Medicare Part D

2026 IRMAA Brackets: Who Pays More for Part B and D

DUNWOODY, Ga. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees in metro Atlanta are getting a fresh look at something that surprises many people every year: the income-related monthly adjustment amount, better known as IRMAA. It's the surcharge that gets tacked onto Part B and Part D premiums when your income crosses certain lines — and for 2026, the first line sits at $109,000 for a single filer.

If you're near that threshold, a small change in income two years ago could mean a bigger Medicare bill in 2027. Here's what to know before the December deadline.

What IRMAA actually is

IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra charge added to your Medicare Part B (doctor visits and outpatient care) and Part D (prescription drug) premiums when your income is above a set threshold.

Most people pay only the standard Part B premium and whatever their Part D plan charges. But if your income is higher, Medicare adds a surcharge in tiers. The higher your income, the higher the tier.

Roughly 8% of Medicare beneficiaries pay IRMAA in any given year, according to CMS. It's not rare, but it's not the norm either.

The 2027 income thresholds

For 2026, IRMAA kicks in above these income levels, based on your modified adjusted gross income (MAGI). CMS typically publishes the 2027 brackets later in the fall:

• Single filers: above $109,000
• Married filing jointly: above $218,000
• Married filing separately: above $106,000 (with a separate schedule)

There are five surcharge tiers above those starting points, climbing to the top bracket for singles with incomes at or above $500,000 (or $750,000 for joint filers). The exact 2026 dollar amounts for each tier are published by CMS at medicare.gov.

Important: the surcharge is a cliff, not a slope. Crossing a threshold by even one dollar puts you into the next tier for the whole year.

Why your 2025 taxes matter now

Here's the part that trips people up. Social Security uses your most recent tax return on file — usually from two years earlier — to decide your IRMAA. So your 2027 surcharge is based on your 2025 tax return.

That means one-time income events from 2025 — selling a home, converting a traditional IRA to a Roth, cashing out stock, or taking a large required minimum distribution — can push you into IRMAA territory in 2027, even if your income has since returned to normal.

What if your income has dropped?

If a "life-changing event" has reduced your income since that tax year, you can appeal. Qualifying events include:

• Marriage, divorce, or the death of a spouse
• You or your spouse stopping work or cutting back hours
• Loss of income-producing property (not due to your own choices)
• Loss or reduction of a pension
• A settlement from a former employer due to closure or bankruptcy

You file Form SSA-44 with Social Security, along with documentation. If approved, your IRMAA is recalculated using the more recent, lower income.

Selling stock at a gain or taking a Roth conversion, on the other hand, does not count as a life-changing event — even though those are exactly the kinds of moves that create surprise surcharges.

How IRMAA gets paid

Part B IRMAA is usually deducted directly from your Social Security benefit, along with your standard premium. If you don't yet collect Social Security, you'll get a bill from Medicare.

Part D IRMAA is different. You pay your regular Part D plan premium to your drug plan, and then you pay the IRMAA portion separately to Medicare — even though it's technically part of your Part D cost. This catches a lot of first-time IRMAA payers off guard.

What this means locally

Dunwoody is in DeKalb County, where Medicare beneficiaries choose among a wide range of stand-alone Part D drug plans and Medicare Advantage plans with drug coverage during the Oct. 15–Dec. 7 window. The 2027 plan lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. IRMAA is a federal surcharge, so it applies no matter which plan you pick — switching plans doesn't change whether you owe it. It's tied to your income, not your coverage choice.

That's worth remembering during Annual Enrollment: comparing plans can affect what you pay for drugs and care, but it won't move you out of an IRMAA bracket.

Other program numbers worth knowing

While you're reviewing coverage, a few other program-level figures for 2026:

• Part D out-of-pocket cap: $2,100. Once you hit that in covered drug costs, you pay $0 for the rest of the year.
• Part D maximum deductible: $615.
• Coverage gap ("donut hole"): eliminated as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that lets you spread your drug costs into monthly payments instead of paying big amounts at the pharmacy counter.