Medicare Part D

How IRMAA Adjusts Medicare Part B and D in Reading

Reading, Pa. — As Medicare's Annual Enrollment Period runs through Dec. 7, many people in Berks County are opening letters from Social Security that mention something called IRMAA — the Income-Related Monthly Adjustment Amount. If you've never seen that acronym before, it can look alarming. Here's what it means for your 2027 Part B and Part D costs, in plain English.

What IRMAA actually is

IRMAA is not a penalty. It's an extra amount added to your monthly Part B (doctor visits) and Part D (prescription drugs) premiums if your income is above a certain level.

Most people pay the standard Part B premium and only the plan's Part D premium. But if your income crosses a threshold, Medicare adds a surcharge on top. That surcharge is paid to Medicare — not to your insurance company — and it's usually deducted right out of your Social Security check.

The 2026 income thresholds

For 2026, IRMAA kicks in above $109,000 in yearly income for a single filer, and above $218,000 for a married couple filing jointly. Below those numbers, you pay the standard premiums.

Above them, the surcharge climbs in tiers. The higher your income, the higher the extra amount for both Part B and Part D. There are five income brackets in all, and the top one applies to single filers with income at or above $500,000 (or $750,000 for joint filers).

One important note: Medicare uses your modified adjusted gross income (MAGI) from two years ago to set each year's surcharge. So your 2026 IRMAA is based on your 2024 tax return, and your 2027 IRMAA will be based on your 2025 return. That's why a big one-time event — selling a house, cashing out an IRA, taking a large capital gain — can push you into a surcharge bracket two years later even if your income is normal now.

How you'll be notified

The Social Security Administration mails an IRMAA determination notice, usually in late fall or early winter. It will tell you which bracket you're in and what your premium will be for the coming year. If you don't get a letter, you're likely paying the standard amount.

Keep that notice. You may need it later if your situation changes.

What to do if your income has dropped

This is the part many people miss. If you've had a life-changing event since that 2024 tax return, you can ask Social Security to recalculate your IRMAA using more recent income.

Qualifying events include:

• Marriage, divorce, or the death of a spouse
• You or your spouse stopped working or reduced hours
• Loss of pension income
• Loss of income-producing property from a disaster or event beyond your control

To request a review, file Form SSA-44 with Social Security, along with documentation. If approved, your surcharge can be lowered or removed. This is one of the most useful tools in the whole IRMAA system, and it's underused.

Reading and Berks County: where to get help

Reading is in Berks County, where Medicare beneficiaries have access to a full range of Original Medicare, Medicare Advantage, and standalone Part D options during the enrollment window that closes Dec. 7. IRMAA applies the same way no matter which route you choose — it's tied to your income, not your plan.

For free, unbiased help understanding your notice or comparing coverage, Pennsylvania's APPRISE program (the state's SHIP) offers one-on-one counseling at no cost. Berks County has local APPRISE volunteers who work through the Berks Encore senior services network.

A few other numbers worth knowing for 2027

While you're reviewing costs, keep these in mind:

• Part D out-of-pocket cap: $2,100 for 2026 and $2,400 for 2027. Once you hit it, you pay nothing for covered drugs the rest of the year.
• Part D deductible: up to $615 in 2026 ($700 in 2027), depending on the plan.
• Medicare Prescription Payment Plan: an optional way to spread your drug costs across monthly payments instead of paying big bills at the pharmacy counter.