Updated August 10, 2026. Quick answer. Your 2027 Medicare IRMAA surcharge, if any, is based on your 2025 tax return — income that is already fixed and on file. That means the 2027 IRMAA tiers (the dollar thresholds) aren’t announced until around November 2026, but whether YOUR income will trigger a surcharge, and roughly which tier, is already knowable, because the income year that decides it (2025) is already closed.
The two-year lookback, explained plainly
Medicare premiums are never based on the current year’s income — the IRS hasn’t finished processing current-year returns when premiums are set. Instead, your 2027 premium is based on your Modified Adjusted Gross Income from the tax return you filed in spring 2026 covering tax year 2025. If 2025 was a high-income year (a large capital gain, a big Roth conversion, a final year of full salary before retiring), that income — even if your income has since dropped — is what sets your 2027 premium.
Projected 2027 thresholds (not yet official)
Based on the same inflation-indexing method CMS has historically used, the first 2027 IRMAA tier is projected to begin around $111,000 MAGI for single filers (roughly $222,000 for joint filers), with additional tiers near $140,000, $175,000, $210,000, and a top tier that is statutorily frozen at $500,000 single / $750,000 joint (this top bracket does not move with inflation, by law). These are projections; CMS’s official 2027 announcement is expected in the first half of November 2026.
An IRMAA appeal or income-management move is exactly what an advisor prices for you
The matching service below introduces you to advisers who pay to meet you. Ask what an SSA-44 appeal or a multi-year Roth-conversion plan around the IRMAA thresholds would look like for your numbers. It is free to you, and it is not the only way to find an adviser.
Before you start, what actually happens. The form is run by Kapitalwise, our advisor-matching partner. Kapitalwise sends your details to advisers who pay for the introduction, so expect calls and texts. Clear Money Guide is paid when you submit the form, whether or not you ever hire anyone. This is free to you and there is no obligation to hire anyone.
The Kapitalwise form opens here — you stay on this page.
What happens when you press the button
It asks about nine questions — age, investable assets, location — then your name, email and phone number, and verifies the phone by text. Nothing loads and nothing reaches Kapitalwise until you press the button.
If your 2025 income doesn’t reflect your current situation
The two-year lookback is not absolute: Form SSA-44 lets you report a “life-changing event” — retirement, loss of a pension, a work-reduction, marriage, divorce, or the death of a spouse — that lowered your income after the year used to calculate your premium. It does not undo the lookback itself, but it can reduce or eliminate a surcharge based on income that no longer reflects your life. If your 2025 income was unusually high for a one-time reason (a large asset sale, a big Roth conversion), it’s worth preparing the SSA-44 documentation now rather than waiting for the November bracket announcement.
Sources
42 U.S.C. §1395r (the statutory IRMAA structure, including the frozen top-tier threshold). Projected 2027 thresholds: inflation-indexing method as historically applied by CMS, reported across financial-planning publications in 2026 — not an official CMS figure. Form SSA-44: Social Security Administration.
Every projected figure above is attributed to the organization that published it and is explicitly not yet announced by the government body that sets it. This page will be updated with the official figure the day it is announced, and the projection will be struck through rather than deleted, so the record of what was projected vs. what actually happened stays visible. See the full current-numbers register for every figure this site tracks, dated and sourced. General information, not tax or legal advice.
The 2027 tiers are not announced, though the income year that decides them is already closed. Your 2027 numbers gives the figures that do exist now, and the window CMS has to publish these in.
More Medicare & IRMAA guides: see the full 44-page index.