Your 2027 Medicare surcharge is set by a number nobody has published
IRMAA decides whether you pay a surcharge on top of Part B. The 2027 brackets are not confirmed until CMS publishes them around November 2026.
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2026 · CMS publishes · IRMAA brackets for 2027
IRMAA is the income-related surcharge added to Medicare Part B and Part D. The brackets that decide who pays it in 2027 are confirmed by CMS around November 2026, and they are based on the income you reported two years earlier — your 2025 tax return.
If your income is above the threshold, you do not pay the standard Part B premium. You pay it plus a surcharge called IRMAA — the income-related monthly adjustment amount.
The brackets that decide whether you are above that line in 2027 have not been published. CMS confirms them around November 2026, at the same time it confirms the premium and the deductible.
The part people miss: it looks two years back
Your 2027 surcharge is based on the income you reported on your 2025 tax return — the one you filed in 2026.
That has a practical consequence. If you retired in 2026, your 2027 IRMAA is calculated on your working income from 2025. You can be paying a surcharge based on a salary you no longer earn.
What to do about it
There is a process for exactly this. If you had a life-changing event — retirement, a spouse’s death, divorce, loss of income-producing property — you can ask SSA to use a more recent year instead. It is filed on form SSA-44, with documentation.
It is not automatic. If you do not file it, the surcharge stands.
The date that matters
Watch for the CMS announcement around November 2026. Until then, any 2027 IRMAA bracket you see published is an estimate carried forward from the current year’s structure.
Questions people ask
Which year's income counts for 2027?
Generally your 2025 tax return — the return filed in 2026. Medicare uses a two-year lookback.
Can I appeal it?
Yes, if you had a qualifying life-changing event such as retirement, divorce or the death of a spouse. That is filed with SSA using form SSA-44.