Medicare Part D

$109,000 Triggers Medicare Part B and D Extra Costs in Caldwell

CALDWELL, Idaho — As Medicare's fall Annual Enrollment Period runs through December 7, higher-income retirees are getting their first clear look at the 2026 income thresholds that decide whether they'll pay extra for Part B and Part D. The surcharge is called IRMAA — the Income-Related Monthly Adjustment Amount — and for 2026 it kicks in above $109,000 in yearly income for a single filer (and above $218,000 for a married couple filing jointly).

The income lines that trigger a Medicare surcharge in 2026

If your income is under those lines, this article probably doesn't affect you. If it's over, or close to it, here's what to know before the December 7 deadline.

What IRMAA actually is

IRMAA is not a separate bill or a new tax. It's an add-on to your standard Medicare Part B premium and, if you have drug coverage, to your Part D premium. Social Security handles the calculation and usually deducts it straight from your monthly benefit.

The important quirk: Medicare looks back two years to decide your IRMAA. Your 2026 surcharge is based on the income you reported on your 2024 federal tax return. That means a one-time bump in 2024 — selling a home, cashing out an IRA, taking a large capital gain — can raise your Medicare premium in 2026 even if your income is normal again now.

The 2026 income thresholds

IRMAA is tiered. You don't pay a little more as your income creeps up — you jump to the next bracket the moment you cross a line. For 2026, the entry points are:

• Single filer: surcharges begin above $109,000
• Married filing jointly: surcharges begin above $218,000
• Married filing separately: a separate, much lower threshold applies

From there, higher income brackets add larger amounts to both Part B and Part D. The top tier applies to single filers with income at or above $500,000 and joint filers at or above $750,000. For the exact dollar amount at each tier, Medicare posts an updated table each fall at Medicare.gov under "Costs."

Part D in 2026: what's changing for everyone

Even if IRMAA doesn't apply to you, 2026 brings real changes to Part D drug coverage:

• The annual out-of-pocket cap is $2,100. Once your covered drug spending reaches that amount, you pay $0 for covered drugs for the rest of the year.
• The maximum Part D deductible is $615.
• The old coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs into level monthly payments across the year, instead of paying a big amount at the pharmacy counter. It's optional and free to sign up.

Higher-income beneficiaries still get all of these protections. IRMAA raises your premium; it does not shrink your benefits.

If your income has dropped, you can appeal

This is the part many people miss. If you've had a "life-changing event" since the tax year Medicare is using, you can ask Social Security to recalculate. Qualifying events include:

• Retirement or reduced work hours
• Death of a spouse
• Marriage or divorce
• Loss of pension income
• Loss of income-producing property (not from a sale)

You file Form SSA-44 with documentation. If approved, Social Security uses your more recent, lower income instead of the two-year-old figure. It's worth doing — the difference across a full year can be significant.

What Caldwell residents should know locally

Caldwell is in Canyon County, where beneficiaries choose between Original Medicare (with or without a standalone Part D drug plan and Medigap) and Medicare Advantage. IRMAA applies the same way in either lane — it's tied to your income, not your plan choice. If you're comparing options during the Annual Enrollment Period (through December 7) or the Medicare Advantage Open Enrollment Period (January 1 – March 31), factor any expected surcharge into your total monthly cost, not just the plan's premium.

Idaho's SHIBA program (Senior Health Insurance Benefits Advisors) is Idaho's SHIP — the free, unbiased counseling service for Medicare questions. Counselors can walk through IRMAA and appeals with you at no charge.