Medicare Part D

How IRMAA Adds to Medicare Costs for McDonough Filers

McDONOUGH, Ga. — As the Medicare Annual Enrollment Period runs through Dec. 7, higher-income retirees in Henry County are asking a familiar question: how much extra will I pay for Medicare in 2026? The answer comes down to a rule called IRMAA — the Income-Related Monthly Adjustment Amount — which adds a surcharge to both Part B and Part D premiums once your income crosses certain lines. For 2026, that first line starts above $109,000 for a single filer.

Here is what McDonough readers should understand before they lock in coverage for 2027.

What IRMAA actually is

IRMAA is not a separate bill or a new tax. It is an extra amount added on top of the standard Medicare Part B and Part D premiums when your income is above a set threshold. Most people on Medicare pay only the standard Part B premium. But if your reported income is higher, Social Security tacks on a surcharge — and the higher your income bracket, the larger the add-on.

The surcharge applies to Part B (doctor visits and outpatient care) and Part D (prescription drugs). It applies whether you get your drug coverage through a stand-alone Part D plan or through a Medicare Advantage plan that includes drugs.

The IRMAA income thresholds

For 2026, the first IRMAA tier begins when a single filer's modified adjusted gross income (MAGI) is above $109,000. For married couples filing jointly, the first tier begins at roughly double that figure. From there, the surcharge grows in steps — there are five brackets in total, with the top bracket reserved for the highest earners.

A few things to know about how the brackets work:

• They are cliffs, not slopes. Going one dollar over a threshold moves you into the next bracket for the whole year.
• Both spouses pay. If a couple's joint income crosses a bracket, each spouse on Medicare pays the surcharge on their own premium.
• The exact dollar amounts for each bracket are published by CMS each fall on medicare.gov.

Why your 2024 tax return matters now

Here is the part that catches people off guard. Social Security determines your 2027 IRMAA using the most recent tax return the IRS has shared with them — usually your 2025 return. So a good year two years ago (a Roth conversion, a home sale, a big capital gain, a bonus at your last job before retiring) can push you into IRMAA territory in 2027, even if your income has since dropped. CMS publishes the 2027 IRMAA brackets and surcharge amounts later in the fall, typically in November.

If you retired, got divorced, lost a spouse, or had another qualifying life event that reduced your income, you can file Form SSA-44 with the Social Security Administration to ask for a new determination based on your current income. It is worth doing — the form is short, and denials can be appealed.

How this fits into 2027 decisions locally

McDonough is in Henry County, where Medicare beneficiaries choose each year between staying with Original Medicare (often paired with a Medigap policy and a stand-alone Part D plan) or enrolling in a Medicare Advantage plan. IRMAA follows you either way — it is a Medicare-level surcharge, not a plan feature. That means comparing plans on premium alone can be misleading if you are in an IRMAA bracket, because the surcharge is added on top by Social Security.

Two other program facts are worth putting alongside IRMAA when you plan:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your drug spending reaches that ceiling, you pay $0 for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 and $700 in 2027, and the old coverage gap ("donut hole") has been eliminated since 2025.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments instead of paying large amounts at the pharmacy counter.

What to do during AEP

The Annual Enrollment Period runs Oct. 15 through Dec. 7, 2026, and it is your window to change Part D or Medicare Advantage coverage for 2027. If you are already on Medicare and expect to be near an IRMAA bracket:

1. Pull your 2024 tax return and look at your MAGI. 2. Check the current-year IRMAA table on medicare.gov to see where you fall. 3. If a life event has cut your income, gather documentation and file SSA-44. 4. Compare plans on total expected cost — premium plus surcharge plus expected drug and medical spending — not premium alone.

For personalized help in Henry County, Georgia's SHIP program (called GeorgiaCares) offers free, unbiased counseling by phone and in person.