Your Medicare premium can change with your income.
IRMAA means Income-Related Monthly Adjustment Amount. It is an income-based addition to Part B and Part D premiums, including for people in Medicare Advantage.
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2026: the published amounts
The standard Part B premium is $202.90 per person per month; the annual deductible is $283. Your own premium can differ because of IRMAA, penalties, assistance, or other rules.
Which income does Social Security use?
Generally, Social Security uses the tax return from two years earlier. For Medicare IRMAA, modified adjusted gross income (MAGI) generally means adjusted gross income plus tax-exempt interest. Coverage in 2026 usually uses 2024 income; 2027 uses 2025; 2028 uses 2026.
A taxable retirement withdrawal, realized gain, or Roth conversion can affect that income. A bracket is not a marginal tax rate: crossing a cutoff can increase your monthly surcharge for the year. For spouses both enrolled in Medicare, premiums apply separately to each person.
| Individual return | Married filing jointly | Total Part B | Part D addition* |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $202.90 | $0 |
| > $109,000–$137,000 | > $218,000–$274,000 | $284.10 | $14.50 |
| > $137,000–$171,000 | > $274,000–$342,000 | $405.80 | $37.50 |
| > $171,000–$205,000 | > $342,000–$410,000 | $527.50 | $60.40 |
| > $205,000–< $500,000 | > $410,000–< $750,000 | $649.20 | $83.30 |
| ≥ $500,000 | ≥ $750,000 | $689.90 | $91.00 |
*Add Part D IRMAA to your plan’s own drug premium. Source: CMS, 2026 Parts A & B premiums and Part D IRMAA release.
Married filing separately can be different.
If you lived with your spouse at any time in the tax year and filed separately, 2026 MAGI up to $109,000 has no IRMAA; over $109,000 but below $391,000 gives a $649.20 total Part B premium and $83.30 Part D addition; $391,000 or more gives $689.90 and $91.00 respectively. If you lived apart all year, confirm the applicable treatment with Social Security.
2027 and 2028: estimates are not official amounts.
As of October 16, 2026, the 2027 standard Part B premium and official IRMAA brackets have not been announced. The 2027 Medicare & You handbook also notes that premium amounts and income limits were unavailable at printing. Do not budget on the assumption that 2026 costs will remain unchanged.
A published projection puts the 2027 standard Part B premium at $209.50, subject to change. No confirmed 2028 premium is presented here.
The following planning estimates are adapted from The Finance Buff’s October 15, 2026 analysis. Each cell gives individual / joint annual MAGI in dollars. The first four rows are upper bounds, inclusive; the top-tier row is a lower bound, inclusive. The tier below the top extends above Tier 3 up to, but not including, the top-tier start. The 2027 ranges reflect alternative calculation methods, not official bracket intervals. The two 2028 columns are scenarios, not guaranteed minimums or maximums.
| Bracket boundary | 2027 projection | 2028: 0% inflation scenario | 2028: 3% inflation scenario |
|---|---|---|---|
| Standard | 112,000 / 224,000 | 115,000 / 230,000 | 116,000 / 232,000 |
| Tier 1 | 141,000–142,000 / 282,000–284,000 | 145,000 / 290,000 | 147,000 / 294,000 |
| Tier 2 | 176,000–177,000 / 352,000–354,000 | 180,000 / 360,000 | 183,000 / 366,000 |
| Tier 3 | 211,000–212,000 / 422,000–424,000 | 216,000 / 432,000 | 219,000 / 438,000 |
| Top tier starts | 500,000 / 750,000 | 511,000 / 766,500 | 518,000 / 777,000 |
Separate-filer projections (when the lived-with-spouse rule applies): 2027 standard up to $112,000, top tier from $388,000; 2028 standard up to $115,000 / $116,000 and top tier from $396,000 / $402,000 in the 0% / 3% scenarios. The intervening income is in the next-to-highest tier. Future surcharge dollars remain unconfirmed here.
The Finance Buff: projection methodology and updates ↗
Income fell after retirement or another life change?
You may be able to request a new IRMAA determination when a qualifying life-changing event lowers income—for example, retirement or reduced work, death of a spouse, marriage, or divorce. Social Security’s Form SSA-44 explains eligible events and evidence. A one-time investment gain alone is not automatically a qualifying event. You can also challenge incorrect information using the appeal instructions on your notice.
IRMAA is reviewed annually; it is different from a late-enrollment penalty. Seek individualized tax advice before changing investments or retirement withdrawals just to meet a bracket.
Social Security: Medicare premiums ↗ · SSA-44: life-changing events ↗
Reviewed October 16, 2026. This dated guide does not update automatically. Check current CMS and Social Security figures before making a decision.
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