Medicare Part D
$109,000 income triggers Middletown Medicare IRMAA in 2026
MIDDLETOWN, Del. — If your income has climbed in recent years, a piece of your 2026 Medicare bill may look different than a neighbor's. Starting in January, higher-income retirees will again pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of the standard Part B and Part D premiums. For 2026, those surcharges kick in when a single filer's modified adjusted gross income tops $109,000, or $218,000 for a married couple filing jointly.
Compare Medicare Part D options near you
Answer 3 quick questions to see Medicare Part D listings from licensed insurance partners.
What’s your ZIP code?
Plan availability is set by your county, so we start here.
How old are you?
This helps match you with options you’re eligible for.
Do you have Medicare Parts A & B?
This affects which Medicare Part D options you can choose.
These listings are provided by licensed insurance partners.
Will your prescriptions still be covered in 2027?
Part D plans rewrite their drug lists every year — tiers move, pharmacies change, drugs drop off. One call checks your exact medications against the 2027 plans in your area.
- Every prescription checked, name by name
- Your pharmacy checked for preferred pricing
Available now — current wait: 0 min
A real person answers. No phone menu, ever.
Advertising disclosure: MyMedicarePlans.org may be compensated when you contact a partner or licensed agent. Listings are not ranked or endorsed by us, and we do not recommend specific plans. You can also contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Speak to a Licensed Insurance Agent
Click to call 855-729-3240
Key takeaways
- Starting in January 2026, single filers with income over $109,000 (or $218,000 for married couples filing jointly) will pay an extra IRMAA surcharge on top of standard Part B and Part D premiums.
- Your 2026 surcharge amount is based on your 2024 tax return, so a temporary income spike two years ago can still raise your premium now.
- If your income has dropped due to a life-changing event, you can file form SSA-44 with Social Security to ask them to use a more recent, lower income year.
- Medicare Advantage and Part D plan choices are based on your county, and the Annual Enrollment Period to compare and switch plans runs from October 15 to December 7.
Here's what Middletown readers should know before the bills arrive.
What IRMAA actually is
IRMAA isn't a separate plan or a penalty for signing up late. It's an extra amount that Medicare adds to two of your monthly premiums — Part B (doctor visits and outpatient care) and Part D (prescription drug coverage) — if your income is above certain thresholds.
Most people on Medicare pay only the standard Part B premium and whatever their drug plan charges. IRMAA affects a smaller slice of beneficiaries, typically those still earning strong wages, drawing large required minimum distributions, or realizing capital gains.
The look-back: why 2024 income drives your 2026 bill
Social Security decides who owes IRMAA using your most recent tax return on file with the IRS — usually from two years earlier. So your 2026 surcharge is based on your 2024 tax return.
That two-year lag catches many new retirees off guard. If 2024 was your last big earning year, or you sold a house or converted a traditional IRA to a Roth, your 2026 Medicare premium may reflect that, even if your income has since dropped.
The 2026 income brackets
For 2026, IRMAA begins above these modified adjusted gross income (MAGI) levels, according to CMS:
- Single filer: more than $109,000
- Married filing jointly: more than $218,000
- Married filing separately (lived with spouse): more than $109,000
From there, surcharges rise in tiers. The higher your income, the larger the add-on to both your Part B and Part D premiums. There are five IRMAA tiers in total, topping out for singles with MAGI at or above roughly $500,000 and joint filers at $750,000.
Because the exact dollar surcharges for each tier are set each fall, check medicare.gov/basics/costs for the finalized 2026 amounts before you budget.
How you pay it
- Part B IRMAA is usually deducted from your Social Security check, just like the standard premium.
- Part D IRMAA is billed separately by Medicare, even if your drug plan premium is paid to a private insurer. This surprises a lot of people — you'll get a bill from Medicare in addition to whatever your plan charges.
If you don't collect Social Security yet, you'll receive a quarterly bill from Medicare for both.
Life changes: when you can appeal
The two-year look-back feels unfair when your income has genuinely fallen. Fortunately, Social Security allows appeals for specific life-changing events, including:
- Marriage, divorce, or the death of a spouse
- Work stoppage or reduced hours (retirement counts)
- Loss of pension income
- Loss of income-producing property due to disaster or other events
The form is SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." You submit it to Social Security with documentation. If approved, they'll use a more recent, lower-income year to calculate your surcharge.
Middletown is in New Castle County
Plan availability — including how many Part D and Medicare Advantage options you can choose from — is set at the county level. Middletown is in New Castle County, so when you shop during the Annual Enrollment Period (Oct. 15 – Dec. 7), the plan menu you see on medicare.gov reflects that county, not the city alone.
Two other 2026 numbers worth knowing while you're comparing drug coverage:
- The Part D out-of-pocket cap is $2,100.
- The Part D maximum deductible is $615.
- The optional Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments.
None of these change your IRMAA, but they do affect your total drug spending — which matters if you're already paying a Part D surcharge.
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 New Castle County
(MA penetration in New Castle 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
2026 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. Your 2026 surcharge is based on your 2024 tax return.
| 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?
Do Roth conversions count toward IRMAA income?
Is IRMAA the same as the Part D late-enrollment penalty?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.