Medicare Part D

Waukegan Medicare: 2026 IRMAA Starts at $109,000 Income

Waukegan, Ill. — As the Medicare Annual Enrollment Period runs through Dec. 7, higher-income retirees across Lake County are getting a closer look at a line item many people don't see coming: the income-related monthly adjustment amount, or IRMAA. It's the extra charge Social Security adds to your Part B and Part D premiums when your income crosses certain thresholds — and for 2026, the first threshold starts at $109,000 for a single filer.

Here's what that means in plain English, and how to think about it before the enrollment window closes.

What IRMAA actually is

IRMAA stands for "income-related monthly adjustment amount." It's not a separate bill from a plan or a carrier — it's an additional charge tacked onto your standard Medicare Part B premium and, if you have drug coverage, your Part D premium. Social Security decides who owes it based on your tax return.

Most people with Medicare pay only the standard Part B premium. But if your income is above the threshold, you'll pay that standard amount plus a surcharge. The surcharge comes out of your Social Security check (or is billed directly if you're not yet collecting Social Security).

The 2026 income thresholds

For 2026, IRMAA kicks in when a single filer's modified adjusted gross income (MAGI) tops $109,000, or when a married couple filing jointly tops $218,000. Above those lines, there are five surcharge tiers — the higher your income, the higher the surcharge on both Part B and Part D.

Two important details Waukegan readers often miss:

• Medicare looks back two years. Your 2026 IRMAA is based on your 2024 tax return, because that's the most recent one the IRS has shared with Social Security.
• The cliff is real. Going one dollar over a threshold moves you into the next tier. There's no gradual phase-in.

The current, official figures for each tier are posted on Medicare.gov under "Costs" and are also mailed to affected beneficiaries by Social Security late in the year.

What's changing on the Part D side in 2026

Even if you don't owe IRMAA, Part D itself looks different next year:

• The out-of-pocket cap for covered drugs is $2,100 in 2026. Once you hit that, you pay $0 for the rest of the calendar year on covered prescriptions.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap is gone as of 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs into level monthly payments through your plan, instead of paying big amounts at the pharmacy counter. It's optional and free to opt into.

Higher-income beneficiaries still pay the Part D IRMAA on top of whatever their plan's premium is — even for a Medicare Advantage plan that includes drug coverage.

If your income has dropped, you can appeal

This is the part a lot of people don't hear about. If you had a life-changing event since your 2024 tax return — retirement, the death of a spouse, divorce, loss of pension income, or reduced work hours — you can ask Social Security to recalculate.

The form is SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." You submit it with documentation (a letter from a former employer, a death certificate, a divorce decree). If approved, Social Security uses your more recent, lower income instead.

Waukegan is in Lake County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are offered during Annual Enrollment. Plan availability is set at the county level, so the exact count and options you see on Medicare's Plan Finder will reflect Lake County, not just the city.

How to decide what to do this fall

A few practical steps if IRMAA might apply to you:

1. Pull your 2024 tax return and check your MAGI against the $109,000 (single) or $218,000 (joint) line. 2. Watch your mail in late November or December. Social Security sends an "Initial IRMAA Determination" notice to anyone affected. 3. If a life event has cut your income, file SSA-44 rather than just paying the surcharge. 4. Compare drug plans on Medicare.gov's Plan Finder during AEP (through Dec. 7). Your IRMAA doesn't change based on which Part D plan you pick, but the plan's own premium and drug pricing certainly do.