Medicare Part D

Medicare Part B & D surcharges in Fairbanks 2027

FAIRBANKS, Alaska — If your income has climbed in the last couple of years — maybe from a strong investment year, a home sale, or a permanent fund draw combined with retirement income — the 2026 Medicare numbers are worth a careful look. Higher-income retirees pay a surcharge on top of the standard Part B and Part D premiums, and the first bracket kicks in above $109,000 for a single filer in 2026.

That extra amount is called IRMAA, short for the Income-Related Monthly Adjustment Amount. It isn't a penalty and it isn't optional. It's built into how Medicare charges people whose income is above certain thresholds.

What IRMAA actually is

IRMAA is an additional monthly amount added to your Part B premium and, if you have Part D drug coverage, to your Part D premium. Most people on Medicare don't pay it — but if your income rises above the thresholds, Social Security will send you a letter explaining the new amount.

Two important things to know:

• It's based on your tax return from two years ago. Your 2027 IRMAA is based on your 2025 tax return (specifically, your modified adjusted gross income, or MAGI).
• It applies to both Part B and Part D. Even if you get Part D through a Medicare Advantage or standalone drug plan, the IRMAA piece is billed separately by Medicare or deducted from Social Security.

The 2027 income thresholds

The first IRMAA bracket in 2026 begins above $109,000 for a single filer and above $218,000 for a married couple filing jointly. From there, the surcharge steps up through several higher tiers, topping out for individuals with income at the highest bracket.

Married couples who file separately have their own, tighter thresholds — a detail that trips up a lot of retirees.

For the exact dollar amounts in each tier, the official source is Medicare.gov's "Costs" page, which is updated each fall as CMS finalizes the numbers.

Why this matters in Fairbanks right now

Fairbanks is in Fairbanks North Star Borough, where Medicare works the same as it does anywhere else — but local income patterns can push more households into IRMAA territory than people expect. A retiree collecting a pension, Social Security, Permanent Fund Dividends, and a required minimum distribution from a retirement account can cross the $109,000 line without feeling "high income."

Timing matters, too. The Medicare Annual Enrollment Period runs October 15 through December 7, and the Medicare Advantage Open Enrollment Period follows from January 1 through March 31. Reviewing your drug coverage during those windows won't change your IRMAA — that's set by the IRS data — but it's the natural time to look at the whole picture.

Life changes that can reduce IRMAA

Because IRMAA looks at income from two years back, it can feel unfair when your situation has changed. Medicare allows you to request a reconsideration if you've had a qualifying life-changing event, including:

• Marriage, divorce, or the death of a spouse
• You or your spouse stopped working or reduced hours
• Loss of pension income
• Loss of income-producing property (not due to sale)

You'd file Form SSA-44 with the Social Security Administration and include documentation. If approved, Social Security uses a more recent, more accurate income figure.

Other 2027 numbers worth knowing

Even if you don't pay IRMAA, a few Part D changes affect nearly everyone:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your covered drug spending hits that amount, you pay $0 for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 and $700 in 2027.
• The old "donut hole" coverage gap was eliminated in 2025, leaving three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter. It's optional and free to join.