Medicare Part D
IRMAA Surcharges on Medicare Part B and Part D in Birmingham
BIRMINGHAM, Ala. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees across Jefferson County are getting a fresh look at something that catches many people off guard: the Income-Related Monthly Adjustment Amount, better known as IRMAA. It's an extra charge added to your Part B and Part D premiums when your income crosses certain lines.
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Click to call 855-729-3240Key takeaways
- IRMAA is an extra charge added to Part B and Part D premiums for people whose income is above certain limits, not a penalty.
- For 2026, the income lines start at $109,000 for a single filer and $218,000 for a couple filing jointly, based on 2024 income.
- People can ask Social Security to reduce or remove IRMAA using Form SSA-44 if they've had a life-changing event like retirement, divorce, or losing a pension.
- IRMAA notices come from Social Security, usually late in the year, and give you 60 days to appeal, so it's important not to ignore that letter.
What's happening now — and why Birmingham retirees should care
For 2026, those lines start at $109,000 for a single filer and $218,000 for a couple filing jointly. If your income sits above those numbers, expect a letter from the Social Security Administration explaining your adjustment. Understanding the brackets now can help you avoid a surprise deduction from your Social Security check later.
How IRMAA actually works
IRMAA is not a penalty. It's a sliding surcharge Medicare adds on top of the standard Part B premium and, separately, on top of whatever Part D drug plan premium you pay. The higher your income, the higher the surcharge — in five tiers.
Two important things to know:
- The income Medicare uses is two years old. Your 2027 IRMAA will be based on your 2025 tax return (specifically, your Modified Adjusted Gross Income, or MAGI).
- It's a cliff, not a phase-in. Go one dollar over a threshold and you jump to the next tier for the whole year.
That second point is where careful planning pays off, especially if you're near a bracket edge.
The IRMAA income thresholds
The 2026 income ranges (based on your 2024 MAGI) determine this year's surcharge. CMS publishes the 2027 brackets later in the fall, typically in November. Here are the 2026 ranges, with higher-tier amounts stepping up from there:
Single filers:
- $109,000 or less — no IRMAA
- Above $109,000 up to $137,000 — Tier 1
- Above $137,000 up to $171,000 — Tier 2
- Above $171,000 up to $205,000 — Tier 3
- Above $205,000 and below $500,000 — Tier 4
- $500,000 and above — Top tier
Married filing jointly:
- $218,000 or less — no IRMAA
- Above $218,000 up to $274,000 — Tier 1
- Above $274,000 up to $342,000 — Tier 2
- Above $342,000 up to $410,000 — Tier 3
- Above $410,000 and below $750,000 — Tier 4
- $750,000 and above — Top tier
Married taxpayers who filed separately have their own, much tighter brackets. For the exact dollar surcharge amounts at each tier, see the current tables at Medicare.gov.
Common mistakes to avoid
A few missteps trip people up every year in the Birmingham area:
1. Forgetting one-time income spikes. Selling a house, cashing out an investment, or taking a large Roth conversion in 2025 can push you into an IRMAA tier for 2027 — even if your normal income is much lower. 2. Ignoring the Part D surcharge. IRMAA hits Part D too. It's billed separately by Medicare, not by your drug plan, and it applies even if you have a very low-premium plan. 3. Not appealing after a life change. If you retired, lost a pension, got divorced, or were widowed, you may qualify to have IRMAA reduced or removed. That's what the SSA-44 form is for. 4. Missing the letter. IRMAA notices usually arrive from Social Security late in the year. Don't toss it — it explains your right to appeal within 60 days.
Life-changing events that can lower your surcharge
Medicare recognizes specific "life-changing events" that let you ask for a reconsideration using Form SSA-44. These include:
- Marriage, divorce, or death of a spouse
- Work stoppage or work reduction (retirement counts)
- Loss of income-producing property (not from a sale you chose to make)
- Loss or reduction of pension income
- An employer settlement payment
If any of these apply, you can submit the form with supporting documents to your local Social Security office. Don't wait — the sooner it's processed, the sooner your premium reflects reality.
How IRMAA fits with the rest of your 2027 costs
IRMAA is only one line on the bill. For 2027, the broader drug-cost picture also matters:
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
- The Part D deductible maxes out at $615 in 2026 and $700 in 2027.
- The old coverage gap ("donut hole") is gone — Part D now has three phases.
- The Medicare Prescription Payment Plan lets you spread drug costs into monthly installments instead of paying at the pharmacy counter.
None of those change your IRMAA, but they do change how a higher-income retiree should think about total spending for the year.
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 Jefferson County
(MA penetration in Jefferson 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
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. The 2026 surcharge is based on your 2024 tax return; CMS publishes the 2027 brackets later in the fall, usually in November.
| 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?
I just retired in 2025. Do I really have to pay based on my 2024 income?
Where does the IRMAA money go?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.