Medicare Part D

Fargo retirees and IRMAA: the 2026 income line that raises Part B and Part D

FARGO, N.D. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, some higher-earning retirees in Cass County are getting a first look at how their 2024 tax return will shape their 2026 Medicare bills. The rule, called the Income-Related Monthly Adjustment Amount, or IRMAA, kicks in once a single filer's income tops $109,000 — and it changes both Part B and Part D premiums.

Medicare Part DFargo, ND

What IRMAA is, in plain terms

IRMAA is not a separate bill or a penalty. It is an extra amount added on top of the standard Part B premium and the standard Part D premium when your income is above a set line. Most people with Medicare pay only the standard premium. A smaller group with higher incomes pays the standard amount plus a surcharge.

The surcharge comes in tiers — the higher your income, the higher the add-on. It is set each year by the Centers for Medicare & Medicaid Services (CMS) using income data from the IRS.

The 2026 income thresholds

For 2026, IRMAA begins above these income levels, based on your 2024 modified adjusted gross income (MAGI):

• Single filer: above $109,000
• Married filing jointly: above $218,000
• Married filing separately: a lower threshold applies, and the surcharge climbs quickly

From there, the brackets step up. Each bracket adds a larger amount to both your Part B premium and your Part D premium. The very top bracket applies to single filers with income at or above $500,000 and married couples at or above $750,000.

Exact per-bracket dollar figures for 2026 are posted on Medicare.gov as CMS finalizes them. Check the "Costs" section at medicare.gov for the current chart before making decisions.

Why your 2024 taxes matter now

Social Security looks back two years to set your Medicare premiums. That means:

• Your 2026 premium is based on your 2024 tax return.
• Your 2025 premium was based on your 2023 tax return.

For someone in Fargo who sold a home, took a large IRA withdrawal, or converted a traditional IRA to a Roth in 2024, that one-year bump in income can push you into an IRMAA bracket for 2026 — even if your income is lower now.

What the Part D piece looks like

The Part D IRMAA is separate from your drug plan's own premium. Medicare bills it directly, usually by deducting it from your Social Security check. This is true whether you get drug coverage through a stand-alone Part D plan or bundled into a Medicare Advantage plan with drug coverage.

The IRMAA surcharge is unrelated to other 2026 Part D changes worth knowing about: the new $2,100 annual out-of-pocket cap on covered drugs, the $615 maximum deductible, and the Medicare Prescription Payment Plan, which lets you spread your drug costs across the calendar year in monthly installments.

When you can appeal

If your income has fallen because of a "life-changing event," you can ask Social Security to use more recent income instead of your 2024 return. Qualifying events include:

• Retirement or reduced work hours
• Marriage, divorce, or death of a spouse
• Loss of pension income
• Loss of income-producing property due to a disaster

The form is SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." You submit it to Social Security with proof of the event and your expected income.

Where Fargo residents can get help

Fargo is in Cass County, and North Dakotans have free, unbiased help through the State Health Insurance Counseling program, known locally as SHIC. Counselors can walk you through IRMAA letters, explain your appeal options, and help you compare coverage during AEP (Oct. 15–Dec. 7) or Medicare Advantage Open Enrollment (Jan. 1–March 31).

For official figures, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7.