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Medicare Changes in 2027: What You’ll Actually Pay

August 31, 2026 · Personal finance
Infographic detailing the 2-year lookback rule, 2027 Part B monthly surcharges across income tiers, and Form SSA-44 appeals.
A two-year lookback rule on 2025 tax returns determines 2027 Part B IRMAA surcharges ranging from $83.70 to $502.60 per month.

High-Income Earners: IRMAA Surcharges for 2027

If your retirement income exceeds specific federal thresholds, you will pay extra for your Part B and Part D coverage. This additional charge is known as the Income-Related Monthly Adjustment Amount (IRMAA).

The Social Security Administration (SSA) calculates your 2027 IRMAA surcharge using your 2025 tax return. The government applies a two-year lookback rule to determine your Modified Adjusted Gross Income (MAGI).

For 2027, Part B IRMAA surcharges are estimated to range from $83.70 to $502.60 per month above the standard premium. This means high-earning individuals could pay between $293.20 and $712.10 monthly for Part B coverage alone.

Part D prescription plans also carry IRMAA surcharges for higher earners. These monthly drug surcharges are billed directly by Medicare or deducted from Social Security, regardless of your specific private plan premium.

You can appeal an IRMAA surcharge if you experienced a qualifying life-changing event in 2025 or 2026. Qualifying events include marriage, divorce, job loss, work reduction, or the loss of income-producing property.

To request a reconsideration, you must submit Form SSA-44 along with documentation proving your reduced income. Filing an appeal promptly can save you thousands of dollars in unnecessary surcharges throughout the year.

“You can’t control what healthcare costs in America, but you can control how prepared you are for those costs.” — Jean Chatzky, Financial Educator

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