Medicare Advantage

2027 Medicare Income Rules: Hillsboro, Ore.

Hillsboro, Ore. — If your income has climbed in the last couple of years, your 2027 Medicare bill may look different from your neighbor's — even if you both pick similar coverage. That's because Medicare stacks its costs in layers: a base premium almost everyone pays, an income-based surcharge for higher earners, and separate rules for drug coverage. Here's how those pieces fit together for 2027 for people in Hillsboro and the rest of Washington County.

The building blocks of your 2027 Medicare cost

Original Medicare has two main cost pieces: Part A (hospital) and Part B (doctor and outpatient). Most people don't pay a premium for Part A because they paid Medicare taxes while working. Part B, though, has a monthly premium set each year by CMS, plus an annual deductible before Medicare starts paying its share.

Part D is prescription drug coverage. It's sold by private insurers, either as a stand-alone plan or built into a Medicare Advantage plan (called MA-PD). Part D has its own premium, its own deductible, and its own out-of-pocket rules.

Medicare Advantage (Part C) bundles Part A, Part B, and usually Part D into one plan from a private carrier. You still owe the Part B premium; the Advantage plan may add its own premium on top.

That's the base. Income is what changes the picture.

How income changes what you pay: IRMAA

IRMAA stands for Income-Related Monthly Adjustment Amount. It's a surcharge added to your Part B and Part D premiums when your income crosses certain thresholds.

For 2026, the first IRMAA tier starts above $109,000 for a single filer (and roughly double that for a married couple filing jointly). Social Security uses your tax return from two years back — so your 2024 income drives your 2026 surcharge.

A few things worth knowing:

• IRMAA is billed separately on the Part B side and the Part D side. Even if your drug plan's own premium is modest, the Part D surcharge is added on top and usually taken from your Social Security check.
• If your income dropped because of a "life-changing event" — retirement, the death of a spouse, divorce, loss of a pension — you can ask Social Security to recalculate using Form SSA-44.
• The surcharge is not permanent. It's recalculated every year using the most recent tax data.

The 2027 Part D cost structure

The drug benefit was redesigned over the past two years, and 2027 continues that simpler shape.

• Deductible phase: You pay full negotiated price until you meet the plan's deductible, which cannot exceed $615 in 2026.
• Initial coverage phase: You pay a share of each prescription (a copay or coinsurance) and the plan pays the rest.
• Catastrophic phase: Once your out-of-pocket spending on covered drugs hits $2,100 in 2026 ($2,400 in 2027), you pay nothing more for covered drugs for the rest of the calendar year.

That hard ceiling — $2,100 in 2026, rising to $2,400 in 2027 — is the biggest structural change from just a couple of years ago, when there was no annual limit.

If paying a large drug bill all at once is a strain, the Medicare Prescription Payment Plan lets you spread your yearly drug costs across monthly installments instead of paying at the pharmacy counter. It doesn't lower your total — it just smooths it out. You have to opt in through your drug plan.

Where local availability fits in

Cost structure is set at the federal level, but which plans you can actually pick is a local question. Hillsboro is in Washington County, where the 2026 CMS Landscape lists 59 Medicare Advantage plans and 13 carriers offering MA-PD coverage, and Oregon has 10 stand-alone Part D plans for 2026, sold statewide. The 2027 lineup is in each plan's ANOC and on medicare.gov's Plan Finder — worth checking, especially if you're on Original Medicare and want drug coverage.

With 89,000-plus residents 65 and older in the county, this is a well-served market, but "more plans" doesn't automatically mean "simpler choice." Comparing on total expected cost — premium plus deductible plus your specific drugs — usually tells you more than premium alone.

Two quick scenarios

A single filer with $95,000 in 2025 income. She's below the IRMAA threshold, so she pays the standard 2027 Part B premium (CMS publishes that figure later in the fall) and whatever her drug plan charges — no surcharge on either side.

A single filer with $140,000 in 2025 income. Based on the 2026 brackets she would be over the first IRMAA tier, owing the standard Part B premium plus a Part B surcharge, plus a Part D surcharge on top of her drug plan premium. CMS publishes the 2027 IRMAA brackets and surcharges later in the fall. If she retired in 2026 and her income has since dropped, she can file SSA-44 and ask Social Security to use her current income instead.

Dates to keep on your calendar

• Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, drop, or switch Medicare Advantage and Part D plans for coverage starting Jan. 1.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment. If you're already in an Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare (and pick up a Part D plan).

If you miss AEP and don't qualify for a Special Enrollment Period, you're generally locked into your current coverage for the year.