Quick version: IRMAA is the income surcharge Medicare tacks onto your Part B and Part D premiums. For 2026 it kicks in above $109,000 (single) or $218,000 (joint) in modified adjusted gross income from your 2024 tax return, and it can push a single retiree's Part B premium as high as $689.90 per month. The 2027 numbers are not final yet, but the first bracket is essentially locked at $112,000 (single) / $224,000 (joint) based on your 2025 return.
Below: the confirmed 2026 brackets, the projected 2027 brackets, why the surcharge is so common in Palm Beach County, and — most important — how to get IRMAA removed after you retire.
What IRMAA actually is
IRMAA — Income-Related Monthly Adjustment Amount — is not a separate program. It is a surcharge Medicare adds on top of the standard Part B and Part D premiums for beneficiaries whose income is above certain thresholds. The Centers for Medicare & Medicaid Services (CMS) recalculates the thresholds and the dollar surcharges every year. About 8 percent of Part B enrollees end up paying it.
Two things about the way the surcharge is calculated tend to catch new retirees off guard:
- It uses a two-year lookback. Your 2026 IRMAA is based on your 2024 tax return. Your 2027 IRMAA will be based on your 2025 return. So the year you retire almost never matches the year IRMAA finally reflects your lower income.
- It is a cliff, not a slope. One dollar over a bracket pushes you into the next tier for the entire year. A married couple filing jointly at $218,001 of MAGI in 2024 pays roughly $2,098 more in combined Part B premiums in 2026 than a couple at $218,000.
Confirmed 2026 IRMAA brackets (from your 2024 income)
These are the official numbers CMS published on November 14, 2025. The standard 2026 Part B premium is $202.90 per month, up 9.7 percent from $185.00 in 2025. The annual Part B deductible is $283.
| 2024 MAGI — Single | 2024 MAGI — Joint | Total Part B / month | Part D surcharge / month |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $202.90 | $0.00 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | +$14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | +$37.50 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | +$60.40 |
| $205,001 – < $500,000 | $410,001 – < $750,000 | $649.20 | +$83.30 |
| ≥ $500,000 | ≥ $750,000 | $689.90 | +$91.00 |
Read that top row honestly: a single Palm Beach County retiree whose 2024 MAGI landed above $500,000 pays $689.90 per month in Part B in 2026 — that is $8,279 a year for one person, before Part D or any Medigap premium. For a couple at the top bracket, the combined annual Part B cost is around $16,558.
Projected 2027 IRMAA brackets (from your 2025 income)
CMS will not release the official 2027 numbers until mid-November 2026, but the first threshold is essentially locked at $112,000 (single) / $224,000 (joint) after the August 2026 CPI print landed on September 13, 2026 and completed the statutory measurement window. The higher tiers depend on how the Social Security Administration handles the never-published October 2025 CPI value, but they will land within about $1,000 of the numbers below.
Consensus 2027 projections from the sources tracking this closely (Kiplinger, IRMAA Hub, The Finance Buff, Cobalt Medicare, Retirement Advisor Pro) look like this — and they use a projected standard Part B premium of roughly $218.60:
| 2025 MAGI — Single | 2025 MAGI — Joint | Projected Part B / mo | Projected Part D surcharge / mo |
|---|---|---|---|
| ≤ $112,000 | ≤ $224,000 | ~$218.60 | $0 |
| $112,001 – ~$142,000 | $224,001 – ~$284,000 | ~$306 | ~$15.40 |
| ~$142,001 – ~$177,000 | ~$284,001 – ~$354,000 | ~$437 | ~$39.70 |
| ~$177,001 – ~$212,000 | ~$354,001 – ~$424,000 | ~$568 | ~$64.00 |
| ~$212,001 – < $500,000 | ~$424,001 – < $750,000 | ~$699 | ~$88.30 |
| ≥ $500,000 | ≥ $750,000 | ~$743 | ~$96.40 |
Two things worth flagging on this table. First, the top tier is frozen by statute at $500,000 single / $750,000 joint through 2027, so wage inflation is quietly pulling more households into the highest bracket every year. Second, "projected" means projected — treat the 2027 dollar amounts as directional until CMS publishes the fact sheet in November 2026. When they do, we will update this post.
Why IRMAA hits Palm Beach County retirees so often
Two years of Roth conversions, a big capital-gain year from selling a second home in Delray or Boca, an inherited IRA distribution, a lump-sum pension buyout, a pre-Medicare sale of a professional practice — every one of these can spike a single tax year and generate an IRMAA surcharge that lasts all 12 months of a future Medicare year. Snowbirds who bought in Palm Beach Gardens or Jupiter in 2010 and finally sold in 2024 have been showing up on IRMAA notices all year long.
None of that is a reason to skip the tax planning that generated the extra income. It is just a reason to look at the two-year IRMAA delay before you sign the closing statement or click "convert" on the Roth. A good CPA plus a Medicare-literate insurance agent working together can usually keep you out of the top brackets if you have any lead time.
Getting hit with an IRMAA surcharge you didn't expect?
I help Palm Beach County retirees walk through their Social Security IRMAA determination letter, decide whether to appeal, and pick a Medicare plan that keeps their Bethesda, JFK, Wellington Regional, Palms West, Jupiter Medical, Palm Beach Gardens Medical Center, Good Samaritan, or Boca Regional doctors in-network. Free. No pressure. Same-day response.
How to appeal an IRMAA surcharge — the SSA-44 route
This is the single most useful thing to know if you retired in 2025 or 2026 and just opened a Social Security letter telling you your Part B premium is going up. If you had a qualifying life-changing event (LCE) that permanently reduced your income after the tax year Medicare is using, you can ask Social Security to recalculate IRMAA using a more recent, more accurate income estimate.
Social Security recognizes eight LCEs:
- Marriage
- Divorce or annulment
- Death of a spouse
- Work stoppage (full retirement)
- Work reduction (partial retirement or hour cut)
- Loss of income-producing property (not due to your own sale — think casualty, disaster, fraud)
- Loss of pension income (employer failure, plan termination)
- Employer settlement payment
The form is SSA-44. You file it with your local Social Security office (in Palm Beach County that is usually the West Palm Beach or Delray Beach field office) along with evidence — a retirement letter, a divorce decree, a death certificate, a pay stub showing reduced hours, whatever fits the LCE. Most Palm Beach County snowbirds who just retired win these appeals on the first pass, but the form has to actually get filed. IRMAA does not go away on its own.
What to do right now if IRMAA is on your radar
If you are already on Medicare
- Pull your Social Security IRMAA determination letter for 2026. Confirm it is using the correct 2024 MAGI. Mistakes happen more often than they should.
- Estimate your 2025 MAGI now. That is the number that will drive your 2027 IRMAA. If you can still influence it before December 31, 2025 tax filing (extensions aside), do the modeling with your CPA.
- File SSA-44 if you have an LCE. Do not wait — the surcharge is prospective from the month you file, not retroactive.
If you are approaching 65 in the next 24 months
- Look at every income source flowing into your first two full Medicare years. Roth conversions, deferred compensation, RSU vests, real-estate closings, business sales. Any of them can turn a "normal" year into an IRMAA year.
- Talk to a Medicare-literate agent before you enroll. Original Medicare + a Medigap + Part D versus a Medicare Advantage plan is a totally different math problem once IRMAA is in the mix. Our turning-65 Florida guide and the six-month countdown timeline walk you through the sequence.
- Coordinate with your CPA. IRMAA is a tax-planning problem as much as an insurance problem.
If you are an early retiree (55–64) not on Medicare yet
- Watch the two-year lookback. The income you generate at ages 63 and 64 sets the IRMAA you pay at 65 and 66.
- Coordinate with your ACA subsidy strategy. Many early retirees in Palm Beach County are already threading a needle around the 400% FPL cliff on the ACA marketplace — IRMAA planning has to sit on top of that. Start with our early-retiree health insurance page.
Medicare Advantage vs. Original Medicare — does IRMAA change the answer?
For higher-income Palm Beach County retirees, yes, a little. IRMAA is charged on Part B regardless of whether you use Original Medicare or a Medicare Advantage (Part C) plan. Where it changes the math is Part D: if you take a $0-premium Medicare Advantage plan that bundles drug coverage, you still owe the Part D IRMAA surcharge separately to Medicare. That surcharge — up to $91 per month in 2026 — is deducted directly from your Social Security check, not from the MA plan. Retirees who assumed the "$0 premium" MA plan really cost zero are sometimes surprised.
The bigger driver of Advantage vs. Original Medicare for higher-income clients is usually network fit — which South Florida hospitals and specialists a plan actually contracts with — and whether Medigap underwriting still gets you into a Plan G or Plan N at a reasonable rate. That is a conversation, not a table.
Frequently asked questions
What is IRMAA and who has to pay it?
IRMAA is the Income-Related Monthly Adjustment Amount — an income surcharge Medicare adds to your Part B and Part D premiums when your MAGI exceeds specific thresholds. For 2026 it kicks in above $109,000 (single) or $218,000 (joint), based on your 2024 tax return. CMS says roughly 8 percent of Part B beneficiaries pay it.
How much is the Medicare Part B premium in 2026?
The standard 2026 Part B premium is $202.90 per month, and the annual Part B deductible is $283. Both numbers were confirmed by CMS on November 14, 2025. Above the IRMAA thresholds, monthly Part B ranges from $284.10 up to $689.90.
What are the projected IRMAA brackets for 2027?
The first threshold is essentially locked at $112,000 single / $224,000 joint, based on your 2025 MAGI. Projected total Part B ranges from roughly $306 per month at Tier 1 to about $743 per month at the top tier. CMS publishes the official numbers in mid-November 2026.
Can I appeal an IRMAA surcharge?
Yes, using Social Security form SSA-44, if you had a qualifying life-changing event that reduced your income after the tax year Medicare is using — retirement, work stoppage or reduction, marriage, divorce, death of a spouse, loss of pension income, or loss of income-producing property. Most Palm Beach County snowbirds who just retired win these appeals.
Do I have to pay IRMAA on a Medicare Advantage plan?
Yes. IRMAA is a Part B and Part D surcharge, not a plan-specific fee. If you enroll in a Medicare Advantage plan, you still pay your Part B premium (with any IRMAA surcharge) to Medicare on top of whatever premium your MA plan charges — often zero. Part D IRMAA is billed separately, usually deducted from Social Security.