Medicare Part D

Medicare Part B and D Income Thresholds for Honolulu

HONOLULU — As Medicare's Annual Enrollment Period runs through Dec. 7, many Honolulu retirees are opening letters from Social Security and finding a surprise: an extra charge added to their Part B and Part D premiums for 2027. The charge has a name — the Income-Related Monthly Adjustment Amount, or IRMAA — and it's tied to the tax return you filed two years ago.

Higher earners in Honolulu will see Medicare surcharges kick in above $109,000

For 2026, IRMAA starts once a single filer's 2024 modified adjusted gross income tops $109,000, or $218,000 for a married couple filing jointly. If you're under those numbers, none of this applies to you. If you're over them, it's worth understanding how the math works so you're not caught off guard.

What IRMAA actually is

IRMAA is not a separate bill. It's an extra amount added to your standard Medicare Part B premium and, if you have drug coverage, your Part D premium. Social Security pulls the income figure from your IRS return from two years back — so your 2025 tax return determines your 2027 Medicare costs.

Because it looks backward, IRMAA can feel unfair when your income has already dropped. The good news: there's a way to appeal if your situation has changed (more on that below).

The 2027 income brackets

CMS publishes the 2027 IRMAA tiers later in the fall, usually in November. For reference, the 2026 tiers (based on your 2024 MAGI) are shown below:

Single filers:

• $109,000 or less — no surcharge
• Above $109,000 up to $137,000 — Tier 1
• Above $137,000 up to $171,000 — Tier 2
• Above $171,000 up to $205,000 — Tier 3
• Above $205,000 up to $500,000 — Tier 4
• Above $500,000 — Tier 5

Married filing jointly: Double each of those thresholds ($218,000, $274,000, $342,000, $410,000, $750,000).

Married filing separately has its own, tighter schedule — the surcharge can begin at a much lower income, so check medicare.gov if this applies to you.

Each tier adds a set dollar amount to both your Part B and Part D premiums. The higher the tier, the higher the add-on.

Why this matters in Honolulu right now

Honolulu is in Honolulu County, where retirees weighing their 2027 coverage during Annual Enrollment (Oct. 15 – Dec. 7) should factor IRMAA into the total cost picture — not just plan premiums. A one-time event in 2025 — selling a rental property, cashing out stock, taking a large IRA distribution, or a Roth conversion — could push you over a bracket line for 2027, even if your everyday retirement income is modest.

Hawaii's cost of living already stretches fixed incomes. Knowing an IRMAA letter may be coming lets you plan the year's cash flow instead of being surprised in January.

How to appeal if your income has dropped

If you've had a life-changing event, you can ask Social Security to recalculate using more recent income. Qualifying events include:

• Marriage, divorce, or death of a spouse
• Work stoppage or reduction (retirement counts)
• Loss of income-producing property
• Loss or reduction of a pension
• An employer settlement payment

File Form SSA-44 with documentation. This is the single most useful step for a recent retiree who had a high final working year in 2024 but is now living on Social Security and savings.

The rest of your 2027 drug cost picture

IRMAA is one piece. The broader Part D rules also affect what you'll pay at the pharmacy:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your covered drug costs hit that amount, you pay nothing for covered drugs the rest of the year.
• Maximum Part D deductible: $615 in 2026 and $700 in 2027.
• The coverage gap ("donut hole") is gone. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan. You can choose to spread your drug costs across the year in monthly installments instead of paying at the counter. It doesn't lower the total — it smooths the timing.

Deciding what to do during Annual Enrollment

A few practical questions to sit with before Dec. 7:

1. Do I expect an IRMAA letter? Look at your 2024 tax return. If your MAGI was over $109,000 (single) or $218,000 (joint), plan for a surcharge. 2. Has my income dropped since? If yes, gather documents for an SSA-44 appeal. 3. Do my prescriptions push me toward the $2,100 cap? If so, the Prescription Payment Plan may help with monthly budgeting. 4. Is my current plan still the right fit for my drug list and doctors in 2026? Plans change every year; so does your health.

If you don't act during Annual Enrollment, there's a second window — the Medicare Advantage Open Enrollment Period, Jan. 1 – March 31 — but it's more limited in what you can switch.