Medicare Part D

How Your Income Shapes 2026 Medicare Part B and D Costs

SPRINGFIELD, Mass. — As Medicare's Annual Enrollment Period runs through Dec. 7, many people across Hampden County are looking at their 2026 costs and spotting something confusing on the paperwork: an extra charge tied to their income. It's called IRMAA, and understanding it now can help you avoid a surprise bill later.

Here's what you need to know for 2026.

What IRMAA actually is

IRMAA stands for "Income-Related Monthly Adjustment Amount." It's an extra amount that higher-income beneficiaries pay on top of their standard Medicare Part B premium and their Part D drug plan premium.

It is not a penalty for doing something wrong. It's simply how Medicare asks people with higher incomes to pay a larger share of their premium costs. The Social Security Administration calculates it automatically using your tax return.

The 2026 income thresholds

For 2026, IRMAA kicks in when your modified adjusted gross income (MAGI) goes above $109,000 for a single filer or $218,000 for a married couple filing jointly, based on figures published by CMS at Medicare.gov.

There are five income tiers above those starting points. The higher your income, the higher your surcharge on both Part B and Part D. At the top tier, the combined extra amount can add several hundred dollars per month to what you pay.

One important detail: Medicare uses your tax return from two years ago. So your 2026 IRMAA is based on the income you reported on your 2024 tax return.

How the surcharge shows up

If IRMAA applies to you, you'll see it in two places:

• Part B: The surcharge is added to your standard Part B premium and is usually deducted from your Social Security check.
• Part D: The surcharge is billed separately by Medicare, even if you pay your drug plan premium directly to a private insurer. This catches people off guard every year — they assume the plan handles it, but the Part D IRMAA is a separate bill.

Springfield is in Hampden County, where residents choose from a range of Part D and Medicare Advantage plans during open enrollment. IRMAA is the same no matter which plan you pick — it's tied to your income, not your plan.

If your income has dropped, you can ask for a review

This is the part many people miss. If you had a "life-changing event" that reduced your income, you can ask Social Security to recalculate your IRMAA using more recent figures.

Qualifying events include:

• Marriage, divorce, or the death of a spouse
• You or your spouse stopped working or reduced hours
• Loss of pension income
• Loss of income-producing property from a disaster or event beyond your control

You file Form SSA-44 with Social Security and include documentation. If approved, your surcharge is adjusted — sometimes back to the standard premium.

Retirees in Springfield who left the workforce in 2024 or 2025 are a common example. Their two-year-old tax return still reflects a full salary, but their actual retirement income is much lower.

Mistakes to avoid this fall

A few things trip people up every year:

1. Ignoring the notice. Social Security mails an IRMAA determination letter. If you think it's wrong or your situation has changed, you have 60 days to request a new decision. 2. Assuming a one-time income spike is permanent. A Roth conversion, a home sale, or a large capital gain in 2024 can push you into IRMAA for 2026 — even if your regular income is much lower. You may not be able to appeal a one-time event, but knowing about it now helps you plan. 3. Forgetting the Part D piece. Even people who don't take many prescriptions may still owe a Part D IRMAA if they're enrolled in a plan. 4. Missing the connection to other 2026 changes. The Part D out-of-pocket cap is $2,100 in 2026, the maximum Part D deductible is $615, and the Medicare Prescription Payment Plan lets you spread drug costs across the year. IRMAA is separate from all of these, but it affects the total you'll pay.