Medicare Part D
How Past Income Raises Medicare Premiums in Carmel
CARMEL, Ind. — As Medicare's Annual Enrollment Period runs through Dec. 7, thousands of Hamilton County residents are reviewing their 2027 coverage options. But there's one detail many overlook until the bill arrives: your income from two years ago can push your Part B and Part D premiums higher next year.
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Key takeaways
- Medicare's Annual Enrollment Period runs through Dec. 7, giving people a chance to review their 2027 coverage options.
- For 2026, an extra charge called IRMAA kicks in on Part B and Part D premiums if your 2024 income was above $109,000 for single filers or $218,000 for married couples filing jointly.
- IRMAA is not a penalty and isn't based on health or plan choice—it's calculated automatically from your tax return, and married people filing separately face different, tighter thresholds.
- If a life change like retirement, divorce, or losing a spouse lowered your income since 2024, you can file form SSA-44 with Social Security to ask for a recalculation.
The rule is called IRMAA — the Income-Related Monthly Adjustment Amount — and for 2026, the first surcharge tier kicks in above $109,000 in income for a single filer, based on your 2024 tax return.
What IRMAA is, in plain English
Most people on Medicare pay the standard Part B premium and whatever their Part D plan charges. But if your income is above a set threshold, the Social Security Administration adds an extra amount to both Part B and Part D. That extra amount is IRMAA.
It is not a penalty. It is not tied to how healthy you are or which plan you choose. It is strictly a look-back at your tax return from two years earlier — so your 2027 premiums are based on your 2025 modified adjusted gross income (MAGI).
The income thresholds for 2027
For 2026, IRMAA begins above $109,000 for single filers and above $218,000 for married couples filing jointly, according to CMS.
From there, the surcharge climbs in tiers. The more your income exceeded the threshold in 2025, the larger the monthly add-on will be on both Part B and Part D in 2027. CMS publishes the 2027 IRMAA brackets later in the fall, typically in November. Married people who file separately have their own, tighter thresholds — which catches some Carmel retirees by surprise after a spouse passes or during a legal separation year.
If you fall into an IRMAA bracket, Social Security will send you a letter explaining the amount and how to respond.
Why 2027 matters even if you're not high-income
Even Medicare beneficiaries who never come near IRMAA territory should pay attention this fall, because two other changes are reshaping drug costs:
- Part D out-of-pocket cap: In 2026, your total out-of-pocket spending on covered prescription drugs is capped at $2,100. Once you hit that, you pay $0 for covered drugs the rest of the year.
- Part D deductible: The maximum allowable deductible for 2026 is $615.
- The "donut hole" is gone. As of 2025, Part D moved to three phases — deductible, initial coverage, and catastrophic — with no coverage gap.
There is also the Medicare Prescription Payment Plan, an optional program that lets you spread your drug costs across monthly payments instead of paying big bills at the pharmacy counter. It doesn't lower what you owe, but it can smooth out the timing.
What to do if a life change dropped your income
This is the part many people miss. If your 2024 income was high but you've since retired, lost a spouse, gotten divorced, or had work hours cut, you can ask Social Security to recalculate your IRMAA using more current numbers.
The form is called SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." Qualifying events include:
- Marriage, divorce, or death of a spouse
- Work stoppage or reduction
- Loss of income-producing property (not due to sale)
- Loss or reduction of pension income
- Employer settlement payment
You'll need documentation, but this is one of the more powerful — and least-used — tools in the Medicare rulebook.
Enrollment dates to circle in Carmel
Carmel is in Hamilton County, where beneficiaries have a broad set of Medicare Advantage and Part D options through Indiana's marketplace. Availability counts are set at the county level by CMS, and your choices are the same whether you live near Clay Terrace or out toward West Carmel.
Two windows matter this season:
- Annual Enrollment Period: Oct. 15 – Dec. 7, 2026. This is when you can join, switch, or drop Medicare Advantage and Part D plans for 2027.
- Medicare Advantage Open Enrollment: Jan. 1 – March 31, 2027. If you're already in a Medicare Advantage plan, you get one chance to switch to a different Advantage plan or return to Original Medicare.
IRMAA itself is not something you enroll in or out of — it's calculated automatically from your tax data.
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 Hamilton County
(MA penetration in Hamilton 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.
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.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Q: I just retired in 2026. Will Medicare still use my higher 2025 income for my 2027 premiums?
Q: Does IRMAA apply if I have Medicare Advantage instead of Original Medicare?
Q: Are Roth conversions or one-time capital gains counted for IRMAA?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.