Medicare Part D

Medicare IRMAA in Carmel, Indiana: 2027 guide

CARMEL, Ind. — As Medicare's Annual Enrollment Period runs from Oct. 15 through Dec. 7, one detail catches many higher-income retirees off guard: your tax return from two years ago can raise what you pay for Part B and Part D in 2026. The rule is called the Income-Related Monthly Adjustment Amount, or IRMAA, and it kicks in for single filers with income above $109,000 next year.

Higher earners in Carmel face familiar Medicare math this fall

If you live in Carmel — which sits in Hamilton County, one of Indiana's higher-income areas — this rule affects more households here than in many parts of the state. Here's a plain-language look at how it works.

What IRMAA actually is

IRMAA is not a penalty. It's an extra monthly amount added to your standard Part B premium and, if you have drug coverage, to your Part D premium. Social Security calculates it automatically using the most recent tax return the IRS has shared with them — generally your 2025 return for 2027 costs.

Most people with Medicare pay only the standard Part B premium. IRMAA only applies to the roughly 8% of enrollees whose income crosses the thresholds.

The income thresholds

For 2026, IRMAA surcharges start above these modified adjusted gross income (MAGI) levels:

• Single filers: more than $109,000
• Married filing jointly: more than $218,000
• Married filing separately: a much lower threshold applies

The surcharge climbs in tiers. The higher your income, the larger the add-on for both Part B and Part D. At the top tier — income above roughly $500,000 single or $750,000 joint — the combined surcharges can add several hundred dollars a month.

Medicare.gov publishes the full tier chart each fall. It's worth pulling up when the 2027 numbers post if your income is anywhere near the first cutoff.

Why the two-year lookback matters

Because Social Security uses your 2024 income to set your 2026 premium, a one-time bump — selling a home, taking a large IRA withdrawal, or cashing out stock — can push you into an IRMAA tier even if your current income is modest.

The good news: if you've had a life-changing event since that tax year, you can ask for a review. Qualifying events include:

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

You file Form SSA-44 with Social Security and attach documentation. Many people don't realize this appeal exists.

What's changing for Part D in 2027

Even if IRMAA doesn't touch you, Part D itself is changing in ways worth knowing:

• The out-of-pocket cap for prescriptions is $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old "donut hole" coverage gap is gone — drug coverage now moves through three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter. It's optional and free to opt into.

These changes apply to everyone with Part D, regardless of income.

What to do during Open Enrollment

Between now and Dec. 7, it's a good time to:

1. Check your Social Security notice. If you'll owe IRMAA in 2027, you should receive a letter later this fall explaining the amount and how to appeal. 2. Review your drug plan. Formularies and pharmacy networks change every year. The Plan Finder at medicare.gov compares plans available in Hamilton County for 2027. 3. Look ahead if you're near a threshold. A conversation with a tax professional about Roth conversions, capital gains timing, or charitable distributions can matter for future IRMAA years. 4. Know the second window. If you're already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period runs Jan. 1 – March 31, 2027 and allows one switch.