If you're on Medicare or approaching 65, your 2025 income is already determining what you'll pay for Medicare in 2027. The Income-Related Monthly Adjustment Amount (IRMAA) can add hundreds — even thousands — of dollars per year to your premiums. Here are the projected 2027 brackets and what you can do about them right now.
Key Takeaway
Your 2027 Medicare premiums are based on your 2025 tax return (filed in 2026). If your Modified Adjusted Gross Income (MAGI) exceeds $111,000 (single) or $222,000 (married filing jointly), you'll pay higher premiums. The window to manage your 2025 income is closing — act before December 31, 2025.
What Is IRMAA?
Most Medicare beneficiaries pay the standard Part B premium. But if your income exceeds certain thresholds, Social Security adds a surcharge called IRMAA to both your Part B (medical insurance) and Part D (prescription drug) premiums. About 7% of Medicare beneficiaries — roughly 4.5 million people — pay IRMAA surcharges.
The key detail: IRMAA uses a two-year lookback. Your 2027 premiums are based on the income reported on your 2025 tax return. This means the income decisions you make this year directly affect your Medicare costs two years from now.
Projected 2027 IRMAA Brackets: Part B Premiums
The official 2027 brackets won't be released by CMS until late 2026, but we can project them based on historical inflation adjustments of approximately 2-2.5% annually. Here are the estimated 2027 Part B brackets and monthly premiums:
Single Filers
| 2025 MAGI (Single) | Monthly Premium | Annual Cost | Annual Surcharge vs. Standard |
|---|---|---|---|
| $111,000 or less | $218.60 | $2,623 | $0 (standard) |
| $111,001 – $140,000 | $306.00 | $3,672 | +$1,049 |
| $140,001 – $175,000 | $437.20 | $5,246 | +$2,623 |
| $175,001 – $210,000 | $568.40 | $6,821 | +$4,198 |
| $210,001 – $500,000 | $699.50 | $8,394 | +$5,771 |
| Above $500,000 | $743.20 | $8,918 | +$6,295 |
Married Filing Jointly
| 2025 MAGI (Joint) | Monthly Premium (each) | Annual Cost (each) | Annual Surcharge per Couple |
|---|---|---|---|
| $222,000 or less | $218.60 | $2,623 | $0 (standard) |
| $222,001 – $280,000 | $306.00 | $3,672 | +$2,098 |
| $280,001 – $350,000 | $437.20 | $5,246 | +$5,246 |
| $350,001 – $420,000 | $568.40 | $6,821 | +$8,396 |
| $420,001 – $750,000 | $699.50 | $8,394 | +$11,542 |
| Above $750,000 | $743.20 | $8,918 | +$12,590 |
Important: These Are Projections
The official 2027 IRMAA brackets will be published by CMS in late 2026. These projections are based on approximately 2.25% annual inflation adjustments. Actual brackets may differ slightly, but they provide a reliable planning baseline. We will update this article when official numbers are released.
Projected 2027 IRMAA: Part D Surcharges
In addition to Part B surcharges, higher-income beneficiaries pay extra for Part D prescription drug coverage. These surcharges are added on top of your plan's regular premium:
| 2025 MAGI (Single / Joint) | Monthly Part D Surcharge | Annual Surcharge |
|---|---|---|
| $111,000 / $222,000 or less | $0 | $0 |
| $111,001–$140,000 / $222,001–$280,000 | $15.40 | $185 |
| $140,001–$175,000 / $280,001–$350,000 | $39.70 | $476 |
| $175,001–$210,000 / $350,001–$420,000 | $64.00 | $768 |
| $210,001–$500,000 / $420,001–$750,000 | $88.10 | $1,057 |
| Above $500,000 / Above $750,000 | $96.50 | $1,158 |
Total 2027 IRMAA Impact: Combined Part B + Part D
When you combine Part B and Part D surcharges, the total IRMAA cost becomes significant — especially for married couples where both spouses are on Medicare:
| IRMAA Tier | Total Monthly Surcharge (per person) | Annual Cost per Person | Annual Cost per Couple |
|---|---|---|---|
| Tier 1 (standard) | $0 | $0 | $0 |
| Tier 2 | $102.80 | $1,234 | $2,467 |
| Tier 3 | $258.30 | $3,100 | $6,199 |
| Tier 4 | $413.80 | $4,966 | $9,931 |
| Tier 5 | $569.00 | $6,828 | $13,656 |
| Tier 6 (highest) | $621.10 | $7,453 | $14,906 |
A married couple in Tier 5 ($420,001–$750,000 joint MAGI) would pay nearly $13,700 per year in IRMAA surcharges alone — on top of their standard Medicare premiums.
How 2027 IRMAA Is Determined From Your 2025 Income
Understanding the timeline is critical for planning:
- January – December 2025: Your income during this year determines your 2027 IRMAA
- April 2026: You file your 2025 tax return
- Late 2026: CMS publishes official 2027 IRMAA brackets
- November 2026: Social Security sends IRMAA determination letters
- January 2027: Higher premiums take effect
IRMAA is based on your Modified Adjusted Gross Income (MAGI), which includes:
- Adjusted Gross Income (AGI) — wages, IRA/401(k) withdrawals, RMDs, pensions, rental income, capital gains, Social Security benefits
- Plus tax-exempt interest — including municipal bond interest
What Doesn't Count Toward IRMAA
Roth IRA withdrawals, return of cost basis from brokerage accounts, HSA distributions for medical expenses, and loan proceeds (reverse mortgage, HELOC) do not count toward MAGI and won't trigger IRMAA.
The Cliff Effect: Why $1 Matters
IRMAA brackets work as cliffs, not gradual scales. If your joint MAGI is $222,000, you pay the standard premium. At $222,001, you jump to Tier 2 and pay an additional $2,467 per year as a couple. That one extra dollar of income costs you thousands.
This makes income management near the thresholds extremely valuable. Common strategies include:
- Limiting Roth conversions to stay just below a threshold
- Timing capital gains — deferring a stock sale to the following year
- Harvesting capital losses to offset gains and reduce MAGI
- Using Qualified Charitable Distributions (QCDs) after age 70½ to satisfy RMDs without adding to MAGI
How 2027 Brackets Compare to Previous Years
IRMAA thresholds are adjusted annually for inflation. Here's how the married filing jointly thresholds have changed:
| Year | Tier 1 Threshold (Joint) | Standard Part B Premium |
|---|---|---|
| 2025 | $206,000 | $185.00 |
| 2026 | $218,000 | $203.40 |
| 2027 (projected) | $222,000 | $218.60 |
The thresholds have been rising 2-6% annually, which is good news — it means slightly more income is sheltered from IRMAA each year. However, the standard premium is also rising, so the base cost of Medicare continues to increase.
What You Can Do Right Now
Since 2027 IRMAA is based on your 2025 income, here are actions to consider before year-end:
- Calculate your projected 2025 MAGI — Add up all income sources including RMDs, Social Security, pensions, investment income, and any planned Roth conversions
- Check which bracket you'll land in — Use the tables above to see if you're near a cliff
- Adjust Roth conversions — If a conversion pushes you over a threshold, consider converting less this year and more next year
- Defer income if possible — Delay selling appreciated assets or taking discretionary IRA withdrawals
- Maximize deductions — Bunch charitable donations, prepay property taxes, or time medical procedures to reduce MAGI
- Consider QCDs — If you're 70½+, use Qualified Charitable Distributions to satisfy RMDs without increasing MAGI
Life-Changing Events: How to Appeal IRMAA
If your income has dropped significantly since 2025 due to a qualifying life event, you can request that Social Security use your current income instead. Qualifying events include:
- Marriage, divorce, or death of spouse
- Work stoppage or reduction (retirement, layoff)
- Loss of pension income
- Loss of income-producing property (sold a rental property)
File Form SSA-44 with your local Social Security office to request a reconsideration based on your reduced income.
Using Bullseye to Plan for 2027 IRMAA
Bullseye automatically calculates IRMAA surcharges as part of your year-by-year retirement projections:
- Automatic IRMAA modeling: Bullseye computes your MAGI each year (RMDs + Social Security + rental income + other sources) and applies the appropriate IRMAA bracket to your Medicare costs
- Spot the cliff years: See exactly which years your projected MAGI crosses an IRMAA threshold so you can plan income adjustments in advance
- Test Roth conversion scenarios: Use the Scenarios feature to model different conversion amounts and see how they affect your IRMAA two years later
- See the full picture: IRMAA is just one piece — Bullseye shows how it interacts with RMDs, taxes, Social Security, and your overall withdrawal strategy
Bottom Line
The projected 2027 IRMAA thresholds start at $111,000 (single) and $222,000 (married filing jointly). With surcharges reaching nearly $15,000 per year for high-income couples, managing your 2025 MAGI is one of the highest-impact financial moves you can make this year. Review your income projections now, adjust Roth conversions and capital gains timing, and use Bullseye to model the long-term impact of IRMAA on your retirement plan.
