Medicare Part D
How IRMAA Raises Medicare Costs for Springfield Filers in 2027
SPRINGFIELD, Ill. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-earning retirees in central Illinois are getting a fresh look at something that often catches people off guard: the income-related monthly adjustment amount, or IRMAA. For 2026, the surcharge kicks in above $109,000 in income for a single filer — and the tax return being checked isn't the one you just filed.
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Click to call 855-729-3240Key takeaways
- For 2026, IRMAA surcharges start above $109,000 in income for single filers and $218,000 for married couples filing jointly, on top of standard Part B and Part D premiums.
- Medicare bases a given year's IRMAA on your tax return from two years earlier, so 2027 surcharges will be calculated using 2025 income.
- If a one-time event like selling a home, a big IRA withdrawal, or a spouse's death temporarily raised your income, you can file Form SSA-44 with Social Security to ask for a recalculation.
- Separately, Part D drug coverage has a $2,100 annual out-of-pocket cap in 2026 and $2,400 in 2027, with a maximum deductible of $615 in 2026 and $700 in 2027 — all worth reviewing before the Dec. 7 enrollment deadline.
Here's what Springfield readers need to know before signing up for Part B or Part D coverage this fall.
What IRMAA Actually Is
IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge that Medicare adds on top of the standard Part B premium and, separately, on top of your Part D drug plan premium if your income is above certain thresholds.
It isn't a penalty. You're not being punished for earning more. IRMAA is simply how Medicare asks higher-income beneficiaries to pay a larger share of their coverage costs. If your income is at or below the first threshold, you pay the standard Part B premium and no Part D surcharge at all.
The Income Thresholds for 2026
For 2026, IRMAA begins above $109,000 in income for a single filer and above $218,000 for a married couple filing jointly, according to Medicare.gov. Above those first thresholds, surcharges rise in steps — there are five IRMAA brackets in total, with the highest reserved for individuals earning $500,000 or more (or married couples at $750,000 or more).
Two important details:
- IRMAA applies to both Part B and Part D. If you cross a threshold, you'll pay a surcharge on each.
- The surcharge is the same dollar amount regardless of which Part D plan you choose. It's added to whatever your plan's premium is.
The Two-Year Look-Back That Trips People Up
This is the piece most Springfield readers miss: Medicare uses your modified adjusted gross income (MAGI) from two years ago to set a given year's IRMAA. So your 2027 surcharges will be based on your 2025 tax return.
That matters because a one-time bump in income — selling a home, cashing out a large IRA distribution, taking a lump-sum pension payout, or a spouse's death changing your filing status — can push you into a higher bracket for a year, even if your current income is far lower.
When a Life Change Can Get IRMAA Reduced
If you've had a "life-changing event," you can ask Social Security to recalculate your IRMAA using more recent income. Qualifying events include:
- Marriage, divorce, or the death of a spouse
- Stopping work or reducing hours (retirement counts)
- Loss of pension income
- An employer settlement payment
To request a review, file Form SSA-44 with the Social Security Administration and include documentation. This is one of the most under-used tools in Medicare, and it's worth knowing about before you pay a full year of surcharges you don't actually owe.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Sangamon County
(MA penetration in Sangamon County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
How This Fits With Other 2027 Changes
IRMAA isn't the only thing shifting for 2027. The Part D annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and the maximum Part D deductible is $615 in 2026 and $700 in 2027. The old coverage gap — the "donut hole" — was eliminated in 2025, so drug coverage now has three phases instead of four. Beneficiaries who want to spread drug costs across the year can also opt into the Medicare Prescription Payment Plan.
None of those changes affect the IRMAA brackets directly, but they change the math on total drug costs for higher-income households — worth reviewing before the Dec. 7 deadline.
Where Springfield Fits In
Springfield is in Sangamon County, where Medicare eligibility and enrollment rules work the same as everywhere else in the country. IRMAA is a federal calculation — it doesn't vary by county or ZIP code. What does vary locally is the set of Part D and Medicare Advantage plans available, and Medicare's Plan Finder at medicare.gov lets you compare those side by side using your own ZIP.
If your income is near a threshold, small planning choices — the timing of a Roth conversion, when you take a required minimum distribution, or how you spread a capital gain — can matter more than choosing between two similar drug plans.
Higher-income surcharges
IRMAA income brackets
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. The brackets and surcharge amounts shown here are for 2026 and are based on your 2024 tax return; CMS publishes the 2027 brackets later in the fall, typically in November.
| Income — single filer | Income — married, joint | Part B monthly premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | Plan premium only |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | + $14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | + $37.40 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | + $60.40 |
| $205,001 – $500,000 | $410,001 – $750,000 | $649.30 | + $83.30 |
| Above $500,000 | Above $750,000 | $689.90 | + $91.00 |
Standard Part B premium is $202.90/month. Part D surcharges are added to your drug plan’s premium. Married-filing-separately uses a different, compressed schedule. Confirm current amounts at Medicare.gov.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Does IRMAA go away if my income drops?
Do I pay IRMAA if I'm on Medicare Advantage instead of Original Medicare?
How will I know if I owe IRMAA?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.