Medicare Part D

IRMAA in 2026: the income thresholds that raise Part B and Part D costs for Syracuse retirees

SYRACUSE, N.Y. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, higher-income retirees in Central New York are getting a fresh look at something that catches many people off guard: the income-related monthly adjustment amount, better known as IRMAA. For 2026, the first surcharge kicks in once a single filer's income tops $109,000, and it applies to both Part B and Part D premiums.

Medicare Part DSyracuse, NY

If your income has changed — because you sold a home, took a Roth conversion, or retired mid-year — this is the season to understand how those numbers translate into what Medicare will bill you next year.

What IRMAA actually is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It is not a separate bill. Instead, it is an extra amount added on top of the standard Part B premium and, for people enrolled in Part D drug coverage, an extra amount added to the Part D premium.

Most people with Medicare pay the standard Part B premium and no Part D surcharge. IRMAA only applies to the roughly 8% of beneficiaries whose income is above the thresholds set by Social Security each year.

The 2026 income thresholds

The first IRMAA tier in 2026 begins at:

• More than $109,000 for a single filer
• More than $218,000 for a married couple filing jointly

Above those amounts, surcharges rise in five steps. The highest tier applies to single filers with income at or above $500,000, or married couples at or above $750,000. Each tier adds a set dollar amount to both the Part B premium and the Part D premium — the exact 2026 dollar amounts are posted on Medicare.gov once CMS finalizes them for the year.

If you file taxes separately from a spouse you lived with during the year, a different, narrower set of brackets applies. Social Security's IRMAA notice will spell out which tier you fall into.

How Social Security decides

Medicare doesn't ask you for your income. Social Security pulls it directly from the IRS, using the most recent return on file — which is usually two years old. That means:

• Your 2026 IRMAA is based on your 2024 tax return.
• Your 2027 IRMAA will be based on your 2025 return.

The number Social Security uses is your Modified Adjusted Gross Income (MAGI): your adjusted gross income plus any tax-exempt interest. Capital gains, IRA withdrawals, and Roth conversions all count.

Because the lookback is two years, a one-time bump — say, selling a rental property in 2024 — can raise your Medicare premiums for 2026 even though your income has since returned to normal.

What to do if your income has dropped

Social Security recognizes that life changes. If you have had a "life-changing event," you can ask for a new determination using Form SSA-44. Qualifying events include:

• Retirement or reduced work hours
• Marriage, divorce, or the death of a spouse
• Loss of pension income
• An employer settlement payment

You'll attach documentation — such as a letter from your former employer or a death certificate — and Social Security will either use a more recent tax return or your estimate for the current year.

If you disagree with an IRMAA determination for another reason (for example, the IRS data is wrong), you can also file an appeal within 60 days of the notice.

Where Part D fits in

Even if you don't hit an IRMAA tier, 2026 brings meaningful changes to Part D worth reviewing this fall:

• The out-of-pocket cap for covered drugs is $2,100.
• The maximum plan deductible is $615.
• The old coverage gap, or "donut hole," is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across monthly installments instead of paying large amounts at the pharmacy counter.

For higher-income filers, the Part D IRMAA is added to whatever premium your drug plan charges, and Social Security typically deducts it directly from your monthly benefit.

Local context for Syracuse

Syracuse is in Onondaga County, where Medicare beneficiaries choose between Original Medicare (often paired with a Medigap policy and a stand-alone Part D plan) and Medicare Advantage. IRMAA rules apply the same way regardless of which path you pick — the surcharge is tied to your income, not your plan choice.

New York's SHIP program, called HIICAP (Health Insurance Information, Counseling and Assistance Program), offers free one-on-one help. Onondaga County residents can reach HIICAP through the county Office for Aging.