Medicare Part D

Medicare Part B and Part D Surcharges Facing Hilo Retirees

HILO, Hawaii — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees on the Big Island have another number to watch closely this fall: the income threshold that triggers extra monthly charges on Part B and Part D in 2027.

Most people on Medicare pay the standard Part B premium and whatever their Part D drug plan charges. But if your income crosses a certain line, Medicare adds a surcharge on top — called the Income-Related Monthly Adjustment Amount, or IRMAA. Here is what Hilo readers should know before the enrollment window closes.

What IRMAA is, in plain English

IRMAA is not a penalty. It is an income-based add-on that higher earners pay for Part B (doctor visits and outpatient care) and Part D (prescription drugs). The Part B surcharge is added to your monthly premium. The Part D surcharge is billed separately by Medicare, even if you get your drug coverage through a Medicare Advantage plan.

Both surcharges are set each year by the Centers for Medicare & Medicaid Services (CMS) and rise in tiers as income goes up.

The 2027 income thresholds

For 2026, IRMAA begins when your modified adjusted gross income (MAGI) is above $109,000 for a single filer, or above $218,000 for a married couple filing jointly. Income below those levels means you pay only the standard Part B premium and your regular Part D plan premium — no surcharge.

Above those thresholds, the surcharge steps up through several brackets. The highest tier applies to single filers with income at or above $500,000 and joint filers at or above $750,000.

One important twist: Medicare looks back two years to decide your bracket. Your 2027 IRMAA will be based on the tax return you filed for 2025. CMS publishes the 2027 brackets later in the fall, typically in November.

Why this matters right now

The Annual Enrollment Period (Oct. 15 – Dec. 7) is when you can change your Part D drug plan or your Medicare Advantage plan for 2027. If you know an IRMAA surcharge is coming, it can change the math on which drug plan actually works for your budget — because the surcharge is on top of whatever the plan itself charges.

Hilo is in Hawaii County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage is available. The plan you pick does not change your IRMAA, but it does affect the base premium the surcharge is added to.

What to do if your income has dropped

Life changes. If you retired, lost a spouse, got divorced, or had another qualifying "life-changing event" since 2024, you can ask Social Security to recalculate your IRMAA using your more recent income. This is done using Form SSA-44.

Common qualifying events include:

• Marriage, divorce, or the death of a spouse
• Work stoppage or reduced work hours
• Loss of pension income
• Loss of income-producing property (not from a sale)

If approved, your surcharge can be lowered — or removed — for the year in question.

Program figures for 2026 and 2027

While you are looking at drug costs, keep these program-wide 2026 figures in mind:

• Part D out-of-pocket cap (2026): $2,100. Once your covered drug spending hits that amount, you pay nothing for covered drugs the rest of the year. For 2027, the cap is $2,400.
• Part D maximum deductible (2026): $615. Plans can charge less, but not more. For 2027, the maximum deductible is $700.
• The old coverage gap ("donut hole") is gone. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments, at no extra charge.