How IRMAA works, in 30 seconds
IRMAA (income-related monthly adjustment amount) is a surcharge on Medicare Part B and Part D for people with higher incomes. Medicare looks at your tax return from two years earlier, so 2027 premiums are set by 2025 income.
It is a cliff, not a phase-in. One dollar over a line moves you into the next tier for the whole year, and on a joint return both spouses on Medicare pay it. The first 2027 line is projected at $112,000 single and $224,000 joint, up from $109,000 and $218,000 in 2026. The standard Part B premium is projected at $209.50 a month for 2027, up from $202.90.
CMS publishes the official 2027 figures in mid November 2026. Until then these are projections from the 2026 Medicare Trustees Report and federal inflation data. See the 2026 premiums and brackets, the IRMAA calculator and how people avoid IRMAA.
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