Medicare Part D
IRMAA in Manchester: Part B & D Surcharges
MANCHESTER, N.H. — As New Hampshire retirees open their fall Medicare mail, many will notice something that catches them off guard: a surcharge tied not to their current paycheck, but to a tax return they filed two years ago. It's called IRMAA — the Income-Related Monthly Adjustment Amount — and for 2026, it kicks in for single filers with income above $109,000.
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Key takeaways
- IRMAA is an extra charge added to Part B and Part D premiums for higher earners, based on tax income from two years earlier, not a penalty.
- For 2026, the standard Part B premium applies to single filers with income at or below $109,000 and joint filers at or below $218,000, with surcharges phasing in above those amounts.
- If a life-changing event, like stopping work, lowered your income since 2024, you can file Form SSA-44 with Social Security to ask for a recalculation, since this adjustment isn't automatic.
- IRMAA applies the same way to Part B and Part D no matter which Medicare option you choose, so it's worth reviewing during the Annual Enrollment Period running October 15 through December 7.
Higher earners could pay more in 2027 — here's the income line that matters
With the Annual Enrollment Period running October 15 through December 7, this is the season when higher-income beneficiaries should double-check whether an IRMAA letter is coming, and what to do if their income has since dropped.
What IRMAA actually is
IRMAA is an extra amount added to your Medicare Part B premium and your Part D drug plan premium if your income is above certain thresholds. It is not a penalty for doing something wrong. It is simply how Medicare asks higher earners to pay a larger share of their coverage.
Two important things to know up front:
- IRMAA is set by the Social Security Administration, based on income data from the IRS.
- It uses your Modified Adjusted Gross Income (MAGI) from two years earlier. So your 2027 surcharge is based on your 2025 tax return.
The income thresholds that apply
For 2026, the standard Part B premium applies to single filers with MAGI at or below $109,000, and to joint filers at or below $218,000. Above those lines, IRMAA phases in across several tiers — the higher your income, the higher the surcharge on both Part B and Part D.
A few examples of how the tiers generally work:
- Single filers between roughly $109,000 and $137,000 (or joint filers between $218,000 and $274,000) fall into the first IRMAA tier.
- Each higher income bracket adds a larger surcharge, up to a top tier for single filers with income above $500,000 (or $750,000 for joint filers).
- The surcharge applies to both your Part B premium and your Part D premium, even if your Part D plan premium itself is modest.
Exact dollar figures for each tier are published by CMS at Medicare.gov. If you're close to a threshold, even a small change — like a Roth conversion or a one-time capital gain in 2024 — can push you into the next bracket.
Why 2027 matters more than usual
Two big Part D changes are still settling in, and they interact with IRMAA in ways worth understanding:
- The Part D out-of-pocket cap is $2,100 in 2026. Once your drug spending hits that ceiling, you pay $0 for covered drugs the rest of the year.
- The Part D deductible maximum is $615, and the old "donut hole" coverage gap is gone — replaced by three simpler phases.
- The Medicare Prescription Payment Plan lets you spread your drug costs into level monthly payments instead of paying big amounts at the pharmacy counter.
None of that erases IRMAA. But it does mean the total picture — premium plus drug costs — looks different than it did a few years ago, and it's worth a fresh look during AEP.
If your income has dropped, you can appeal
This is the piece most people miss. If a "life-changing event" has lowered your income since 2024, you can ask Social Security to recalculate your IRMAA using more recent figures. Qualifying events include:
- Retirement or reduced work hours
- Loss of a spouse
- Divorce
- Loss of pension income
- Certain settlements or employer changes
You file Form SSA-44 with documentation. If approved, the surcharge is adjusted — sometimes eliminated. Many retirees in the Manchester area who stopped working in 2025 will qualify, but Social Security won't do this automatically. You have to ask.
Local context for Manchester
Manchester is in Hillsborough County, where beneficiaries have a range of Original Medicare, Medicare Advantage, and stand-alone Part D options to compare during AEP. IRMAA applies the same way regardless of which path you choose — it attaches to Part B and to Part D, whether your Part D coverage is stand-alone or built into a Medicare Advantage plan.
For personalized help sorting through the choices, New Hampshire's SHIP program — called NH SHIP / ServiceLink — offers free, unbiased counseling.
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 Hillsborough County
(MA penetration in Hillsborough 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; 2027 figures pending
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 brackets shown here are for 2026, based on your 2024 tax return; CMS typically publishes the 2027 brackets and surcharge amounts later in the fall, alongside the 2027 Part B premium.
| 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 got an IRMAA letter but my income is much lower now. What do I do?
Q: Does IRMAA come out of my Social Security check?
Q: If I switch drug plans during AEP, does my IRMAA change?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.