Medicare Part D
2026 Medicare IRMAA: Who Pays More Above $109,000
PAWTUCKET, R.I. — If your income has climbed in recent years, your 2026 Medicare bill may look different than your neighbor's. Higher earners pay an extra amount on top of their standard Part B and Part D premiums, called the Income-Related Monthly Adjustment Amount, or IRMAA. For 2026, that surcharge kicks in once modified adjusted gross income tops $109,000 for a single filer or $218,000 for a married couple filing jointly, according to the Centers for Medicare & Medicaid Services.
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Key takeaways
- In 2026, Medicare charges higher earners an extra amount called IRMAA once income passes $109,000 for single filers or $218,000 for married couples filing jointly.
- IRMAA is not something you sign up for separately; Social Security automatically adds it to your Part B premium and, if you have drug coverage, your Part D premium too.
- If a life-changing event, like a one-time income spike from selling a home or a large IRA withdrawal, affected your finances, you can file form SSA-44 to ask Social Security to use more recent income instead.
- IRMAA applies whether you stay in Original Medicare or choose a Medicare Advantage plan, since it's tied to your income, not your plan type.
Here's what Pawtucket readers should know before the Annual Enrollment Period wraps up on December 7.
What IRMAA actually is
IRMAA isn't a separate bill you sign up for. It's an automatic surcharge Social Security adds to your monthly Medicare Part B premium and, if you have Part D drug coverage, to your Part D premium too. It applies only to beneficiaries whose income sits above the thresholds set each year by Medicare.
Two important points:
- It's based on your tax return from two years ago. Your 2026 IRMAA looks at your 2024 IRS return.
- It's a cliff, not a slope. Cross a threshold by even one dollar and you move into the next bracket for the full year.
The 2026 income brackets, in plain numbers
IRMAA uses five tiers above the base. For single filers in 2026, the surcharges begin above these income levels:
- Above $109,000 up to $137,000
- Above $137,000 up to $171,000
- Above $171,000 up to $205,000
- Above $205,000 and below $500,000
- $500,000 or more (the top tier)
For married couples filing jointly, double those figures until the top bracket, which starts at $750,000. Married filing separately has its own, tighter schedule that starts at the same $109,000 mark.
Each tier adds a set dollar amount to both Part B and Part D. The higher the bracket, the larger the add-on. Exact 2026 surcharge amounts are published at Medicare.gov.
Why Pawtucket residents should double-check
Pawtucket is in Providence County, where a mix of Medicare Advantage and stand-alone Part D drug plans are available for 2026. Whether you stay in Original Medicare or choose an Advantage plan, IRMAA still applies to your Part B premium — and to Part D if you enroll in drug coverage, even if that coverage is bundled into an Advantage plan.
A one-time income spike — selling a home, taking a large IRA withdrawal, cashing in stock — can push you into IRMAA territory two years later. Retirees in Rhode Island who downsized in 2024 are a common example.
Life-change events that let you appeal
You don't have to accept an IRMAA bill if your circumstances have changed. Social Security allows an appeal (form SSA-44) after certain "life-changing events," including:
- 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 due to a disaster
If one of these applies, you can ask Social Security to use a more recent year's income instead of the 2024 return.
What's new for Part D in 2026
Even if you don't hit IRMAA, Part D itself is changing in ways worth noting:
- The annual out-of-pocket cap is $2,100 for covered drugs.
- The maximum Part D deductible is $615.
- The old coverage gap ("donut hole") is gone — Part D now has three phases.
- The Medicare Prescription Payment Plan lets you spread drug costs over the calendar year in monthly installments instead of paying at the pharmacy counter.
These apply to everyone with Part D, regardless of income.
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 Providence County
(MA penetration in Providence 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
2026 IRMAA income brackets
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. Your 2026 surcharge is based on your 2024 tax return.
| 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
Q: I just got a letter saying I owe IRMAA. Is this a scam?
Q: My income dropped in 2025. Do I still pay the 2026 surcharge?
Q: Does IRMAA go away on its own?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.