Medicare Part D
How IRMAA Raises Medicare Part B and Part D in Lincoln
LINCOLN, Neb. — If you're on Medicare in Lancaster County, the amount you pay for Part B and Part D in 2027 depends on more than just the standard premium. It also depends on what you reported on your tax return two years ago. For higher-income retirees, that can mean an extra monthly charge called IRMAA — the Income-Related Monthly Adjustment Amount. With the Annual Enrollment Period running now through Dec. 7, here's a plain-English look at how the income thresholds work and how to plan around them.
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Key takeaways
- Your 2027 Part B and Part D premiums can include an extra charge called IRMAA if your income is above certain limits, based on your 2025 tax return.
- IRMAA is not a penalty, it's just a higher share of Medicare costs that higher earners pay, based on modified adjusted gross income.
- If your income has dropped since 2024 due to a life-changing event like retirement, you can file Form SSA-44 to ask Social Security for a redetermination instead of just accepting the charge.
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and IRMAA applies the same way no matter which type of Medicare coverage you choose.
What IRMAA is, in plain English
IRMAA stands for Income-Related Monthly Adjustment Amount. It's a surcharge that Social Security adds to your Part B premium and, if you have drug coverage, your Part D premium. It kicks in when your income crosses certain lines set by the Centers for Medicare & Medicaid Services (CMS).
The important thing to know: IRMAA is not a penalty. It's simply a higher share of the program's cost that Medicare asks higher earners to pay. And it's based on your modified adjusted gross income (MAGI) — that's your adjusted gross income plus any tax-exempt interest.
The IRMAA income thresholds
For 2026, IRMAA starts once your 2024 income (the tax return Social Security is looking at now) climbs above:
- $109,000 for someone filing as single
- $218,000 for a married couple filing jointly
If you're under those numbers, you'll pay the standard Part B premium and only your plan's Part D premium — no extra surcharge. Above those numbers, IRMAA rises in tiers: the higher your income, the higher the monthly add-on for both Part B and Part D.
Because the thresholds move a little each year and the tier amounts change, always check the current figures at medicare.gov before you plan.
How Social Security decides — and how to appeal
Social Security uses a two-year lookback. Your 2027 IRMAA will be based on your 2025 tax return. If you retired, sold a business, lost a spouse, or had another major life change since then, your current income may be very different from what the IRS has on file.
The good news: you can ask for a redetermination. It's called a life-changing event request, and you file it using Form SSA-44. Qualifying events include:
- Marriage, divorce, or death of a spouse
- Work stoppage or reduction (like retirement)
- Loss of pension income
- Loss of income-producing property from a disaster
If you got an IRMAA notice this fall and something big has changed, don't just accept it — appeal.
What else is new for Part D in 2027
Even if IRMAA doesn't touch you, there are big changes to Part D worth knowing:
- The annual out-of-pocket cap on prescription drugs is $2,100 in 2026 and $2,400 in 2027. Once you hit that ceiling, you pay nothing for covered drugs the rest of the year.
- The maximum Part D deductible is $615 for 2026 and $700 for 2027.
- The old "donut hole" coverage gap is gone. Part D now has three simpler phases.
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big bills at the pharmacy counter.
What this means for Lincoln residents
Lincoln is in Lancaster County, where retirees have a range of Original Medicare, Medicare Advantage, and stand-alone Part D options to sort through during the Annual Enrollment Period. IRMAA applies the same way no matter which path you pick — it's tied to your income, not your plan choice.
If you're comparing coverage this fall, run the numbers with your full 2027 monthly cost in mind: the plan premium, plus any IRMAA surcharge, plus expected out-of-pocket drug costs under the $2,400 cap.
For free, unbiased help in Nebraska, the Nebraska SHIIP (Senior Health Insurance Information Program) offers one-on-one counseling. It's the state's SHIP program, and counselors don't sell insurance.
Key dates to keep on the calendar
- Oct. 15 – Dec. 7, 2026: Annual Enrollment Period. Changes take effect Jan. 1, 2027.
- Jan. 1 – March 31, 2027: Medicare Advantage Open Enrollment Period, if you're already in an Advantage plan and want to switch or return to Original Medicare.
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 Lancaster County
(MA penetration in Lancaster 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
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. The 2026 brackets below use your 2024 tax return; CMS publishes the 2027 brackets later in the fall, based on your 2025 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: I just retired this year. Will Medicare use my old, higher income for 2027?
Q: Does IRMAA apply if I only have Part B and no drug plan?
Q: Is the $2,100 drug cap automatic?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.