Medicare Part D
Why Higher Earners in Providence Pay More for Medicare Part B and D
PROVIDENCE, R.I. — As Medicare's Annual Enrollment Period runs through Dec. 7, many Rhode Islanders are opening letters from the Social Security Administration that mention two unfamiliar words: income-related monthly adjustment amount, better known as IRMAA. If your income is above a certain line, you'll pay more for Part B and Part D in 2027 — and the surprise can sting if you didn't see it coming.
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Click to call 855-729-3240Key takeaways
- Medicare's Annual Enrollment Period runs through Dec. 7, and higher-income beneficiaries may see extra IRMAA charges added to their 2027 Part B and Part D premiums.
- IRMAA is based on your modified adjusted gross income (MAGI) from your 2025 tax return, with five surcharge tiers and separate billing for Part B and Part D.
- If your income dropped since 2025 due to retirement, job loss, divorce, widowhood, or a pension ending, you can file Form SSA-44 to ask Social Security to use more recent income.
- Free, unbiased help with IRMAA notices and Medicare plan choices is available through your local SHIP counselor or by calling 1-800-MEDICARE.
Here's a plain-English guide to how the surcharge works, how the thresholds are set, and the common missteps to sidestep this fall.
What IRMAA actually is
IRMAA is an extra amount added to your standard Medicare Part B premium and, if you have drug coverage, your Part D premium. It isn't a penalty for signing up late — that's a different rule. IRMAA is simply Medicare asking higher-income beneficiaries to pay more each month.
Two important things to know upfront:
- Medicare looks back two years. Your 2027 surcharge is based on your 2025 tax return.
- It's a cliff, not a slope. Cross a threshold by even one dollar and you move up to the next bracket for the full year.
The 2027 income thresholds
For 2026, IRMAA kicks in when your modified adjusted gross income (MAGI) from your 2024 return is above:
- $109,000 if you filed single, or
- $218,000 if you filed a joint return.
Above those lines, there are five surcharge tiers that climb higher as income rises, with the top tier reserved for single filers with MAGI at or above roughly $500,000 (double that for joint filers). Both Part B and Part D have their own IRMAA add-on, and they're billed separately — Part B is deducted from Social Security (or billed directly), while the Part D surcharge is billed by Medicare even if your plan premium is paid to a private insurer.
For the exact 2027 dollar amounts at each tier once released, check Medicare.gov or the official notice from Social Security.
Why 2027 feels different
A few pieces of the 2027 Part D landscape are worth putting side by side with IRMAA, because they change how the math lands for higher earners:
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your covered drug costs hit that ceiling, you pay nothing more for covered drugs the rest of the year.
- The Part D deductible maxes out at $615 in 2026 and $700 in 2027.
- The coverage gap ("donut hole") is gone as of 2025 — Part D now has just three phases.
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big bills at the pharmacy counter.
None of that erases IRMAA, but it does mean drug costs are more predictable now — even if your premium is higher because of your income.
Mistakes to avoid this fall
1. Assuming the letter is wrong and ignoring it. If Social Security sends you an IRMAA determination, read it. You have a right to appeal, but only if you act.
2. Missing a life-changing event. If your income dropped since 2024 because you retired, lost a job, got divorced, were widowed, or had a pension end, you can file Form SSA-44 to ask Social Security to use a more recent year. This is one of the most overlooked fixes.
3. Forgetting that one-time income counts. A Roth conversion, a home sale, or a big capital gain in 2025 can push you over the line in 2027. If that's you, don't panic — it's usually a one-year problem, and the following year's bracket will reset.
4. Not comparing Part D plans during AEP. Even with IRMAA, your base Part D premium and drug formulary can change year to year. The window to switch is Oct. 15 – Dec. 7.
Where to get help in Providence
Providence is in Providence County, and Rhode Island's State Health Insurance Assistance Program (SHIP) — known locally as THE POINT — offers free, unbiased Medicare counseling. Counselors can walk you through an IRMAA notice, help you weigh whether to file SSA-44, and explain your options during AEP.
You can also call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, or visit Medicare.gov to review plans and current figures.
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
2027 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 2027 surcharge is based on your 2025 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
Q: I just got an IRMAA letter. Can I appeal?
Q: Does IRMAA go away on its own?
Q: Do I pay IRMAA if I have a Medicare Advantage plan instead of Original Medicare?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.