Medicare Part D

How Your Income Affects Medicare Costs in 2026

Eugene, Oregon — If you're reviewing your Medicare choices this fall, there's one detail that catches many people off guard: your income from two years ago can change what you pay for Part B and Part D in 2026. It's called IRMAA, and understanding it now — during the Annual Enrollment Period running October 15 through December 7 — can help you avoid a costly surprise when your first 2026 bill arrives.

What IRMAA Is, in Plain Language

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added on top of the standard Medicare Part B and Part D premiums for people whose income sits above a certain level. It isn't a penalty for doing anything wrong — it's simply Medicare's way of asking higher earners to pay more.

The Social Security Administration decides whether IRMAA applies to you. They look at your most recent tax return on file, which for 2026 usually means your 2024 return.

The 2026 Income Thresholds

For 2026, IRMAA kicks in once your modified adjusted gross income (MAGI) crosses these lines:

• Single filers: above $109,000
• Married filing jointly: above $218,000
• Married filing separately: a much lower threshold applies

If you're below those numbers, you'll pay the standard Part B premium and whatever your Part D plan charges — no surcharge. Above those numbers, IRMAA is tiered: the higher your income, the higher the added amount. There are five income brackets in total, with the top bracket reserved for the highest earners.

Because these figures can shift year to year, always confirm the current tiers on medicare.gov before making decisions based on them.

How the Surcharge Reaches You

IRMAA shows up in two places:

1. Part B: The surcharge is added to your monthly Part B premium. Most people have this pulled directly from their Social Security check. 2. Part D: Even though you pay your Part D plan directly for the plan's premium, the IRMAA surcharge for drug coverage is billed separately by Medicare — not by your plan. This trips up a lot of people who assume everything drug-related comes from the insurer.

If you have a Medicare Advantage plan that includes drug coverage, the Part D IRMAA still applies the same way.

Common Mistakes to Avoid

Assuming last year's letter still applies. Social Security sends a new IRMAA determination letter each fall. Read it carefully. If your income has dropped, you may qualify for relief.

Ignoring a life-changing event. If you retired, lost a spouse, divorced, or had another major income change since 2024, you can ask Social Security to recalculate using more recent figures. The form is SSA-44, and you can file it any time — you don't have to wait.

Overlooking the appeal option. If you believe the income data is wrong or outdated, you have the right to appeal. Don't just pay a surcharge you think is incorrect.

Forgetting Part D even when you're healthy. Skipping Part D when you're first eligible can trigger a separate late-enrollment penalty that lasts for life — a different issue from IRMAA, but one that also raises your monthly costs.

Other 2026 Numbers Worth Knowing

While you're looking at income-related costs, keep these program-level figures in mind for 2026:

• Part D out-of-pocket cap: $2,100. Once you spend that much on covered drugs, you pay nothing more for the rest of the year.
• Part D maximum deductible: $615, though many plans set theirs lower.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three simpler phases.
• Medicare Prescription Payment Plan: You can spread your drug costs across the year in monthly installments instead of paying large amounts at the pharmacy counter.

Eugene is in Lane County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are available. The number of options can change each year, which is why the Annual Enrollment Period matters even if you're happy with your current coverage.