Medicare Part D

How Your 2024 Income Shapes 2026 Medicare Part B and D Costs

COLUMBUS, Ohio — As Medicare's Annual Enrollment Period runs through Dec. 7, many Ohioans are getting a clearer picture of what their 2026 Part B and Part D costs will look like — and for higher-income retirees, that picture includes a surcharge known as IRMAA.

Higher earners will pay more for Medicare in 2026

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added to your standard Part B and Part D premiums if your income is above certain thresholds. For 2026, those surcharges begin once a single filer's income tops $109,000, or $218,000 for a married couple filing jointly.

If your income is below those numbers, you don't pay IRMAA at all. If it's above them, the surcharge climbs in tiers based on how much higher your income goes.

How Social Security decides what you owe

Here's the part that surprises many new retirees: the income Medicare uses to set your 2026 premiums isn't your 2026 income. It's usually your 2024 tax return — the most recent one the IRS has shared with the Social Security Administration.

Specifically, Medicare looks at your Modified Adjusted Gross Income (MAGI), which is your adjusted gross income plus any tax-exempt interest. If that MAGI crosses a threshold, Social Security mails you a letter explaining the adjustment and your appeal rights.

For Columbus residents in Franklin County, that letter typically arrives in late fall or early winter, before the new premium takes effect in January.

The 2026 income thresholds at a glance

For single filers, the tiers begin at:

• More than $109,000 up to $137,000
• More than $137,000 up to $171,000
• More than $171,000 up to $205,000
• More than $205,000 up to $500,000
• $500,000 and above

For married couples filing jointly, the thresholds are doubled at each step until the top bracket, which starts at $750,000. Married people who file separately have their own, tighter schedule.

Each tier adds a set dollar amount to both your Part B premium and your Part D premium. The higher your income tier, the higher both surcharges climb. Medicare.gov publishes the exact 2026 dollar figures for each bracket, and it's worth checking them directly rather than relying on memory from last year.

Part D surcharges work a little differently

The Part D piece of IRMAA is added on top of whatever premium your drug plan already charges. Even if you enroll in a low-premium Part D plan, the IRMAA surcharge still applies and is billed separately — usually deducted from your Social Security check along with your Part B premium.

This matters in 2026 because Part D is going through big structural changes. The out-of-pocket cap for covered drugs is $2,100 for the year, the maximum deductible any plan can charge is $615, and the old coverage gap ("donut hole") is fully gone — replaced by a simpler three-phase design. The optional Medicare Prescription Payment Plan also lets you spread your drug costs across the calendar year in monthly installments if that helps your budget.

None of those changes remove IRMAA, though. If your income triggers a surcharge, you'll still see it on top of your plan's regular premium.

When life changes, you can ask for a review

One of the most useful things to know about IRMAA is that it isn't set in stone. If you've had a "life-changing event" that dropped your income since 2024, you can ask Social Security to recalculate.

Qualifying events include:

• Marriage, divorce, or the death of a spouse
• Stopping work or reducing hours (a common one for new retirees)
• Loss of income-producing property through no fault of your own
• Loss or reduction of a pension

You file Form SSA-44 with proof of the change. If approved, Social Security uses your more recent income instead of the 2024 return.

What to do during this year's enrollment window

Because Part B and Part D premiums both flow through the same IRMAA calculation, income planning and plan shopping go hand in hand. A few practical steps for Columbus-area readers:

• Look at your 2024 tax return before Dec. 7 so you know which side of the $109,000 (or $218,000) line you're on.
• If you're close to a threshold, talk with a tax professional about whether Roth conversions, capital gains, or required minimum distributions might push you into the next tier.
• If you've already retired or reduced work since 2024, gather documentation in case you need to file Form SSA-44.
• Compare Part D plans on medicare.gov's Plan Finder with your actual drug list — the redesigned 2026 benefit affects plans differently.