2028 Medicare IRMAA Brackets
2028 Medicare IRMAA based on 2026 MAGI (two-year lookback). Tiers $109k/$137k/$171k/$205k/$500k single. Doubled for MFJ. Plan Roth conversions accordingly.
| 2026 MAGI | — |
| Part B surcharge/mo | — |
| Part D surcharge/mo | — |
| Part B annual extra | — |
| Part D annual extra | — |
| Total per person/year | — |
2028 Medicare IRMAA is based on your 2026 MAGI (two-year lookback). The tier system means $1 over a threshold triggers the full surcharge — a 'cliff' tax. Plan large Roth conversions, IRA distributions, and capital gains realization at least 2 years before Medicare enrollment to avoid hitting tiers.
Two-Year Lookback
2028 IRMAA uses 2026 income reported on the 2027 tax return. SSA receives this from IRS in late 2027 and applies surcharges starting January 2028. One-time income events (Roth conversion, home sale, inheritance) hit you 2 years later.
Tier Cliff Risk
IRMAA is not phased — $1 over a threshold triggers the full surcharge. Standard 2028 Part B premium projected $190/mo. Top IRMAA tier adds ~$442/mo extra = $632/mo total. Plus Part D surcharge. For a couple, top tier costs ~$15,000+/year extra Medicare premium.
Appeal — SSA-44
Life-changing events (retirement, work cessation, divorce, spouse death) allow IRMAA appeal via Form SSA-44. Use a projected lower MAGI instead of 2-year lookback. Filed with local SSA office. Approval takes 2-8 weeks.
Planning Strategies
QCD from IRA at 70½+ counts as RMD without raising MAGI. Roth conversions before Medicare start age. Bunching capital gains in alternate years. Strategic asset location. Avoid cliff events by spreading income across years.
Last updated May 2026. Sources: CMS Medicare.