Medicare Part D

Hickory retirees and IRMAA: how income brackets change your 2027 Medicare bill

HICKORY, N.C. — As the Medicare Annual Enrollment Period runs through Dec. 7, higher-income retirees in Catawba County are getting a fresh look at a rule that often catches people off guard: the Income-Related Monthly Adjustment Amount, or IRMAA. For 2026, the surcharges kick in once a single filer's income tops $109,000 (or $218,000 for a couple filing jointly), and they apply to both Part B and Part D — even if you get your drug coverage through a Medicare Advantage plan.

If that sounds like it could describe you or a family member, here's what to know before the year closes out.

What IRMAA actually is

IRMAA isn't a separate bill or a penalty. It's an extra amount added on top of the standard Part B premium and, if you have drug coverage, on top of your Part D premium. Most people with Medicare pay just the standard Part B premium. But if your income is above a certain level, Social Security adds a surcharge that gets deducted from your monthly benefit (or billed directly if you're not yet collecting Social Security).

The key thing to understand: IRMAA is based on your Modified Adjusted Gross Income (MAGI) from your tax return two years ago. So your 2027 premiums are based on what you reported to the IRS for 2025.

The income thresholds for 2027

For 2026, the first IRMAA tier begins above:

• $109,000 for individuals filing a single return
• $218,000 for couples filing jointly
• $109,000 for someone married filing separately who lived with their spouse (this tier is much tighter — surcharges start almost immediately)

From there, the surcharges step up through several higher brackets, with the largest amounts owed by individuals earning above roughly $500,000 (or couples above roughly $750,000). Both the Part B and Part D surcharges rise at each tier. Medicare.gov publishes the full bracket chart each fall, and the amounts are set nationally — they don't vary between Hickory, Charlotte, or anywhere else in the country.

Why the Part D piece surprises people

Many Hickory residents know Part B has an income-related surcharge, but fewer realize Part D has one too. If your income is above the threshold, you'll pay an IRMAA amount for Part D on top of whatever premium your drug plan charges — and that's true whether your drug coverage comes from a stand-alone Part D plan or is bundled into a Medicare Advantage plan.

This extra Part D amount is billed by Medicare, not by your plan. So if you switch plans during AEP, the IRMAA piece follows you.

What to do if your income has dropped

Because IRMAA looks back two years, a lot of new retirees get hit with a surcharge based on their last full year of working. If you've had a qualifying life-changing event — retirement, the death of a spouse, divorce, loss of pension income, or a few others — you can appeal.

The form is SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." You'll submit it to Social Security with proof of the event and an estimate of your new income. If approved, Social Security will use the more recent figure instead.

This is one of the most under-used tools in Medicare, and it's worth asking about if your situation has changed.

Local help in Hickory

Hickory is in Catawba County, and North Carolina's State Health Insurance Information Program (SHIIP) offers free, unbiased Medicare counseling to residents here. SHIIP counselors can walk you through an IRMAA notice, help you understand your Part B and Part D bills, and explain your options during AEP. They don't sell insurance and aren't paid by any plan.

You can reach SHIIP through the North Carolina Department of Insurance or by calling 1-855-408-1212.

What's changing for 2027 beyond IRMAA

A quick reminder of other program-level updates worth knowing for 2027, since they interact with what higher-income enrollees pay:

• The Part D out-of-pocket cap is $2,100 for 2026 and $2,400 for 2027. Once you hit that, you pay nothing more for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 ($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 drug costs across the calendar year in monthly installments instead of paying at the pharmacy counter. It's optional and free to opt into.