Medicare Part D

Above $109,000: Medicare surcharges for Erie single filers

Erie, Pa. — If you're on Medicare in Erie and your income has climbed in recent years, your 2026 premiums may look different than your neighbor's. That's because Medicare adds a surcharge on top of standard Part B and Part D premiums for higher earners. The rules for 2026 are now set, and the first income step starts above $109,000 for a single filer.

Here's what that means for households in Erie County — and how to decide whether it applies to you.

What IRMAA actually is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge Medicare adds to your Part B premium (medical insurance) and your Part D premium (prescription drugs) if your income sits above certain thresholds.

A few things to know up front:

• IRMAA is not a penalty. It's a tiered surcharge, similar to how tax brackets work.
• It's set each year by the Centers for Medicare & Medicaid Services (CMS) using data from the IRS.
• It shows up automatically — usually deducted from your Social Security check, or billed directly if you don't collect Social Security yet.

The income Medicare looks at

Medicare uses your Modified Adjusted Gross Income (MAGI) from your tax return two years ago. So your 2026 Part B and Part D premiums are based on the income you reported on your 2024 tax return.

That two-year lookback trips up a lot of people. If you retired in 2024 or 2025 and your income has since dropped, you may be paying a surcharge based on a year that no longer reflects your reality. (More on how to fix that below.)

The 2026 income thresholds

For 2026, the standard Part B premium applies to single filers with MAGI at or below $109,000, and married couples filing jointly at or below $218,000. Above those numbers, IRMAA kicks in and rises in steps.

There are five income tiers in total. The highest tier applies to single filers with MAGI at or above roughly $500,000 (about $750,000 for joint filers). Each tier adds a set dollar amount to both your Part B and Part D premiums.

For the exact 2026 dollar figures at each tier, check the Medicare costs page at medicare.gov — it's updated annually and is the authoritative source.

How this fits with other 2026 changes

IRMAA isn't the only number changing. A few program-wide updates worth knowing:

• Part D out-of-pocket cap: $2,100 for 2026. Once your drug spending hits that ceiling, you pay $0 for covered drugs the rest of the year.
• Part D maximum deductible: $615.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan: an optional program that lets you spread drug costs across monthly payments instead of paying big bills at the pharmacy counter.

These apply to everyone on Medicare — regardless of income.

If your income has dropped, you can appeal

This is the piece most Erie retirees miss. If you've had a life-changing event — retirement, the death of a spouse, divorce, loss of pension income, or the sale of a business — you can ask Social Security to recalculate IRMAA using your current income instead of your 2024 return.

You do this by filing Form SSA-44 ("Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event") with the Social Security Administration. You'll need documentation of the event and your expected income.

If approved, your surcharge is reduced or removed for the year in question.

What Erie residents should do this fall

Erie is in Erie County, where the Annual Enrollment Period runs October 15 through December 7. That's the window to review your Part D or Medicare Advantage coverage for 2026. IRMAA itself isn't something you "enroll" in or out of — it's automatic — but AEP is a good moment to look at the full picture: your premiums, your drug plan, and whether an appeal makes sense.

If you had a Medicare Advantage plan and want to switch, the Medicare Advantage Open Enrollment Period runs January 1 through March 31.

For free, unbiased, one-on-one help in Pennsylvania, contact APPRISE, the state's SHIP (State Health Insurance Assistance Program). Counselors can walk through your situation without trying to sell you anything.