Medicare Part D

How Income Affects Your 2026 Medicare Part B and Part D Costs

TOMS RIVER, N.J. — As Medicare's Annual Enrollment Period runs through Dec. 7, retirees along the Jersey Shore are getting a fresh look at what their 2026 coverage will cost. For most people, the standard Part B premium is the same figure everyone sees quoted on the news. But if your income crossed certain lines two years ago, you'll pay more — sometimes hundreds of dollars more per month — thanks to a surcharge called IRMAA.

Higher earners in Toms River will pay more for Medicare in 2026

Here's a plain-English look at how the income rules work in 2026, who they hit, and what Toms River residents can do about it.

What IRMAA is, in plain terms

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added to your Part B premium and your Part D drug plan premium if your income is above a set threshold.

A few key points to know:

• IRMAA is set by Social Security, not by your insurance company.
• It's based on your modified adjusted gross income (MAGI) from two years ago — so your 2026 surcharge is based on your 2024 tax return.
• If you're subject to IRMAA, you'll get a letter from Social Security explaining the amount.
• The extra Part B amount is taken out of your Social Security check (or billed directly). The Part D piece is billed separately from your drug plan premium, even if you have a Medicare Advantage plan that includes drug coverage.

The 2026 income thresholds

For 2026, IRMAA kicks in above $109,000 for a single filer and above $218,000 for a married couple filing jointly. From there, the surcharge climbs in tiers — the higher your income, the higher the add-on.

Both Part B and Part D have their own IRMAA amounts, and they apply on top of whatever your regular premiums would be. Someone at the top tier can pay several hundred dollars more each month for Part B alone.

Because the exact dollar amounts for each tier are updated by CMS each fall, the most reliable place to check the current figures is medicare.gov/basics/costs.

Why this matters more in 2026

Two things make the income conversation especially relevant this year:

1. Part D has a new $2,100 out-of-pocket cap. Once your covered drug spending hits that ceiling in 2026, you pay $0 for the rest of the year on covered drugs. The deductible can be up to $615, and the old "donut hole" is gone — replaced with a simpler three-phase design. 2. The Medicare Prescription Payment Plan lets you spread your drug costs over the calendar year in monthly installments instead of paying big amounts at the pharmacy counter. It doesn't lower what you owe, but it can smooth the bumps.

Neither of these changes the IRMAA rules — but they do change the overall math of what your drug coverage will cost, especially if you take expensive medications.

If your income has dropped, you can appeal

This is the part many Toms River retirees miss. IRMAA looks back two years, so if you retired, sold a business, lost a spouse, or had another life-changing event, the income on your 2024 return may not reflect what you're actually earning now.

Social Security lets you request a reconsideration using Form SSA-44. Qualifying life-changing events include:

• Marriage, divorce, or the death of a spouse
• Work stoppage or reduced hours
• Loss of income-producing property
• Loss of pension income
• An employer settlement payment

If any of those apply, it's worth filing the form with documentation rather than quietly paying the surcharge.

Ocean County context

Toms River is in Ocean County, where seniors have a wide range of Medicare Advantage and stand-alone Part D options available during the Annual Enrollment Period. Availability is set at the county level, so two neighbors in Toms River generally see the same menu of plans.

IRMAA, though, is personal — it follows the enrollee, not the plan. That means two people on the exact same drug plan can pay very different Part D totals if their incomes fall on opposite sides of the threshold.

Quick FAQ

Q: I just retired this year. Will my 2026 premium reflect that? A: Not automatically. Social Security will use your 2024 tax return. If your income has dropped because you stopped working, file Form SSA-44 to ask for an adjustment.

Q: Does IRMAA apply if I have a Medicare Advantage plan? A: Yes. IRMAA is tied to Part B and Part D themselves, not to how you get your coverage. Even if your Advantage plan includes drug coverage, the Part D surcharge is billed separately.

Q: What income counts? A: Modified adjusted gross income — which is your AGI plus tax-exempt interest. Capital gains, IRA withdrawals, and Roth conversions all count in the year they happen.

Q: Where can I see the exact 2026 tier amounts? A: The official chart is on medicare.gov under "Costs." Social Security will also mail a personalized notice if IRMAA applies to you.

Where to get help

For the current IRMAA brackets and Part B and Part D premium figures, go to medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7.

New Jersey residents can also get free, unbiased, one-on-one counseling through the State Health Insurance Assistance Program (SHIP), known locally as NJ SHIP. Counselors can walk through your specific tax situation and help you decide whether to file an appeal — at no cost to you.

Annual Enrollment ends Dec. 7. If you're already enrolled in a Medicare Advantage plan, you'll get a second chance to switch during Medicare Advantage Open Enrollment, Jan. 1 through March 31.