Medicare Part D

IRMAA Surcharges on Medicare in North Little Rock

NORTH LITTLE ROCK, Ark. — If your income has climbed in the past couple of years — maybe from a home sale, a Roth conversion, or picking up consulting work — your 2026 Medicare bill could look bigger than you expect. The Income-Related Monthly Adjustment Amount, or IRMAA, is the extra charge higher earners pay on top of standard Part B and Part D premiums. For 2026, those surcharges kick in once a single filer's income tops $109,000, or $218,000 for a married couple filing jointly.

Here's what Pulaski County readers need to know before Medicare's Annual Enrollment Period closes on Dec. 7.

What IRMAA actually is

IRMAA is not a penalty. It's an income-based add-on to your monthly premium for Medicare Part B (doctor visits, outpatient care) and Part D (prescription drugs). Most people pay the standard Part B premium and whatever their Part D plan charges. But if the IRS says your income is above certain thresholds, Social Security adds a surcharge to both.

The surcharge is billed by Social Security (or deducted from your benefit check). For Part D, it's collected separately from whatever you pay your drug plan.

How Medicare decides your 2027 surcharge

Here's the part that trips people up: your 2027 IRMAA is based on your 2025 tax return — the most recent one the IRS has on file. Medicare uses your Modified Adjusted Gross Income (MAGI), which is your AGI plus any tax-exempt interest.

That two-year lookback is why a one-time income spike — selling a house, cashing out stock, an inherited IRA distribution — can push you into a higher bracket for a single year, then drop you back down.

The 2026 income brackets

Surcharges rise in five tiers. According to the Centers for Medicare & Medicaid Services, the 2026 brackets are:

Single filers (MAGI in 2024):

• $109,000 or less — no surcharge
• 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 less than $500,000 — Tier 4
• $500,000 and above — Tier 5

Married filing jointly (MAGI in 2024):

• $218,000 or less — no surcharge
• 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 less than $750,000 — Tier 4
• $750,000 and above — Tier 5

Married filing separately has its own, tighter set of thresholds — surcharges begin at a much lower income level, so check medicare.gov if that's your situation.

Each tier adds a fixed dollar amount to both your Part B and Part D premiums. The 2027 surcharge amounts will be posted on medicare.gov once CMS finalizes them later this fall.

The mistake to avoid: not appealing when life changes

If your income dropped after 2024 because of a "life-changing event," you can ask Social Security to recalculate your IRMAA using more recent income. Qualifying events include:

• Retirement or reduced work hours
• Marriage, divorce, or the death of a spouse
• Loss of a pension or income-producing property
• An employer settlement payment

The form to file is SSA-44. Bring documentation — a pay stub, a termination letter, a death certificate. Many people who qualify never file it and simply pay the higher premium for a year. Don't leave that money on the table.

What's new for Part D in 2027

IRMAA isn't the only Part D change worth watching. The out-of-pocket cap on covered prescription drugs is $2,100 in 2026 and $2,400 in 2027. The maximum Part D deductible is $615 in 2026 and $700 in 2027. The old coverage gap (the "donut hole") was eliminated in 2025, and drug coverage now moves through three phases instead of four.

There's also the Medicare Prescription Payment Plan, an optional program that lets you spread your drug costs across monthly payments instead of paying big amounts at the pharmacy counter. It doesn't lower your total costs, but it can smooth out the timing.

What this looks like locally

North Little Rock is in Pulaski County, where residents have access to Original Medicare plus a range of Medicare Advantage and standalone Part D plans during Annual Enrollment (Oct. 15 – Dec. 7). IRMAA applies the same way regardless of which route you choose — the surcharge follows the person, not the plan. If you switch from a Medicare Advantage plan back to Original Medicare and a standalone drug plan, your Part D IRMAA still applies.