Medicare surcharges, known as the Income-Related Monthly Adjustment Amount (IRMAA), raise Part B and Part D premiums for people with higher incomes. In 2026, they start once modified adjusted gross income (MAGI) tops $109,000 for individuals or $218,000 for married couples filing jointly. Medicare looks at your tax return from two years earlier, so your 2026 income sets your 2028 premiums.
The surcharges add up fast, and they apply per person. A married couple in the top bracket pays close to $13,900 a year combined in extra premiums.
2026 IRMAA Brackets for Part B and Part D
These 2026 brackets use income from your 2024 tax return. Part B amounts are your total monthly premium. Part D amounts are added to your plan’s own premium.
| MAGI, individual | MAGI, married filing jointly | Part B premium per month | Part D surcharge per month |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 | $14.50 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 | $37.50 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 | $60.40 |
| Above $205,000 and less than $500,000 | Above $410,000 and less than $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Source: CMS, 2026 Medicare Parts A & B Premiums and Deductibles fact sheet.
Married but filing separately, and lived with your spouse during the year? You pay $649.20 for Part B plus $83.30 for Part D with MAGI above $109,000 and below $391,000. At $391,000 or more, it’s $689.90 plus $91.00.
IRMAA Brackets for 2027 and 2028
CMS announces 2027 premiums and IRMAA brackets in November 2026, based on 2025 tax returns. The 2026 Medicare Trustees Report projects a 2027 standard Part B premium of $209.50 a month.
The 2028 brackets apply to income you earn in 2026, and they won’t be published until fall 2027. The income thresholds rise with inflation each year, so the 2026 thresholds work as a conservative line for planning. Keep your 2026 MAGI at or below $109,000 (single) or $218,000 (joint), and you should stay clear of the first 2028 bracket. The top thresholds of $500,000 and $750,000 have been fixed since 2019 and start adjusting for inflation in 2028.
That timing matters most for income you control this year: Roth conversions, capital gains, and large IRA withdrawals.
What Does Medicare Cost?
There are many different costs associated with Medicare. You may pay monthly premiums, IRMAA (see above), coinsurance, co-pays, and deductibles.
Your total out-of-pocket costs for Medicare depend on the coverage you select, your income, where you live, your health, and how much care you use.
For a personalized estimate of your Medicare costs, use the Boldin Planner. It estimates your total lifetime out-of-pocket medical spending, including premiums based on your income.
What is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. Social Security explains that if your modified adjusted gross income (MAGI) from your tax return two years earlier is above a set amount, you’ll pay the standard premium plus IRMAA. For IRMAA, MAGI means your adjusted gross income plus any tax-exempt interest, such as interest from municipal bonds. That’s a different calculation from the MAGI used for Roth IRA contribution limits or ACA premium subsidies, so a figure from one may not match the other.
IRMAA is an extra charge added to your Part B and Part D premiums. The brackets above show how much it adds at each income level.
What is the Maximum IRMAA You Might Pay?
The standard Part B premium is $202.90 a month in 2026. In the top IRMAA bracket, you’ll pay an extra $487 a month for Part B and $91 for Part D. That’s $578 a month, or $6,936 a year, per person.
How Can You Reduce a Medicare Surcharge?
With some planning, there are steps you can take to avoid or reduce IRMAA.
Here are 5 ideas:
1. Find Out Which Future Years You’ll Pay IRMAA
You can use the Boldin Planner which provides you with an IRMAA analysis. You can see your projected annual income and assess when you might be assessed for IRMAA and how much for every year from now through your (and your spouse’s) longevity.
NOTE: Medicare sets your IRMAA from your MAGI two years earlier. The IRMAA you’d owe in 2028 depends on your 2026 income.
2. Take Steps to Minimize Taxable Income
If you can keep your MAGI below an IRMAA threshold, you can save hundreds or thousands of dollars a year. The thresholds work like cliffs: go $1 over, and you pay the full surcharge for that bracket.
Keeping income down gets harder once Required Minimum Distributions (RMDs) start.
Planning ahead is key. You may be able to time large income events, manage capital gains, give through qualified charitable distributions (QCDs) from an IRA, and draw from Roth accounts or HSAs in high-income years. A tax professional or financial planner can help you map it out.
Or, explore 25 tips for retirement taxes.
3. Consider a Roth Conversion
Converting money from a traditional IRA or 401(k) to a Roth account shrinks future RMDs, and qualified Roth withdrawals don’t count toward MAGI. The catch: a conversion adds to your income in the year you do it, which can push you into IRMAA two years later. Spreading conversions over several years can keep each year under a threshold.
Use the Roth Conversion Explorer in the Boldin Planner to see your potential opportunity for reducing your tax and IRMAA liability.
You can use this tool to explore only converting to IRMAA brackets.
4. Ask Social Security to Use Your Current Income After a Life Change
Your IRMAA is based on income from two years ago. If your income has dropped because of a life-changing event, you can ask Social Security to use a more recent year by filing Form SSA-44.
Qualifying events include marriage, divorce, a spouse’s death, stopping or cutting back work, losing income-producing property, and losing pension income.
5. Create and Maintain Your Overall Retirement Plan
Healthcare is a major consideration when planning a secure retirement, but there are hundreds if not thousands of different elements that impact your current and future wealth and security.
Make sure that you have a comprehensive plan and that you keep it updated.
Use the Boldin Planning Platform to feel in control of your money today and secure about your future. The tools will help you do better with your time, taxes, income, investments, and more.
Other 2026 Medicare Premiums
These 2026 amounts come from CMS. Part A and Part C premiums don’t depend on income. Part B and Part D premiums do, as the IRMAA table above shows.
Medicare Part A Premiums
The monthly premium for Medicare Part A ranges from $0 to $565 in 2026.
Most people pay no Part A premium because they paid Medicare taxes long enough while working. If you have to buy Part A, you’ll pay $311 or $565 a month, depending on how long you or your spouse paid Medicare taxes.
Medicare Part B Premiums
The standard Part B premium is $202.90 a month in 2026, and the annual deductible is $283.
The IRMAA table above shows Part B premiums at each income level. Once your financial plan is set up in the Boldin Planner, you can see whether you’ll owe IRMAA and how much, year by year. Look for the IRMAA and Income and Expenses charts in the Insights section of the Planner.
Medicare Part C Premiums
Part C, better known as Medicare Advantage, has a monthly premium that varies by plan.
Medicare Part D Premiums
Medicare Part D (prescription drug coverage) premiums also vary depending on the plan you choose.
If your income is above the IRMAA thresholds, you’ll also pay a monthly surcharge on top of your plan’s premium. In 2026 it runs from $14.50 to $91.00, as shown in the table above.
When Did These Surcharges on Medicare Premiums Become Law?
Congress created the Part B surcharge in the Medicare Modernization Act of 2003, and it took effect in 2007. The Affordable Care Act added the Part D surcharge in 2011. Later laws tightened the upper brackets in 2018 and added the top bracket for the highest earners in 2019.
FAQ: IRMAA and Medicare Surcharges
What are the IRMAA brackets for 2026?
In 2026, IRMAA applies to individuals with MAGI above $109,000 and married couples filing jointly above $218,000, based on 2024 tax returns. Part B premiums range from $202.90 a month with no surcharge to $689.90 in the top bracket. Part D surcharges range from $14.50 to $91.00 a month.
What are the IRMAA brackets for 2028?
The 2028 IRMAA brackets haven’t been published yet. Medicare will set them in fall 2027 based on 2026 tax returns. Because the thresholds rise with inflation, keeping 2026 MAGI at or below $109,000 (single) or $218,000 (joint) should keep you out of the first 2028 bracket.
How does Medicare decide if I owe IRMAA?
Social Security uses the modified adjusted gross income (MAGI) from your federal tax return two years earlier. MAGI is your adjusted gross income plus tax-exempt interest. For 2027 premiums, that means your 2025 return.
Can I appeal an IRMAA surcharge?
You can ask Social Security to lower an IRMAA surcharge if your income dropped after a life-changing event such as retirement, a spouse’s death, or divorce. File Form SSA-44 to request a new decision based on a more recent year. You can also request reconsideration if the tax information Social Security used is wrong.
When are the 2027 IRMAA brackets announced?
CMS announces the next year’s Part B premium and IRMAA brackets each November. The 2027 brackets will use 2025 tax returns. The standard Part B premium is projected at $209.50 a month for 2027.
