Medicare Part D
Income Thresholds Behind Medicare IRMAA in Salem
SALEM, Ore. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, higher-income retirees in the Willamette Valley are getting a fresh look at something that catches many by surprise: the income-related surcharge, or IRMAA, that can raise both Part B and Part D premiums in 2027.
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Key takeaways
- IRMAA is an extra charge added to Part B and Part D premiums for higher-income beneficiaries, and it is not a penalty or tied to any specific plan.
- For 2026, Medicare uses your 2024 tax return to decide if you owe IRMAA, and the surcharge rises in tiers, with the top tier hitting single filers at or above roughly $500,000 and joint filers at or above $750,000.
- Switching Medicare Advantage or Part D plans during the Annual Enrollment Period, which runs through Dec. 7, will not remove IRMAA because it is based on income, not plan choice.
- If your income has dropped since 2024 due to a life-changing event like retirement or the death of a spouse, you can file form SSA-44 with the Social Security Administration to ask for a recalculation.
The rules haven't changed in structure, but the income thresholds shift slightly each year — and the tax return Medicare uses to decide who pays is now two years old. Here's what Salem readers should know before making enrollment decisions this season.
What IRMAA actually is
IRMAA stands for the Income-Related Monthly Adjustment Amount. It's not a penalty, and it isn't tied to any specific plan. It's an extra amount added to your standard Part B premium and your Part D premium if your income is above a certain level.
Most people on Medicare pay only the standard Part B premium. IRMAA only applies to a smaller share of beneficiaries — generally those with higher retirement income, investment income, or a large one-time event like the sale of a home or a Roth conversion.
The income thresholds in use right now
For 2026, IRMAA kicks in when your modified adjusted gross income (MAGI) is above:
- $109,000 for a single filer
- $218,000 for a married couple filing jointly
Above those numbers, the surcharge is tiered. As income climbs, the extra amount you pay for Part B and Part D goes up in steps, with the highest tier hitting single filers with income at or above roughly $500,000 and joint filers at or above $750,000. Medicare publishes the exact tier amounts each fall at medicare.gov.
One quirk that trips people up: Medicare looks at your 2025 tax return to set your 2027 premiums. So the income that matters for next year is income you already reported.
Why this matters for Salem retirees
Salem is in Marion County, where beneficiaries have a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. IRMAA applies the same way regardless of which type of coverage you choose — it's added on top of whatever Part D premium your plan charges (or, for Medicare Advantage with drug coverage, on top of your Part B premium and any drug portion).
In other words, switching plans during AEP doesn't make IRMAA go away. It's based on income, not plan choice.
What to do if your income has dropped
If your income has fallen since 2024 because of a "life-changing event" — retirement, the death of a spouse, divorce, loss of pension income, or a work stoppage — you can ask Social Security to recalculate your IRMAA using more recent income.
The form is SSA-44, and you file it with the Social Security Administration, not Medicare. Salem residents can drop it off at the local Social Security office or mail it in with supporting documentation.
A few other numbers worth knowing
While you're planning:
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027 — once you hit it, you pay nothing more for covered drugs the rest of the year.
- The Part D maximum deductible is $615 for 2026 and $700 for 2027.
- The old "donut hole" coverage gap is gone; Part D now has three phases (deductible, initial, catastrophic).
- The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments instead of paying big amounts up front at the pharmacy.
These figures apply nationwide, including here in Marion County.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Marion County
(MA penetration in Marion County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Higher-income surcharges
IRMAA income brackets for 2026
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. The surcharge in effect for 2026 is based on your 2024 tax return. CMS publishes the 2027 brackets later in the fall.
| Income — single filer | Income — married, joint | Part B monthly premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | Plan premium only |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | + $14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | + $37.40 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | + $60.40 |
| $205,001 – $500,000 | $410,001 – $750,000 | $649.30 | + $83.30 |
| Above $500,000 | Above $750,000 | $689.90 | + $91.00 |
Standard Part B premium is $202.90/month. Part D surcharges are added to your drug plan’s premium. Married-filing-separately uses a different, compressed schedule. Confirm current amounts at Medicare.gov.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Does IRMAA come out of my Social Security check?
If I appeal IRMAA, how long does it take?
I had a big capital gain in 2025. Am I stuck with the surcharge for 2027?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.