Medicare Part D

Medicare IRMAA surcharges facing Towson higher earners

TOWSON, Md. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-earning retirees in Baltimore County are getting a fresh reminder that what they earned two years ago can quietly reshape what they pay next year. For 2026, an income-related surcharge — known as IRMAA — kicks in for single filers with modified adjusted gross income above $109,000, and it applies to both Part B and Part D premiums.

If that sounds like a lot of moving parts, you're not alone. Here's what Towson residents should know before the enrollment window closes.

What IRMAA Actually Is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added on top of the standard Medicare Part B premium and, separately, on top of your Part D prescription drug premium. It is not a penalty for late enrollment — it's a surcharge tied strictly to your income.

Most people on Medicare pay the standard Part B premium and no extra Part D adjustment. But if your income crosses certain thresholds, Social Security adds an IRMAA amount to your monthly bill.

The IRMAA Income Thresholds

For 2026, IRMAA begins for:

• Single filers with modified adjusted gross income (MAGI) above $109,000
• Married couples filing jointly with MAGI above $218,000

From there, the surcharge climbs in tiers. The higher your income, the higher your Part B and Part D adjustments. At the top tier, the extra amount can be substantial — which is why planning ahead matters.

One important detail: Social Security uses your 2025 tax return to set your 2027 premiums. That two-year lookback catches many new retirees off guard, especially if 2025 included a home sale, Roth conversion, large capital gains, or a final year of full-time work.

How You'll Be Notified

If you owe IRMAA in 2027, Social Security will mail you a determination letter — usually in late fall or early winter. The letter explains which tier you fall into and how the surcharge will be collected. For most people, it's deducted directly from their Social Security benefit.

If you don't yet receive Social Security, you'll get a separate bill from Medicare.

What to Do If Your Income Has Dropped

This is the part many people miss. If you've had a "life-changing event" since 2024, you can ask Social Security to recalculate your IRMAA using more recent income. Qualifying events include:

• Retirement or reduced work hours
• Loss of a spouse
• Divorce
• Loss of pension income
• A settlement from an employer

You'll file Form SSA-44 and provide documentation. If approved, Social Security adjusts your surcharge — sometimes eliminating it entirely. It's worth doing; the form is free, and there's no penalty for asking.

Why 2027 Feels Different

This year's IRMAA conversation lands alongside a continuing Part D shakeup. In 2027, the Part D out-of-pocket cap is $2,400, up from $2,100 in 2026, and the maximum Part D deductible is $700, up from $615 in 2026. The old coverage gap (the "donut hole") was eliminated in 2025, replaced by a simpler three-phase structure. There's also the Medicare Prescription Payment Plan, an optional program that spreads your drug costs across monthly payments instead of hitting you all at once at the pharmacy.

None of those changes erase IRMAA — but they do mean the total picture of Part D costs looks different than it did even two years ago. Higher earners still pay the Part D surcharge on top of whatever their plan charges.

Local Context for Towson

Towson is in Baltimore County, where Medicare beneficiaries choose among a range of Medicare Advantage and stand-alone Part D plans during the Annual Enrollment Period. Plan availability is set at the county level, so two neighbors in Towson generally see the same menu of options. IRMAA, however, is federal — it applies the same way whether you live in Towson, Timonium, or anywhere else in the country.

If you want personalized help sorting through your options, Maryland's State Health Insurance Assistance Program (SHIP), called SHIP-MAP here, offers free one-on-one counseling.