Medicare Part D

Hazelwood Medicare: 2027 IRMAA Thresholds for Part B & D

Hazelwood, Mo. — As Medicare's Annual Enrollment Period runs through Dec. 7, many people in the St. Louis area are getting their first look at what they'll pay for Part B and Part D coverage in 2027 — and for a small but growing group of higher-income retirees, the bill will include an extra line item known as IRMAA.

Here's a plain-English guide to how income affects your Medicare costs in 2027, who pays more, and what to do if your income has recently dropped.

What IRMAA is, in plain terms

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added to your standard Medicare Part B premium and your Part D drug plan premium if your income is above a certain level.

It is not a penalty for doing anything wrong. It's simply how Medicare asks higher-income beneficiaries to pay a larger share of their premium. Most people on Medicare don't pay IRMAA at all — only those above the income thresholds do.

The 2026 income thresholds

For 2026, IRMAA surcharges begin when your modified adjusted gross income (MAGI) is above:

• $109,000 for a single filer
• $218,000 for a married couple filing jointly

If your income is at or below those numbers, you'll pay the standard Part B premium and just your plan's regular Part D premium — no surcharge.

Above those thresholds, IRMAA is tiered. The higher your income, the higher the extra amount added to both your Part B and your Part D premium. The top tier applies to single filers with income of $500,000 or more (and couples at $750,000 or more).

How Medicare decides what you owe

Social Security uses your tax return from two years ago to figure out your IRMAA. That means your 2027 premiums will be based on the income reported on your 2025 federal tax return.

If you cross a threshold, you'll get a letter from Social Security explaining the adjustment. The extra amount is usually taken directly out of your Social Security check, along with your regular Part B premium. Your Part D surcharge is paid to Medicare, not to your drug plan — even though the base premium still goes to the plan.

What if your income has dropped?

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

• Retirement or reduced work hours
• Loss of a spouse
• Divorce
• Loss of pension income
• A one-time event like selling property that inflated a past tax year

You file Form SSA-44 with documentation. If approved, your surcharge can be reduced or removed. This is one of the most useful appeals in the Medicare system, and it's underused.

Other 2027 numbers worth knowing

Even if IRMAA doesn't apply to you, a few program-wide figures are changing:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once you hit that in covered drug costs, you pay nothing more for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• The coverage gap ("donut hole") is gone as of 2025 — Part D now has three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter. It's optional and free to join.

A quick note on local coverage

Hazelwood is in St. Louis County, where Medicare Advantage and Part D plan availability is set at the county level. That means Hazelwood residents see the same menu of plans as neighbors elsewhere in the county. IRMAA, however, is federal — it doesn't change based on where you live.