Medicare Part D

Medicare IRMAA 2026: Part B and Part D Surcharges in North Royalton

North Royalton, Ohio — If your income has climbed in the last couple of years, your 2026 Medicare bill could climb too. The Social Security Administration is finalizing Income-Related Monthly Adjustment Amounts, or IRMAA, for 2026 — the extra charges added to Part B and Part D premiums for higher-income beneficiaries. For most people, the surcharge kicks in above $109,000 in yearly income for a single filer, based on the tax return from two years back.

Here in Cuyahoga County, where North Royalton sits, the questions come in every fall: Why did my premium go up? Can I appeal? And what counts as income? Here's a plain-language look at how IRMAA works for 2027, and the mistakes that catch people off guard.

What IRMAA is, in plain English

IRMAA is not a separate bill or a penalty. It's an extra amount added to your standard Part B premium and your Part D premium when your income is above certain thresholds. Everyone with Medicare pays the same base Part B premium; higher-income beneficiaries pay that base amount plus an IRMAA surcharge.

The surcharge is set by Social Security using your modified adjusted gross income (MAGI) from your IRS return two years earlier. So your 2027 IRMAA is based on your 2025 tax return.

About 8% of people with Medicare pay IRMAA. If you're not in that group, you don't need to do anything — the standard premium applies.

The 2027 income thresholds

IRMAA uses a tiered structure. In 2026, the first tier begins at income above $109,000 for a single filer and above $218,000 for a married couple filing jointly. From there, the surcharge steps up through several higher brackets, topping out for single filers with income at or above roughly $500,000 and joint filers at or above $750,000.

A few important points about the brackets:

• They apply to both Part B and Part D. If you owe IRMAA, you'll see a surcharge on each.
• The Part D surcharge is paid in addition to whatever premium your Part D or Medicare Advantage drug plan charges.
• Married couples who file separately and lived together during the year have their own, much lower threshold — the surcharge starts at a far lower income level.

CMS publishes the 2027 IRMAA brackets and surcharge amounts later this fall, typically in November, at medicare.gov. Check there for the exact dollar amounts before making any decisions.

What counts as income for IRMAA

This is where people trip up. MAGI for IRMAA includes your adjusted gross income plus any tax-exempt interest (for example, from municipal bonds). It also captures:

• Wages and self-employment income
• Taxable Social Security benefits
• Pension and annuity payments
• IRA and 401(k) withdrawals, including Roth conversions
• Capital gains, including a one-time home sale above the exclusion
• Dividends and interest, taxable or not

A single large event in 2025 — selling a rental property, converting a traditional IRA to a Roth, cashing out stock — can push you into IRMAA for 2027 even if your ongoing income is modest.

How you'll find out, and how to appeal

Social Security mails an "initial determination" letter, usually late in the year, telling you what your 2027 Part B and Part D amounts will be. Read it carefully. If you owe IRMAA, the letter explains why and what to do if you disagree.

You can request a new initial determination if you've had a life-changing event that lowered your income. Qualifying events include:

• Marriage, divorce, or death of a spouse
• You or your spouse stopped working or reduced hours
• Loss of income-producing property (not from your own actions)
• Loss or reduction of certain pension income
• An employer settlement payment

You file Form SSA-44 with proof of the event and your expected income. If your 2025 return was later amended or contained an IRS error, that's a separate appeal path.

Mistakes to avoid this fall

• Ignoring the letter. If you don't respond, the surcharge simply starts. An appeal is much easier before the deduction begins coming out of your Social Security check.
• Assuming a one-time bump is permanent. IRMAA is recalculated every year. A high-income 2025 might mean a surcharge in 2027, but if 2026 income drops, 2028 could return to the base premium.
• Overlooking Roth conversions and RMDs. Talk with a tax advisor before year-end if you're near a threshold. Even a few hundred dollars over a bracket line moves you into the next tier — there's no gradual phase-in.
• Forgetting the Part D piece. People sometimes budget for the Part B surcharge and are surprised by the Part D one. Both are billed together, typically through your Social Security deduction.
• Missing enrollment windows. IRMAA doesn't change when you can enroll or switch coverage. The Annual Enrollment Period runs October 15 through December 7, and the Medicare Advantage Open Enrollment Period runs January 1 through March 31.

Other 2027 numbers worth knowing

While you're reviewing your Medicare costs, keep these program-level figures in mind for 2027:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once you hit it, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 for 2026 and $700 for 2027.
• Coverage gap ("donut hole"): eliminated. Part D now has three phases — deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan: an optional program that spreads your drug costs across monthly payments instead of paying at the pharmacy counter.