Medicare Part D
Chicago IRMAA Surcharges for Part B & Part D 2027
CHICAGO — If your income is above average, Medicare could be about to cost you more in 2027. As Annual Enrollment runs through December 7, higher-income beneficiaries in Chicago and across Cook County are starting to think about the income-related monthly adjustment amounts, or IRMAA — the extra dollars added to Part B and Part D premiums when income crosses certain thresholds. CMS publishes the 2027 IRMAA brackets and surcharge amounts later this fall, typically in November.
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Key takeaways
- For 2026, extra Medicare charges called IRMAA start above $109,000 in income for single filers and $218,000 for married couples filing jointly.
- Medicare figures out your 2027 IRMAA using the tax return you filed in 2026 for income earned in 2025, so a one-time income spike two years ago can still raise your premium now.
- If your income has dropped due to a life-changing event, you can ask Social Security for a new decision by filing Form SSA-44 with supporting documents.
- Medicare's Annual Enrollment Period runs from October 15 to December 7, and while IRMAA adds extra cost on top of Part B and Part D premiums, it does not limit which plans you can choose.
Here's what to know before the year turns.
What IRMAA actually is
Most people pay the standard Medicare Part B premium and whatever their Part D drug plan charges. But if your income is above a set line, Medicare adds a surcharge on top of both. That surcharge is IRMAA.
A few key points:
- IRMAA applies to Part B and Part D, separately.
- It's based on your modified adjusted gross income (MAGI) from your tax return two years earlier. So your 2027 IRMAA is based on your 2025 tax return.
- Social Security typically deducts the Part B portion directly from your monthly benefit. The Part D portion is billed on top of your drug plan premium.
Only a small share of people with Medicare pay IRMAA — but if you do, it can add up quickly.
The income thresholds for 2026
For 2026, IRMAA kicks in above $109,000 for a single filer and $218,000 for a married couple filing jointly, according to CMS. Income above those lines is grouped into tiers, and each tier has a higher surcharge than the one below it. The top tier applies to single filers with income of $500,000 or more, and joint filers at $750,000 or more.
A simplified look at how the tiers work in 2026:
- Tier 1: Single above $109,000 / Joint above $218,000
- Tier 2: Single above $137,000 / Joint above $274,000
- Tier 3: Single above $171,000 / Joint above $342,000
- Tier 4: Single above $205,000 / Joint above $410,000
- Tier 5 (top): Single $500,000+ / Joint $750,000+
Married couples who file separately have their own, narrower schedule that reaches the top surcharge much sooner. For the exact dollar amounts of each surcharge, check medicare.gov — those figures are updated by CMS every fall.
Why 2025 income matters for your 2027 bill
This is the part that surprises people. When Medicare looks at your income for 2027, it looks back at the tax return you filed in 2026 — for tax year 2025. If you had a one-time bump in 2025 — a Roth conversion, a home sale, a large capital gain, an inherited IRA distribution — it can push you into an IRMAA tier two years later, even if your income is back to normal now.
That's why financial planners often talk about IRMAA when discussing retirement withdrawals: timing matters.
If your income has dropped, you can appeal
If you've had a "life-changing event" since that 2025 tax year, you don't have to just accept the surcharge. Social Security lets you request a new determination using Form SSA-44. Qualifying events include:
- Marriage, divorce, or death of a spouse
- You or your spouse stopped working or reduced hours (retirement counts)
- Loss of income-producing property (not from a sale)
- Loss or reduction of a pension
- An employer settlement payment
You'll need documentation — a benefits letter, a death certificate, a signed statement from an employer. Many appeals succeed when the paperwork is clean.
How this fits into open enrollment in Chicago
Chicago sits in Cook County, where Medicare beneficiaries choosing between Original Medicare, Medicare Advantage, and stand-alone Part D drug plans have many options during Medicare's Annual Enrollment Period (Oct. 15 – Dec. 7). IRMAA doesn't change which plans you can pick — it changes what you pay on top of Part B and any Part D plan you enroll in.
A few other 2027 figures worth keeping in the same mental file:
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
- The Part D maximum deductible is $615 in 2026 and $700 in 2027.
- The coverage gap (the old "donut hole") is gone, replaced by a simpler three-phase structure.
- The Medicare Prescription Payment Plan lets you spread drug costs into monthly installments instead of paying at the pharmacy counter.
None of these change IRMAA, but together they shape what a higher-income year on Medicare actually costs.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Cook County
(MA penetration in Cook County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Higher-income surcharges
IRMAA income brackets for 2026
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. Your 2027 surcharge is based on your 2025 tax return. CMS publishes the 2027 bracket figures later this fall; the 2026 figures below are shown for reference.
| Income — single filer | Income — married, joint | Part B monthly premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | Plan premium only |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | + $14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | + $37.40 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | + $60.40 |
| $205,001 – $500,000 | $410,001 – $750,000 | $649.30 | + $83.30 |
| Above $500,000 | Above $750,000 | $689.90 | + $91.00 |
Standard Part B premium is $202.90/month. Part D surcharges are added to your drug plan’s premium. Married-filing-separately uses a different, compressed schedule. Confirm current amounts at Medicare.gov.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Does IRMAA ever go away on its own?
Do Roth IRA withdrawals count toward IRMAA?
Is the IRMAA surcharge the same for everyone in a tier?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.