Medicare Part D
Medicare Part D drug cap and payment plan in Dundalk
DUNDALK, Md. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees in eastern Baltimore County are getting a fresh reminder that what you earned two years ago can still show up in your monthly premium. IRMAA income thresholds and surcharges for 2027 have not yet been published; CMS typically releases them later in the fall along with the Part B figures, so it pays to know where you stand before your first bill of the new year arrives.
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Key takeaways
- IRMAA is an extra charge added to Part B and Part D premiums for higher-income Medicare enrollees, based on income from two years earlier (2025 income will affect 2027 premiums).
- For 2026, IRMAA starts when a single filer's income is above $109,000, or above $218,000 for married couples filing jointly, with higher surcharges kicking in at higher income tiers.
- If your income has dropped since 2024 due to a life-changing event, you can file Form SSA-44 with documentation to ask Social Security to recalculate your IRMAA.
- The Part D out-of-pocket cap on covered prescriptions is $2,100 in 2026 and $2,400 in 2027, and the maximum deductible a plan can charge is $615 in 2026 and $700 in 2027. The donut hole remains replaced by a three-phase design, though IRMAA surcharges still apply on top.
What IRMAA actually is
IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge that gets added to your standard Part B premium and, if you have drug coverage, your Part D premium. It isn't a penalty for doing anything wrong — it's simply how Medicare asks higher earners to pay a larger share of program costs.
Social Security handles the paperwork. If you owe an IRMAA, you'll get a letter explaining the amount and how it was calculated. The extra Part B amount is taken from your Social Security check (or billed directly). The Part D piece is billed separately from your plan's premium, even if your plan premium is paid another way.
The IRMAA income thresholds
Medicare looks back two years to decide whether IRMAA applies. That means your 2027 premiums will be based on the income reported on your 2025 tax return. The 2027 brackets and surcharge amounts have not yet been published; CMS announces them later in the fall.
For 2026, IRMAA begins when a single filer's modified adjusted gross income (MAGI) is above $109,000, or above $218,000 for a married couple filing jointly. Below those numbers, you pay the standard Part B premium and just your plan's Part D premium — no surcharge.
Above those thresholds, IRMAA is tiered. The higher your income, the higher the surcharge, with the top tier kicking in at very high incomes (roughly $500,000 for singles and $750,000 for joint filers). Married couples who file separately have their own, much tighter set of brackets.
For the exact dollar amounts at each tier, check the official IRMAA chart on medicare.gov — those figures are updated each year and are the source of truth.
Why 2024 income matters right now
Because of the two-year lookback, a one-time bump in 2025 income can raise your 2027 premiums. Common triggers we hear about from readers in the Dundalk area include:
- Selling a longtime home in Turner Station or Eastpoint and booking a large capital gain
- Cashing out or converting a traditional IRA to a Roth
- Taking a lump-sum pension or a big required minimum distribution
- Picking up part-time or consulting work after retiring
None of these are bad decisions on their own. They just have a side effect on Medicare that's easier to plan for than to unwind.
Life-change exceptions you can appeal
If your income has dropped since 2024, you may not have to accept the higher premium. Social Security allows an appeal — officially called a "life-changing event" request — for situations like:
- Retirement or reduced work hours
- Death of a spouse
- Divorce or annulment
- Loss of pension income
- Loss of income-producing property from a disaster or other event outside your control
You file Form SSA-44 with documentation. If approved, Social Security recalculates your IRMAA based on your more recent income. It's one of the most underused tools in Medicare, and it's worth asking about if your situation has changed.
How this connects to Part D in 2027
Part D is having a big year. The out-of-pocket cap on covered prescriptions is $2,100 for 2026, the maximum deductible a plan can charge is $615, and the old coverage gap ("donut hole") remains gone — replaced by a simpler three-phase design that started in 2025. There's also the Medicare Prescription Payment Plan, an optional program that lets you spread your drug costs across monthly payments instead of paying big amounts at the pharmacy counter.
IRMAA sits on top of all that. If your income puts you above the threshold, the Part D surcharge applies whether you're enrolled in a stand-alone drug plan or getting drug coverage through a Medicare Advantage plan.
What Dundalk residents can do during AEP
Dundalk is in Baltimore County, where Medicare's Annual Enrollment Period (Oct. 15 – Dec. 7, 2026) is the main window to change your Part D or Medicare Advantage coverage for 2027. IRMAA itself isn't something you "shop around" — it's tied to your tax return, not your plan choice — but AEP is a natural time to:
- Pull your most recent Social Security IRMAA letter and check the tier
- Look at whether your 2024 income was unusually high (or low) and plan accordingly
- Ask your tax preparer about Roth conversions or withdrawal timing before year-end
- If you've had a life-changing event, start gathering documents for Form SSA-44
Medicare Advantage members also get a second window — Jan. 1 – March 31 — to switch Advantage plans or drop back to Original Medicare.
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 Baltimore County
(MA penetration in Baltimore 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.
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. Your 2027 surcharge will be based on your 2025 tax return. The 2027 brackets have not yet been published; CMS typically releases them later in the fall.
| 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 ever go away on its own?
I'm barely over the threshold. Is there anything I can do?
Does IRMAA apply if I only have Part B and no drug plan?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.