Medicare Part D
Buffalo Retirees Face Medicare Part B and D Surcharges
Buffalo, N.Y. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees in Western New York are getting a fresh look at something that catches many people off guard: an income-based surcharge that raises what they pay for Part B and Part D in 2027.
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Key takeaways
- Medicare's Annual Enrollment Period runs through Dec. 7, and it's a good time for higher-income retirees to check on IRMAA, an income-based surcharge added to Part B and Part D premiums.
- IRMAA is based on your tax return from two years earlier, so 2027 costs are generally tied to your 2025 income, and it's paid to Medicare directly, often taken from your Social Security check.
- If your income has dropped due to a life-changing event, you can file Form SSA-44 with Social Security to ask for your surcharge to be recalculated.
- IRMAA stays the same no matter which Medicare plan you choose, since it's based on your income and filing status, not the plan itself.
The surcharge is called the Income-Related Monthly Adjustment Amount, or IRMAA. It's not a penalty and it's not tied to any specific plan. It's an extra amount the Social Security Administration adds to your monthly Medicare premiums when your income crosses certain lines. Here's how it works, who it affects, and what to check before the enrollment window closes.
What IRMAA is, in plain English
Most people pay the standard Part B premium and whatever premium their Part D drug plan charges. But if your income is above a set threshold, Medicare adds a surcharge on top of both.
The surcharge is based on your modified adjusted gross income (MAGI) from your tax return two years earlier. So your 2027 Medicare costs are generally based on your 2025 tax return. That two-year lookback surprises a lot of newly retired Buffalonians whose income has since dropped.
IRMAA is paid directly to Medicare — usually deducted from your Social Security check — not to a private insurance company.
The income thresholds for 2026
For 2026, IRMAA kicks in above these income levels (based on your 2024 MAGI):
- Single filers: surcharges begin above $109,000.
- Married, filing jointly: surcharges begin above $218,000.
- Married, filing separately: a separate, tighter schedule applies and surcharges begin at a much lower income level.
Above those first thresholds, IRMAA is tiered. The higher your income, the higher the surcharge — with five brackets in total. Both your Part B premium and your Part D premium get an add-on if you land in a bracket.
If your income is at or below the first threshold, IRMAA doesn't apply to you at all.
Why this matters more for 2027
Two things make IRMAA worth a closer look as you choose 2027 coverage:
1. The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. That cap protects you from runaway drug costs, but it doesn't affect IRMAA — the surcharge is separate from what you pay at the pharmacy. 2. The Part D maximum deductible is $615 for 2026 and $700 for 2027, and the coverage gap (the old "donut hole") is gone, replaced by a simpler three-phase structure. If you're comparing drug plans during AEP, remember that IRMAA is added to the plan's premium — it isn't part of the premium the plan advertises.
For higher-income retirees, that means the "sticker price" of a Part D plan isn't the whole story.
What to do if your income has dropped
This is the part many people miss. If you've had a life-changing event since your 2024 tax return, you can ask Social Security to recalculate IRMAA using more recent income. Qualifying events include:
- Retirement or reduced work hours
- Death of a spouse
- Marriage or divorce
- Loss of income-producing property
- Loss of a pension
You file Form SSA-44 with documentation. If approved, your surcharge is adjusted — sometimes eliminated. Buffalo residents can bring the form to the Social Security office on Main Street or mail it in.
How this fits with local plan choices
Buffalo is in Erie County, where retirees have a wide range of Medicare Advantage and stand-alone Part D options each year. IRMAA applies the same way regardless of which plan you pick — it follows the person, not the plan. Whether you stay in Original Medicare with a drug plan or enroll in a Medicare Advantage plan that includes drug coverage, the surcharge is calculated on your income and added on.
That's useful to know when comparing options during AEP (Oct. 15–Dec. 7) or the Medicare Advantage Open Enrollment Period (Jan. 1–March 31). The plan choice doesn't change your IRMAA; only your income and filing status do.
A quick planning checklist
Before the Dec. 7 deadline, it's worth taking 15 minutes to:
- Pull your 2024 tax return and check your MAGI against the thresholds above.
- If you're close to a bracket line, talk with a tax professional about whether Roth conversions, IRA withdrawals, or capital gains this year could push you into a higher tier for 2028 costs.
- If you've had a life-changing event, download Form SSA-44 from ssa.gov.
- Review any letter you receive from Social Security about your 2027 premiums — it will spell out your bracket.
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 Erie County
(MA penetration in Erie 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 2027 brackets and surcharge amounts have not yet been released by CMS. The 2026 brackets below are based on 2024 tax returns; the 2027 figures, when published, will be based on 2025 returns.
| 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
Does IRMAA ever go away on its own?
If my spouse and I file jointly, is IRMAA calculated on our combined income?
Does IRMAA apply if I have a Medicare Advantage plan instead of Original Medicare?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.