Medicare Part D

Paterson Medicare: 2027 IRMAA Thresholds

PATERSON, N.J. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees here in Passaic County are taking a second look at something that often catches people off guard: the income-related surcharges that raise Part B and Part D premiums.

The rules haven't changed, but the numbers have. For 2026, the income thresholds that trigger these surcharges — known as IRMAA, or the Income-Related Monthly Adjustment Amount — begin above $109,000 for a single filer. If your income sits near that line, a small change on your tax return two years ago could mean a noticeably bigger Medicare bill this year.

Here's what Paterson readers should know before the enrollment window closes.

What IRMAA actually is

IRMAA is an extra amount added on top of the standard Part B premium and, separately, on top of your Part D drug plan premium. It's not a penalty for doing anything wrong. It's simply how Medicare asks higher-income beneficiaries to pay a larger share of program costs.

Two important points:

• IRMAA is set by the Social Security Administration, not by your insurance company.
• It applies whether you have Original Medicare or a Medicare Advantage plan, and whether your drug coverage is standalone Part D or built into an Advantage plan.

The income thresholds

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

• $109,000 for individuals filing a single return
• $218,000 for married couples filing jointly

Income above those figures moves you into higher IRMAA tiers, with the top tier reserved for the highest earners. Each tier adds a set dollar amount to both your Part B premium and your Part D premium.

One detail that surprises people: Medicare uses your tax return from two years ago. So your 2027 premiums will be based on the income you reported on your 2025 taxes.

Why 2027 feels different

Even setting IRMAA aside, 2027 brings further changes to drug coverage that affect the math for higher-income households:

• The Part D out-of-pocket cap is $2,100 for 2026. Once you hit that limit on covered drugs, you pay nothing more for the rest of the year.
• The Part D deductible maxes out at $615 in 2026 ($700 in 2027).
• The old 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.

If IRMAA is pushing your Part D premium up, these changes can still make total drug spending more predictable than it used to be.

What to do if your income has dropped

A common frustration: your 2024 income was high because of a one-time event — selling a home, a large retirement account withdrawal, severance — but your current income is much lower.

You can ask Social Security to reconsider using Form SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." Qualifying events include:

• Marriage, divorce, or death of a spouse
• Work stoppage or reduced work hours
• Loss of income-producing property
• Loss or reduction of certain pension income

If approved, Social Security will use your more recent income instead of your two-year-old return.

Paterson-area context

Paterson is in Passaic County, where Medicare beneficiaries can choose from a wide range of Medicare Advantage and standalone Part D plans during Annual Enrollment. IRMAA is added on top of whatever plan premium you pay, so comparing plans on Medicare.gov's Plan Finder gives you the clearest picture of your true monthly cost.

New Jersey's State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling and can walk you through an IRMAA notice line by line.