Medicare Part D
Does Your 2024 Tax Return Trigger a 2026 IRMAA Bill?
WEST PALM BEACH, Fla. — If your 2025 income crept above six figures, your 2027 Medicare bill may look different from your neighbor's. The Social Security Administration will start mailing IRMAA notices this fall, and the income thresholds that trigger those higher Part B and Part D premiums are updated each year. For retirees along Florida's Treasure Coast — many of whom draw from IRAs, pensions, and part-time work — a single year of higher income can quietly push you into a surcharge bracket for a full calendar year.
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
- IRMAA surcharges kick in for 2026 when a single filer's modified adjusted gross income tops $109,000, or $218,000 for a married couple filing jointly.
- Medicare uses your 2025 tax return to set your 2027 Part B and Part D premiums — a two-year lookback that catches many new retirees off guard.
- If a life event like retirement, divorce, or a spouse's death has lowered your income, you can ask Social Security to reconsider using Form SSA-44.
- The Annual Enrollment Period runs Oct. 15 through Dec. 7, and it's a good moment to review your Part D coverage even if IRMAA applies to you.
Here's how the "two-year lookback" works, what's known so far about 2027, and what to do if your income has dropped since then.
What IRMAA actually is
IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added on top of the standard Medicare Part B premium and, separately, on top of whatever Part D drug plan premium you pay. It is not a tax and it is not optional. Social Security calculates it automatically based on income data from the IRS.
Most people on Medicare don't pay IRMAA at all. It only applies to the roughly 8% of beneficiaries whose incomes clear the threshold. But if you're in that group, the surcharge can add hundreds of dollars a month to your Medicare costs.
The 2027 income brackets
CMS publishes the 2027 IRMAA brackets later in the fall, along with the 2027 Part B premium and deductible. The 2027 thresholds will be based on your 2025 modified adjusted gross income (MAGI).
- Single filers: surcharge starts above $109,000
- Married filing jointly: surcharge starts above $218,000
- Married filing separately: a separate, tighter schedule applies
From there, IRMAA is tiered — the higher your income, the larger the monthly add-on. There are five brackets in all, with the top tier reserved for single filers above roughly $500,000 (or $750,000 for couples). The exact dollar amounts for each tier are published on Medicare.gov and in your Social Security notice.
The two-year lookback catches people off guard
Here's the part that surprises West Palm Beach retirees the most: your 2027 premium is based on your 2025 income. Medicare always looks two years back because that's the most recent full tax year the IRS can share.
That timing matters. If you sold a home in 2025, took a large IRA distribution to pay off a mortgage, converted a traditional IRA to a Roth, or had a strong year of self-employment before retiring, that spike shows up on your 2027 Medicare bill — even if your income today is much lower.
What to do if your income has dropped
You are not stuck. Social Security allows an appeal if you've had a qualifying "life-changing event," including:
- Retirement or reduced work hours
- Marriage, divorce, or the death of a spouse
- Loss of pension income
- Loss of income-producing property from a disaster or other event beyond your control
The form is SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." You submit it to your local Social Security office with documentation, such as a letter from a former employer or a death certificate. If approved, your IRMAA is recalculated based on your current, lower income.
Part D and the bigger 2027 picture
IRMAA on Part D works the same way as on Part B — the surcharge is added to whatever premium your drug plan charges. It's paid directly to Medicare, not to the insurance company.
Even with IRMAA, other 2027 changes still apply to you. The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and the maximum Part D deductible is $615 in 2026 and $700 in 2027. The coverage gap (the old "donut hole") remains gone. The Medicare Prescription Payment Plan, which lets you spread drug costs across the calendar year in level monthly amounts, is also available regardless of income.
How West Palm Beach retirees can plan ahead
West Palm Beach is in Palm Beach County, where beneficiaries have a wide range of stand-alone Part D and Medicare Advantage options to compare during the Annual Enrollment Period, which runs Oct. 15 through Dec. 7. Even if you'll owe IRMAA, comparing drug plans still matters — the surcharge is a fixed add-on, but the underlying plan premium and formulary are yours to choose.
For a personalized review, Florida's SHINE program (the state's SHIP counseling service) offers free, unbiased Medicare help by appointment.
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 Palm Beach County
(MA penetration in Palm Beach 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
2027 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 2027 surcharge is based on your 2025 tax return. CMS publishes the 2027 bracket amounts and surcharges later in the fall.
| 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 apply forever once I trigger it?
What income counts toward the IRMAA threshold?
How will I know if I owe IRMAA in 2027?
Is IRMAA the same for everyone in the same bracket?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for West Palm Beach
Content Integrity Standards
- No invented figures. Program-level numbers come from CMS / Medicare.gov; we never use placeholder data.
- No plan rankings or recommendations. This is educational content. We don't rank, score, or recommend specific plans.
- AI-assisted, human-reviewed. Articles are produced with AI-assisted tools and reviewed by the responsible desk before publishing.
- Inline sourcing. Facts and figures are cited to primary sources — CMS, SSA, and Medicare.gov.
- Correction transparency. We fix errors openly and note when a page was last updated.
- Not a government site. MyMedicarePlans.org is privately owned and not affiliated with or endorsed by Medicare or any government agency.
This page was last updated: October 7, 2026.