Medicare Part D
Income Thresholds That Trigger Medicare IRMAA in Grand Island
GRAND ISLAND, Neb. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, retirees across Hall County are getting a fresh look at what their 2027 coverage will cost. For most people, the standard Part B premium is the whole story. But for a smaller group of higher-income beneficiaries, an extra charge called IRMAA — the Income-Related Monthly Adjustment Amount — kicks in and raises the price of both Part B and Part D.
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Key takeaways
- In 2026, an extra charge called IRMAA kicks in for single filers with income above $109,000 or married couples above $218,000, based on 2024 tax returns, and it raises both Part B and Part D premiums.
- Most people on Medicare stay below these thresholds and simply pay the standard Part B premium with no Part D surcharge.
- If a life-changing event lowered your income since 2024, you can file Form SSA-44 with Social Security to ask for a recalculation, which can reduce or remove the surcharge.
- Separately, Part D coverage in 2027 includes a $2,400 out-of-pocket cap and a maximum deductible of $700, and the old coverage gap has been replaced with a simpler three-phase structure.
Higher earners in Grand Island will pay more for Part B and Part D in 2027
Here's what that surcharge is, who pays it, and where the 2026 income thresholds start.
What IRMAA actually is
IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra amount added to your Medicare Part B premium and your Part D drug plan premium if your income is above a certain level.
A few key points to keep in mind:
- IRMAA is set by the Social Security Administration, not by your insurance plan.
- It's billed on top of whatever your Part B and Part D premiums already are.
- It applies to the person, not the plan — so switching drug plans won't get rid of it.
Most people on Medicare don't pay IRMAA at all. It only affects beneficiaries above the income thresholds.
The income thresholds for 2026
For 2026, IRMAA starts when your modified adjusted gross income (MAGI) is above $109,000 for a single filer or $218,000 for a married couple filing jointly, based on your 2024 tax return.
From there, the surcharge climbs in tiers. The higher your income, the higher the add-on for both Part B and Part D. The top tier applies to single filers with income at or above $500,000 and married couples at or above $750,000.
If your income is at or below those starting thresholds, you'll pay the standard Part B premium and no Part D surcharge — no action needed on IRMAA.
Why 2025 income matters for 2027
Medicare uses a two-year look-back. Your 2027 IRMAA will be based on the tax return you filed for 2025. That's why a one-time bump in income — from selling a home, cashing out investments, or taking a large IRA withdrawal — can surprise people two years later when their Medicare bill arrives.
If you're planning a large financial move this year or next, it's worth talking with a tax professional about how it might ripple into your Medicare costs down the road.
What to do if your income has dropped
If you had a "life-changing event" that reduced your income since 2024, you can ask Social Security to recalculate your IRMAA. Qualifying events include:
- Marriage, divorce, or the death of a spouse
- You or your spouse stopped working or cut back hours
- Loss of income-producing property (not from a normal sale)
- Loss or reduction of a pension
You'll use Form SSA-44 and provide documentation. If Social Security agrees, they'll adjust your surcharge — sometimes eliminating it entirely.
How this connects to the rest of your 2027 coverage
IRMAA isn't the only number changing in 2027. Part D also has a new $2,400 out-of-pocket cap on covered prescriptions, and the maximum Part D deductible is $700. The old coverage gap ("donut hole") is gone, replaced by a simpler three-phase structure.
There's also the Medicare Prescription Payment Plan, which lets you spread your drug costs across the calendar year in monthly installments instead of paying large amounts at the pharmacy counter. It doesn't lower your total bill, but it can smooth out the timing.
For Grand Island residents, plan availability is set at the county level. Hall County has a range of stand-alone Part D and Medicare Advantage options during AEP, and the number of choices is one reason it pays to compare during open enrollment rather than letting a plan auto-renew.
Key dates to keep in mind
- Oct. 15 – Dec. 7: Medicare Annual Enrollment Period. Changes take effect Jan. 1.
- Jan. 1 – March 31: Medicare Advantage Open Enrollment Period, for people already in an Advantage plan who want to switch or return to Original Medicare.
If you get an IRMAA notice you disagree with, don't wait — the letter itself explains how to appeal, and the sooner you act, the sooner it can be corrected.
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 Hall County
(MA penetration in Hall 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 for 2026
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 2026 surcharge is based on your 2024 tax return.
| 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
Q: If I'm just barely over the $109,000 line, do I pay a small surcharge or a big one?
Q: Does IRMAA apply to Medicare Advantage members too?
Q: I got an IRMAA letter but my income has dropped a lot since 2024. What now?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.