Already planning ahead for 2028? Smart move. Your 2028 Medicare IRMAA surcharges will be determined by your 2026 income — meaning you have all of 2026 to manage your Modified Adjusted Gross Income (MAGI) and potentially save thousands in Medicare premiums. Here are the projected 2028 brackets and what you should be planning now.
Key Takeaway
Your 2028 Medicare premiums are based on your 2026 tax return. The projected IRMAA thresholds start at approximately $113,000 (single) and $226,000 (married filing jointly). Managing your 2026 income now gives you the best chance of avoiding costly surcharges.
How 2028 IRMAA Is Determined
Medicare uses a two-year lookback to determine IRMAA surcharges. Here's the timeline for 2028:
- January – December 2026: Your income during this year sets your 2028 IRMAA
- April 2027: You file your 2026 tax return
- Late 2027: CMS publishes official 2028 IRMAA brackets
- November 2027: Social Security sends IRMAA determination letters
- January 2028: Higher premiums take effect
This means the financial decisions you make throughout 2026 — Roth conversions, asset sales, RMD amounts, rental income — directly determine what you'll pay for Medicare in 2028.
Projected 2028 IRMAA Brackets: Part B Premiums
Official 2028 brackets won't be published until late 2027. These projections are based on historical CPI adjustments of approximately 2-2.5% annually applied to the 2027 projected brackets.
Single Filers
| 2026 MAGI (Single) | Projected Monthly Premium | Projected Annual Cost |
|---|---|---|
| $113,000 or less | ~$224 | ~$2,688 (standard) |
| $113,001 – $143,000 | ~$313 | ~$3,756 |
| $143,001 – $179,000 | ~$448 | ~$5,376 |
| $179,001 – $215,000 | ~$582 | ~$6,984 |
| $215,001 – $500,000 | ~$716 | ~$8,592 |
| Above $500,000 | ~$761 | ~$9,132 |
Married Filing Jointly
| 2026 MAGI (Joint) | Projected Monthly Premium (each) | Projected Annual Surcharge per Couple |
|---|---|---|
| $226,000 or less | ~$224 | $0 (standard) |
| $226,001 – $286,000 | ~$313 | ~$2,136 |
| $286,001 – $358,000 | ~$448 | ~$5,376 |
| $358,001 – $430,000 | ~$582 | ~$8,592 |
| $430,001 – $750,000 | ~$716 | ~$11,808 |
| Above $750,000 | ~$761 | ~$12,888 |
Important: These Are Projections
These brackets are estimated based on ~2.25% annual inflation adjustments. The official 2028 brackets will be published by CMS in late 2027 and may differ. Use these as a planning baseline, not exact figures. We will update this article when official numbers are released.
Projected 2028 Part D Surcharges
Part D IRMAA surcharges are added on top of your prescription drug plan's regular premium:
| 2026 MAGI (Single / Joint) | Projected Monthly Part D Surcharge | Projected Annual Surcharge |
|---|---|---|
| $113,000 / $226,000 or less | $0 | $0 |
| $113,001–$143,000 / $226,001–$286,000 | ~$15.80 | ~$190 |
| $143,001–$179,000 / $286,001–$358,000 | ~$40.60 | ~$487 |
| $179,001–$215,000 / $358,001–$430,000 | ~$65.50 | ~$786 |
| $215,001–$500,000 / $430,001–$750,000 | ~$90.20 | ~$1,082 |
| Above $500,000 / Above $750,000 | ~$98.80 | ~$1,186 |
How 2028 Compares to 2027 and 2026
IRMAA thresholds have been rising steadily with inflation:
| Year | Tier 1 Threshold (Single / Joint) | Standard Part B Premium | Based on Income From |
|---|---|---|---|
| 2026 | $106,000 / $212,000 | $203.40 | 2024 |
| 2027 (projected) | $111,000 / $222,000 | $218.60 | 2025 |
| 2028 (projected) | $113,000 / $226,000 | ~$224 | 2026 |
The rising thresholds are good news — they mean slightly more income is sheltered each year. However, the standard premium is also increasing, so total Medicare costs continue to grow.
Planning Actions for 2026 (To Reduce 2028 IRMAA)
Since 2028 IRMAA is based on your 2026 income, here's what to focus on this year:
- Project your 2026 MAGI now: Add up expected income from all sources — Social Security, RMDs, pensions, investment income, planned Roth conversions, and any asset sales
- Size Roth conversions carefully: If your base MAGI is $200,000 (joint), you have room for approximately $26,000 in Roth conversions before crossing the projected $226,000 threshold
- Time capital gains: If you're planning to sell investments or real estate, consider whether the gains could push you over an IRMAA cliff. Spreading sales across 2026 and 2027 may keep you below the threshold in both years
- Use QCDs for charitable giving: If you're 70½+, donate directly from your IRA to charity. QCDs count toward your RMD but don't increase MAGI
- Maximize pre-tax contributions: If still working, maximize 401(k) contributions to reduce AGI
- Harvest capital losses: Offset realized gains with losses to bring net capital gains down
Two-Year Planning Window
The two-year lookback creates a unique planning challenge: you need to manage your 2026 income now for 2028 IRMAA while simultaneously considering that your 2026 Roth conversions won't show up in IRMAA until 2028. Planning both years together ensures you don't inadvertently spike your income in either year.
Using Bullseye to Plan for 2028 IRMAA
Bullseye's year-by-year projections help you plan ahead for future IRMAA costs:
- Multi-year IRMAA forecasting: See projected IRMAA surcharges for 2027, 2028, and beyond based on your income trajectory
- Scenario testing: Model different 2026 income levels to see how they affect your 2028 Medicare costs
- RMD projections: As your traditional IRA grows, Bullseye shows how increasing RMDs push you into higher IRMAA brackets over time
- Comprehensive view: See how IRMAA interacts with taxes, Social Security, and your overall withdrawal strategy
Bottom Line
2028 IRMAA planning starts now — your 2026 income determines your 2028 Medicare premiums. The projected thresholds start at $113,000 (single) and $226,000 (joint). Use this year to optimize Roth conversions, time asset sales, and leverage QCDs to keep your MAGI below the nearest IRMAA cliff. A few thousand dollars of income management today can save you $2,500-$13,000+ in Medicare surcharges in 2028.
