Medicare Part D

Asheville Medicare IRMAA & income surcharges 2027

ASHEVILLE, N.C. — As the Medicare Annual Enrollment Period runs through Dec. 7, some higher-income retirees here are getting a reminder that what you earned two years ago still shows up in this year's Medicare bill. In 2026, single filers with income above $109,000 — and married couples filing jointly above $218,000 — will pay an income-related surcharge on top of their standard Part B and Part D premiums.

Higher earners in Asheville face bigger Medicare bills in 2027

That surcharge is called IRMAA, short for Income-Related Monthly Adjustment Amount. It catches a lot of people off guard, especially in the first year or two of retirement. Here's what to know.

What IRMAA is, in plain English

Most people on Medicare pay the standard Part B premium and whatever premium their Part D drug plan charges. But if your income is above a certain level, Social Security adds an extra monthly charge to both.

A few key points:

• It's based on your tax return from two years ago. Your 2027 IRMAA is calculated from your 2025 IRS return.
• It uses your MAGI — modified adjusted gross income, which is your AGI plus any tax-exempt interest.
• It's a cliff, not a slope. Cross a threshold by even one dollar and you jump to the next tier for the whole year.
• It applies to both Part B and Part D, even if you get your drug coverage through a Medicare Advantage plan.

The 2026 income thresholds

For 2026, the first IRMAA tier begins above $109,000 for single filers and $218,000 for married couples filing jointly. From there, the surcharge steps up through several higher tiers, with the largest amounts hitting single filers above roughly $500,000 and couples above $750,000. Married-filing-separately has its own, tighter schedule.

CMS publishes the 2027 IRMAA brackets later in the fall, typically in November, alongside the Part B premium. Because tiers can adjust each year, check the current chart on medicare.gov rather than relying on last year's numbers.

Why Asheville retirees should look twice this fall

Buncombe County has a large share of residents who retired here from other states, and many are drawing from a mix of Social Security, pensions, IRAs, and investment accounts. A one-time event in 2025 — selling a second home, converting a traditional IRA to a Roth, taking a large capital gain, or cashing out stock — could have pushed your MAGI over a threshold you didn't know existed.

If that's you, the higher premium will show up quietly in your 2027 Social Security deposit or Medicare bill. It's not a penalty and it's not permanent; when your income drops back down, so does the surcharge (with the same two-year lag).

What to do if your income has dropped

If you've had a life-changing event since 2025, you can ask Social Security to recalculate your IRMAA using more recent income. Qualifying events include:

• Marriage, divorce, or the death of a spouse
• You or your spouse stopped working or reduced hours
• Loss of a pension
• Loss of income-producing property from a disaster or event beyond your control

You file Form SSA-44 with documentation. If approved, Social Security adjusts your surcharge — sometimes back to zero.

How this fits with the rest of your 2027 drug costs

IRMAA is one piece of the drug-cost picture. A few other 2027 numbers worth knowing:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your covered drug spending reaches that amount, you pay nothing for covered drugs the rest of the year.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying at the pharmacy counter. It doesn't lower the total — just smooths it out.