustment and the life-changing events.
• SSA POMS HI 01101.010, HI 01120.005 and HI 01140.001: Social Security's operating instructions on income, life-changing events and appeals.
• Medicare.gov, publication 11469: how the Part D surcharge is billed.
• 2026 Medicare Trustees Report, tables V.E2 and V.E3 (intermediate estimates): the 2027 projections, labelled as such above.
• CMS fact sheets for 2022, 2023, 2024, 2025, linked from each row of the history table.