Medicare Part D
$109,000 IRMAA threshold shapes Lowell Medicare premiums
LOWELL, Mass. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees along the Merrimack Valley are getting a fresh look at how their tax returns can quietly push up next year's Part B and Part D premiums. For 2026, the income thresholds that trigger an income-related surcharge — known as IRMAA — start at $109,000 for a single filer, and knowing where you fall can prevent an unwelcome surprise on your Social Security statement.
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Click to call 855-729-3240Key takeaways
- Medicare's Annual Enrollment Period runs through Dec. 7, giving you time to review how income affects your premiums.
- For 2026, the IRMAA surcharge on Part B and Part D starts once income crosses $109,000 for a single filer, based on your tax return from two years earlier (usually 2024).
- If your income has dropped due to a life-changing event, like stopping work or losing a spouse, you can file Form SSA-44 to ask Social Security to use more recent income instead of the older tax return.
- Your ZIP code determines which Part D and Medicare Advantage plans you can choose from, but your income—not your location—determines whether you owe an IRMAA surcharge.
Here's a plain-English guide to how income affects Part B and Part D in 2026, and what Lowell residents can do about it during this enrollment season.
What IRMAA actually is
IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra amount added to your standard Part B premium and to your Part D premium if your income is above certain limits. It is not a penalty for signing up late — that's a different charge. IRMAA is simply Medicare's way of asking higher earners to pay more for the same coverage.
The Social Security Administration decides who owes IRMAA. They look at your most recent tax return on file with the IRS — usually from two years ago. So your 2026 surcharge is generally based on your 2024 tax return.
The 2026 income thresholds
For 2026, IRMAA kicks in once your modified adjusted gross income (MAGI) crosses these lines:
- Single filer: above $109,000
- Married filing jointly: above $218,000
- Married filing separately: a much lower threshold applies
Above those first tiers, there are several higher brackets. The more you earn, the larger the surcharge on both Part B and Part D. If your income sits below the threshold, you pay only the standard Part B premium and whatever your Part D plan charges — no add-on.
For the current-year figures and full bracket chart, Medicare posts them at medicare.gov.
Part B and Part D are billed differently
The Part B surcharge is added to the Part B premium that Social Security typically deducts from your monthly benefit. It's automatic — you don't send a separate check.
The Part D surcharge works differently. You still pay your drug plan's premium to the plan, but the IRMAA portion is billed separately by Medicare (usually deducted from Social Security). That's why some higher earners see two Medicare-related deductions each month.
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 Middlesex County
(MA penetration in Middlesex 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.
What changed for Part D in 2026
Even if you owe an IRMAA surcharge, the underlying Part D benefit is more predictable than it used to be:
- The out-of-pocket cap for covered drugs is $2,100 in 2026. Once you hit it, you pay $0 for the rest of the year on covered medications.
- The maximum Part D deductible is $615.
- The old coverage gap — the "donut hole" — was eliminated in 2025. Part D now has three phases instead of four.
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying large amounts at the pharmacy counter. It's optional and free to join.
These changes apply regardless of income. IRMAA only affects your premium, not your cost-sharing at the pharmacy.
If your income has dropped, you can appeal
This is the piece many Lowell readers miss. Because IRMAA looks at a two-year-old tax return, retirees whose income has dropped — often because they stopped working, sold a business, or lost a spouse — can ask Social Security to reconsider.
You'd file Form SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." Qualifying events include:
- Retirement or reduced work hours
- Marriage, divorce, or the death of a spouse
- Loss of pension income
- Certain settlement or property losses
Bring documentation. If approved, Social Security uses a more recent income estimate instead of the older tax return.
Where Lowell fits in
Lowell is in Middlesex County, where Medicare beneficiaries generally have a wide range of stand-alone Part D and Medicare Advantage options to choose from during Annual Enrollment. Plan availability, formularies, and pharmacy networks are set at the county level, so two neighbors in Lowell see the same menu of choices — but IRMAA is set at the individual level based on your tax return, not where you live.
That means your ZIP code determines your plan choices, but your income determines whether you'll pay a surcharge on top of the premium.
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 this year. Will Medicare know my income went down?
Q: Does IRMAA apply if I have a Medicare Advantage plan?
Q: Do withdrawals from a traditional IRA count toward the IRMAA threshold?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.