By Qamar S, 15 years in US medical billing · Last reviewed September 28, 2026
IRMAA is an extra charge added to your Medicare Part B and Part D premiums when your income is above a set limit. For 2026, it starts when your modified adjusted gross income (MAGI) is over $109,000 if you file single or $218,000 if you file jointly. The official 2027 brackets come out in the fall, usually in early November, and they’re based on your 2025 tax return.
Two-year lookback: your 2027 premiums use the income on your 2025 tax return. If your income has dropped since then because you retired, stopped working or lost a spouse, you can ask Social Security to use a newer year.
2026 IRMAA brackets (official)
| Your 2024 MAGI: single | Your 2024 MAGI: joint | Part B monthly premium | Part D extra per month |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | $60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
The Part D amount is added on top of your drug plan’s own premium. If you have a Medicare Advantage plan with drug coverage, you still pay the Part D IRMAA.
What about 2027?
The 2027 brackets and premiums haven’t been announced yet. The income limits rise with inflation each year, so early estimates put the first 2027 threshold at about $112,000 single and $224,000 joint. Treat those as estimates only. We’ll update this page when Medicare publishes the official numbers.
How IRMAA works
- Social Security decides using the MAGI the IRS reports from your tax return two years back.
- MAGI means your adjusted gross income plus tax-exempt interest.
- It’s a cliff. Going $1 over a threshold puts you in the higher tier for the whole year.
- It’s set each year. If your income drops, your IRMAA can drop the next year.
How to lower or appeal IRMAA
If a life-changing event reduced your income, you can ask Social Security to use a more recent year’s income. Qualifying events include:
- Retirement or cutting back work hours
- Marriage, divorce or the death of a spouse
- Losing income-producing property or a pension
Use Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event) and include proof, such as a letter from your employer or a newer tax return. If Social Security used the wrong income or an amended return, you can also ask for a new decision.
From 15 years in billing: keep the IRMAA letter Social Security sends you. If you appeal and win, the premium change can take a few months to show up. That letter and your SSA-44 paperwork are what you’ll need if the bills don’t match.
Free, unbiased help: your State Health Insurance Assistance Program (SHIP) at shiphelp.org or 1-877-839-2675.
Frequently asked questions
What income triggers IRMAA in 2026?
A modified adjusted gross income above $109,000 if you file single, or above $218,000 if you file jointly, based on your 2024 tax return.
What year’s income is used for 2027 IRMAA?
Your 2025 tax return. Social Security uses the income from two years before.
When will the 2027 IRMAA brackets be announced?
Medicare usually publishes them in the fall, often in early November, along with the 2027 Part B premium.
How do I appeal IRMAA?
If a life-changing event such as retirement, reduced work, divorce or a spouse’s death lowered your income, file Form SSA-44 with Social Security and include proof.
Sources: Social Security: Medicare premiums and IRMAA · Medicare.gov: Part B costs · ValuePenguin: 2026 IRMAA brackets · Kiplinger: projected 2027 IRMAA
This guide is educational and is not legal, financial or insurance advice. MedBillGuide is not connected to Medicare, CMS or any government agency, and we do not sell insurance. See our Disclaimer.