Medicare Part D

2026 Medicare IRMAA: Where the Income Brackets Start

KEARNEY, Neb. — If your income has climbed in recent years, the mail you get from Social Security this fall may include a surprise: an extra monthly charge on top of your standard Medicare Part B and Part D premiums. It's called IRMAA — the Income-Related Monthly Adjustment Amount — and for 2026, the first surcharge tier kicks in when a single filer's income tops $109,000, or $218,000 for a couple filing jointly.

Here's what higher-income Medicare enrollees in Kearney need to know before Annual Enrollment closes on December 7.

What IRMAA actually is

IRMAA is not a separate bill or a penalty. It's an added amount that gets tacked onto your Medicare Part B premium and your Part D drug plan premium if your income sits above certain thresholds. Social Security calculates it automatically using your tax return — and here's the part that trips people up: it uses your return from two years ago. So your 2026 IRMAA is based on the income you reported for 2024.

That two-year lookback is why a one-time income spike — selling a home, cashing out an IRA, taking a large Roth conversion — can raise your Medicare premiums later, even after your income drops back down.

The 2026 income brackets, in plain numbers

For 2026, IRMAA begins above these modified adjusted gross income (MAGI) levels:

• Single filer: surcharges begin above $109,000
• Married filing jointly: surcharges begin above $218,000
• Married filing separately: a much lower threshold applies, and the surcharge climbs quickly

Above those first thresholds, IRMAA is tiered. There are five brackets in all, with the top tier reaching well above $500,000 in income for single filers (and roughly double that for joint filers). The higher the bracket, the larger the monthly add-on for both Part B and Part D.

The exact dollar amounts for each tier are published by CMS each fall on medicare.gov under "Costs." Because those figures can shift year to year, it's worth checking the official page rather than relying on last year's numbers.

Two surcharges, one income test

One point that surprises many readers: IRMAA hits both Part B and Part D. The Part B surcharge is added to your monthly Part B premium. The Part D surcharge is billed separately — usually deducted from Social Security — even if your drug plan's own premium is low. You don't avoid the Part D surcharge by picking a cheaper drug plan; it's a flat amount tied to your income bracket, not your plan.

If you have a Medicare Advantage plan that includes drug coverage, the Part D portion of IRMAA still applies.

The mistakes to avoid

A few common missteps cost Kearney-area beneficiaries real money each year:

• Ignoring the letter. Social Security mails a "predetermination notice" when your income crosses a threshold. Open it. It explains what you'll owe and how to appeal.
• Not appealing after a life-changing event. If your income dropped because you retired, lost a spouse, divorced, or stopped working, you can file Form SSA-44 to ask Social Security to use a more recent year. This is the single most-missed step.
• Forgetting tax-exempt interest counts. MAGI for IRMAA includes tax-exempt municipal bond interest. It's easy to overlook.
• Assuming IRMAA is permanent. It's recalculated every year based on the most recent tax return on file. If your income drops, the surcharge drops with it — usually two years later.

How Kearney fits in

Kearney is in Buffalo County, where beneficiaries choose from a range of Medicare Advantage and standalone Part D plans during Annual Enrollment (Oct. 15 – Dec. 7). IRMAA rules are federal, so the thresholds are the same whether you live in Kearney, Grand Island, or Omaha — but your plan options and the standard premiums you build on top of are set locally and nationally by CMS.

Also worth knowing for 2026: the new Part D out-of-pocket cap is $2,100, the maximum Part D deductible is $615, and the Medicare Prescription Payment Plan lets you spread drug costs across the year in level monthly amounts. Those changes apply regardless of whether you owe IRMAA.