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2027 Medicare Open Enrollment: IRMAA Checklist for Retirees

Compare 2027 coverage by Dec. 7, then use the planner to check 2027 IRMAA and your Dec. 31 income watchlist.

By Michael Ryan
| Updated:

Medicare Open Enrollment runs October 15 through December 7, 2026, for coverage that starts January 1, 2027. That is the plan-choice deadline. IRMAA runs on a different clock, and confusing the two can get expensive. The planner below turns four quick answers into your own Dec. 7 coverage checklist, 2027 IRMAA check, and Dec. 31 income watchlist that you can print or save as a PDF. Medicare confirms the October 15–December 7 Open Enrollment window here.

Many people assume that once they pick a plan, the Medicare-cost decision is finished. It is not.

Here is the bottom line: Open Enrollment lets you choose or change your Medicare Advantage or Part D coverage. It does not determine whether you owe IRMAA. Your total Medicare cost can include both your plan premium and separate income-related surcharges.

For 2027 IRMAA, Social Security will generally look to your 2025 MAGI, because IRMAA normally uses tax information from two years before the premium year. That income year is already closed. What you can still control before December 31, 2026 is your 2026 MAGI, which will generally be used for 2028 IRMAA. See the current IRMAA income brackets, learn how Part B and IRMAA work together, and use the IRMAA planning checklist for year-end moves.

A low-premium plan can still be expensive overall if IRMAA applies. Before you get buried in plan details, use the two-deadline planner below to identify what actually deserves your attention. Then use the deeper checklist and examples to finish the job.

⚡ The Two-Deadline Strategy

  • Deadline 1 (Dec 7, 2026): Make your Medicare Advantage or Part D choice for coverage beginning in 2027.
  • Deadline 2 (Dec 31, 2026): Finalize year-end income decisions that affect your 2026 MAGI and, generally, your 2028 IRMAA.
  • The “Base + Surcharge” Rule: Your total Medicare cost can include the applicable Part B premium, your plan premium, and any Part B or Part D IRMAA you owe.
  • The Action: Run the personalized planner next. It separates your Dec. 7 plan-shopping job from your Dec. 31 income-planning job.

Build Your Medicare + IRMAA Two-Deadline Plan

2-minute Medicare + IRMAA checkup

Build your two-deadline action plan

Answer four quick questions. Get a Dec. 7 plan-shopping checklist, a 2027 IRMAA check, and a Dec. 31 income watchlist you can print or save as a PDF.

Question 1 of 4

What kind of Medicare coverage are you reviewing?
Your answers stay in your browser. This tool does not submit or store your income or plan information. Educational use only. Verify plan details with Medicare.gov and tax or IRMAA questions with the appropriate professional or agency.

My Medicare + IRMAA Action Sheet

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The “Base + Surcharge” Medicare Advantage Trap

Many retirees use the Medicare Advantage Plan Finder, sort by “Lowest Premium,” and enroll in a $0 or $15/month plan. They feel like they won.

Then, in January, they get a bill from Medicare for $500+ a month. Why?

Medicare Plan Finder only shows the Base Premium. It does not include your personal IRMAA Surcharge.

  • Part B: Pay the applicable Part B premium, plus Part B IRMAA if your income is above the published threshold.
  • Part D Surcharge: Added to whatever drug plan you choose.

🧮 Your Real Medicare Cost

Do not judge a Medicare plan by the advertised plan premium alone. Your monthly cost can include:

  • Part B premium
  • Part B IRMAA, if your income is above the applicable threshold
  • Medicare Advantage or Part D plan premium
  • Part D IRMAA, if applicable

2027 update: Medicare & You 2027 says Part D IRMAA starts when 2025 MAGI is above $111,000 for individual filers or $222,000 for married couples filing jointly. Medicare still directs readers to Medicare.gov for the latest Part B premium amount and income limits, so do not carry the 2026 Part B premium forward as a 2027 number.

💡 Stop overpaying for retirement.

One clear financial move each week — straight from 28 years of seeing what goes wrong.

  • → Avoid hidden fees like IRMAA
  • → Lower your taxes legally
  • → Protect your nest egg

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The 2027 Coverage AEP & IRMAA Master Checklist

Use this timeline to ensure you don’t miss a critical window.

The end of the year is a critical time for managing your health care costs and taxes. The following timeline outlines key deadlines for Medicare’s Annual Enrollment Period (AEP) and strategic financial actions to avoid future IRMAA surcharges. Paying attention to these dates can save you significantly on premiums and ensure your plan continues to meet your needs for 2027 and beyond.
Key Medicare & Financial Planning Dates for Year-End 2026
Dates Action Item Why It Matters
Oct 1 – Oct 15 Review ANOC and plan changes Check your 2027 plan changes, including doctors, pharmacies, covered drugs, formularies, and costs before Open Enrollment.
Oct 15 – Dec 7 Compare Plans Compare and choose coverage for 2027. Check the full annual cost, not just the advertised premium.
Nov 15 – Dec 31 Project 2026 MAGI Estimate your 2026 IRMAA MAGI. It will generally be the income year used for 2028 Medicare IRMAA.
Before Dec 31 Execute “Income Defense” Harvest losses, do QCDs, or defer income to stay under an IRMAA cliff.
Review your 2027 Medicare options before December 7, then keep monitoring year-end income through December 31. The two decisions are related to your overall Medicare cost, but they affect different years.

Case Study: The “December Surprise”

Here is a simple hypothetical showing why year-end income monitoring matters.

The Setup:

  • Date: December 6th.
  • Action: Jim and Sarah enroll in a new Part D plan with a $40/month premium. They are happy.
  • Income Status: Their projected 2026 MAGI is close to a future IRMAA threshold. The exact 2028 thresholds are not known yet, so they leave themselves a buffer instead of planning to an unpublished number.

The Failure:

  • Date: December 20th.
  • Event: Their mutual fund pays out a large year-end capital gain distribution of $5,000.
  • Result: Their 2026 MAGI rises by $5,000 after they thought their year-end planning was finished.

The Consequence:
Because they stopped watching income after Open Enrollment, they may have increased their 2028 IRMAA exposure. The actual result will depend on the 2028 thresholds and their final tax return.

  • What changed: Their MAGI increased after their Medicare plan decision was already finished.
  • What to do: Recheck taxable distributions, realized gains, Roth conversions, and other year-end income before December 31.
  • What not to do: Do not assume a specific future IRMAA threshold before CMS publishes it.

The Lesson: Open Enrollment ends December 7, but your ability to change most items that affect this year’s MAGI generally ends December 31. Keep monitoring income after you choose your plan. Use the IRMAA Calculator to model current published surcharges, and see the IRMAA appeal and life-changing-event guide if your income has dropped for a qualifying reason.

Defensive Move: The “December Distribution Watchlist”

⚠️ Michael Ryan Money Warning: Mutual funds typically pay out capital gains distributions in mid-December. These are taxable to you even if you reinvest them.

Action Step: Check your fund provider’s estimated year-end capital gains distributions. If you are near a projected IRMAA threshold, review the tax impact before acting. Selling before a distribution can create its own taxable gain, so compare the consequences rather than selling solely to avoid the distribution.

💡 Stop overpaying for retirement.

One clear financial move each week — straight from 28 years of seeing what goes wrong.

  • → Avoid hidden fees like IRMAA
  • → Lower your taxes legally
  • → Protect your nest egg

📬 No spam. Unsubscribe.

Frequent Reader Questions About AEP & IRMAA

📚 Deepen Your IRMAA Defense

Don’t let surcharges eat your retirement. Check out these guides:

Does changing my plan affect my IRMAA?

No. Changing your insurance carrier does not by itself change your IRMAA tier. IRMAA is based on the income information Social Security uses. Your total Medicare cost can still change because plan premiums and IRMAA are separate pieces.

If I retire this year, will I still pay IRMAA?

Possibly. Social Security normally uses tax information from two years earlier, but retirement can be a qualifying life-changing event. If your household income dropped, you can ask Social Security to use more recent information through the SSA-44 process.

Can I pay my IRMAA directly to the plan?

No. IRMAA is paid to Medicare, usually through your Social Security or Railroad Retirement benefit or a Medicare bill. It is separate from the premium you pay your Medicare Advantage or Part D plan.

What are the IRMAA income thresholds for 2027?

Medicare & You 2027 says the Part D IRMAA starting income level is above $111,000 of 2025 MAGI for individual filers and above $222,000 for married couples filing jointly. Married-filing-separately rules are different. See the official Medicare & You 2027 handbook.

Conclusion: Finish the Drill

Most retirees sprint to the December 7th deadline and then stop. That is a mistake.

The period between December 7 and December 31 is still important for year-end tax planning. Depending on your situation, that can include reviewing realized gains and losses, qualified charitable distributions, Roth conversions, and other income items that affect MAGI. Those choices should fit your broader tax plan, not just IRMAA.

Your Next Steps:

  1. Finalize Plan Choice: Pick your 2027 Part D or Medicare Advantage coverage by Dec. 7, 2026.
  2. Check YTD Income: Log into your brokerage account and check your Year-to-Date realized gains.
  3. Look for Dividends: Check for upcoming mutual fund distributions.
  4. Execute Offsets: If you are near a projected threshold, review tax-loss harvesting and other year-end moves before Dec. 31, but only when they make sense in your overall tax plan.

For a clearer picture of your overall retirement health, use our IRMAA Calculator to project your potential surcharges. See the 5-step plan Jane used to erase her $2,400 Medicare surcharge. Social security’s impact on irmaa can significantly affect your retirement budget. Understanding how your benefits may influence your IRMAA calculations is essential for financial planning. Additionally, reviewing your income sources regularly can help you anticipate any changes in your surcharges.

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Michael Ryan
Michael Ryan
Michael Ryan, Retired Financial Planner & Founder of MichaelRyanMoney.com Michael Ryan is a retired financial planner and financial educator with nearly three decades of experience in financial planning, retirement planning, estate planning, insurance, and risk management. He is the founder of MichaelRyanMoney.com, where he explains Social Security, Medicare and IRMAA, retirement income, taxes, estate planning, insurance, investing, and personal finance in plain English. His commentary has been featured by outlets including The Wall Street Journal, U.S. News & World Report, Business Insider, Yahoo Finance, Forbes, Newsweek, and Nasdaq. Michael no longer sells financial products, manages investments, or provides individualized investment, tax, legal, or insurance advice through the site.

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