Medicare Part D

Medicare IRMAA surcharges facing Jacksonville retirees

JACKSONVILLE, Fla. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, higher-income retirees on the First Coast are getting a fresh look at something that catches many people off guard: the income-related monthly adjustment amount, or IRMAA. It's the surcharge Medicare adds to Part B and Part D premiums when your income crosses certain lines — and for 2026, that first line sits at $109,000 for a single filer.

Here's what that means in plain English, and how to check whether it applies to you.

What IRMAA Actually Is

IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra charge added on top of the standard Part B premium and, separately, on top of your Part D drug plan premium. It's not a penalty for doing anything wrong — it's simply how Medicare asks higher-income enrollees to pay a larger share of the program's cost.

Two important things to know up front:

• IRMAA is billed by Medicare, not by your plan. Even if your Part D plan comes from a private insurer, the Part D surcharge is paid to Medicare, usually pulled from your Social Security check.
• It's based on your tax return from two years ago. For 2026 surcharges, Medicare looks at your 2024 IRS return — specifically your Modified Adjusted Gross Income (MAGI).

The 2026 Income Threshold: $109,000

For 2026, IRMAA starts to apply when a single filer's MAGI is above $109,000, or above $218,000 for a married couple filing jointly. Below those numbers, you pay the standard Part B premium and just your plan's Part D premium — no surcharge.

Above those thresholds, the surcharge climbs in tiers. The higher your income, the higher the adjustment on both Part B and Part D. The very top tier applies to single filers with MAGI at or above $500,000 (or $750,000 for joint filers).

CMS updates the exact dollar amount of each tier every fall. For the current, official numbers, the best source is the "Medicare costs at a glance" page at medicare.gov.

How Medicare Decides — and Why It Feels Delayed

Because Medicare uses your tax return from two years back, the income that triggers a 2026 surcharge is income you earned in 2024. That two-year lag surprises a lot of new retirees in Duval County who assume their premium will drop the moment they stop working.

If your income has fallen since 2024 because of a life-changing event, you can ask Social Security to use more recent numbers. Qualifying events include:

• Marriage, divorce, or the death of a spouse
• Work stoppage or reduced work hours (retirement counts)
• Loss of income-producing property
• Loss or reduction of certain pensions

You'd file Form SSA-44 with documentation. If approved, Social Security recalculates your surcharge based on your estimated current income.

Part D Surcharges Look Small — Until They Add Up

The Part D IRMAA is often the one people miss, because Part D premiums themselves are usually modest. But the surcharge is added on top every month, for both Medicare Advantage plans that include drug coverage and stand-alone Part D plans.

This matters more in 2026 because Part D itself is going through big changes:

• The new $2,100 annual out-of-pocket cap on covered drugs is in place.
• The Part D deductible maximum is $615.
• The old coverage gap (the "donut hole") is gone, replaced by three simpler phases.
• The Medicare Prescription Payment Plan lets you spread drug costs into monthly installments instead of paying big amounts at the pharmacy counter.

None of those changes remove IRMAA — they just change what happens after you pay the premium.

What to Do If You Get an IRMAA Letter

Every fall, Social Security mails "initial determination" letters to people who will owe IRMAA the following year. If one shows up in your Jacksonville mailbox:

1. Read it carefully. It will list the income figure Medicare used and the tier it placed you in. 2. Check the tax year. Confirm it matches your actual 2024 return. 3. If your income has since dropped, look into Form SSA-44. 4. If you think the IRS data is wrong, you have the right to request a reconsideration.

You don't need to change plans because of IRMAA — the surcharge follows you, not the plan.

Local Context for Jacksonville

Jacksonville is in Duval County, where beneficiaries have a wide range of Medicare Advantage and stand-alone Part D options during Annual Enrollment. Plan availability, benefits, and pricing vary, and IRMAA sits on top of whatever plan you choose. For personalized help comparing options, Florida's SHINE program (the state's SHIP) offers free, unbiased counseling to Medicare beneficiaries and their families.