Medicare Part D

East Providence Guide to Medicare Part B & D IRMAA 2027

By the numbers

East Providence retirees: here's how income changes your 2027 Medicare bill

EAST PROVIDENCE, R.I. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, higher-income retirees along the East Bay are getting a fresh look at something many people don't realize until the bill arrives: what you earned two years ago can raise what you pay for Medicare in 2027.

The extra charge is called IRMAA — the Income-Related Monthly Adjustment Amount. It applies to both Part B (doctor visits and outpatient care) and Part D (prescription drugs). CMS publishes the 2027 IRMAA income brackets and surcharge amounts later in the fall, usually in November, alongside the 2027 Part B figures.

Where the 2027 IRMAA thresholds will be set

For 2026, IRMAA kicks in when your modified adjusted gross income (MAGI) is above $109,000 for a single filer or $218,000 for a married couple filing jointly, based on your 2024 tax return.

If your income is at or below those numbers, you pay the standard Part B premium and no Part D surcharge. Above them, you move into one of several income brackets, and the surcharge grows at each step. The highest bracket applies to single filers with income above roughly $500,000 and joint filers above $750,000.

The key thing to remember: IRMAA is not a penalty. It's an income-based adjustment, and Medicare uses your most recent tax data on file — usually from two years back — to set it each January.

How the surcharge shows up

If you owe IRMAA, you'll get a letter from the Social Security Administration late in the year explaining the amount. The Part B surcharge is usually deducted from your Social Security check, along with your standard premium. The Part D surcharge is billed separately by Medicare — you pay it even if your drug plan premium itself is low.

That surprises a lot of people. Your Part D plan sends one bill; Medicare sends another for the income-related piece.

What if your income has dropped?

This is the part many East Providence readers miss. If you've had a "life-changing event" — retirement, the death of a spouse, divorce, loss of a pension, or reduced work hours — you can ask Social Security to recalculate IRMAA using your current income instead of your 2025 return.

You do this with Form SSA-44. Bring proof of the change (a retirement letter, for example). If approved, your surcharge is adjusted, sometimes down to zero.

Why 2027 matters more than usual

A few things are converging for next year:

• The Part D out-of-pocket cap on covered drugs is $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible is $615 for 2026 and $700 for 2027.
• The old "donut hole" coverage gap is gone — Part D now has three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter.

None of those changes erase IRMAA, but they do change the math on your total drug spending. If you're near an income threshold, even a modest Roth conversion or a large one-time capital gain in 2025 could push you over — and it's worth checking before January.

Where East Providence fits

East Providence is in Providence County, where beneficiaries have a broad set of Medicare Advantage and stand-alone Part D options during Annual Enrollment. The plan choices themselves don't change your IRMAA — that's set by Social Security based on income — but Annual Enrollment (Oct. 15–Dec. 7) is still the right window to review your Part D coverage, especially if your drug list has changed.

Medicare Advantage Open Enrollment then runs Jan. 1 through March 31 for anyone already in an Advantage plan who wants to switch or return to Original Medicare.