Medicare Part D

How Your 2024 Income Shapes 2026 Medicare Part B and D

Warwick, R.I. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees in Rhode Island are getting a closer look at a part of the program that often surprises people: the income-related surcharges that can raise what you pay for Part B and Part D in 2026.

These surcharges — known as IRMAA, short for Income-Related Monthly Adjustment Amount — aren't new. But because they're tied to your tax return from two years earlier, the 2026 amounts are based on the income you reported for 2024. If your income crossed a threshold that year, your Medicare bill next year may look different than a neighbor's, even if you're on the same coverage.

Here's a plain-language guide to how it works.

What IRMAA actually is

Most people on Medicare pay the standard Part B premium and whatever their Part D drug plan charges. But if your income is above a certain level, Social Security adds an extra monthly amount on top of both. That extra amount is IRMAA.

A few things to know upfront:

• IRMAA applies to Part B (doctor visits, outpatient care) and Part D (prescription drugs).
• It's billed monthly, usually taken out of your Social Security check.
• It's based on your Modified Adjusted Gross Income (MAGI) from two years ago — so 2026 surcharges look at your 2024 tax return.

The 2026 income thresholds

For 2026, IRMAA begins for single filers with MAGI above $109,000, and for married couples filing jointly with MAGI above $218,000. Below those amounts, you pay the standard premiums with no surcharge.

Above those levels, there are several tiers. The higher your income, the higher the surcharge — and it applies to both Part B and Part D at the same time. Medicare.gov publishes the full tier chart, and Social Security mails a determination letter each fall to anyone affected.

Why 2024 income matters now

This is the part that trips people up. If you retired in 2025, sold a house in 2024, converted a traditional IRA to a Roth, or took a large one-time distribution, that income shows up on the return Medicare uses for 2026.

The good news: IRMAA is not permanent. Each year it's recalculated using a fresh tax return. So a one-time income spike in 2024 typically stops affecting your Medicare premium after a year or two.

You can appeal after a life change

If your income has dropped because of a specific life event, you can ask Social Security to use more recent numbers instead of your 2024 return. Qualifying events include:

• Marriage, divorce, or the death of a spouse
• Stopping work or reducing hours
• Loss of pension income
• Loss of income-producing property due to a disaster or other event beyond your control

The form is SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." You can file it with documentation at your local Social Security office. Many Warwick-area retirees who recently stopped working qualify but don't know to ask.

How this fits with other 2026 changes

IRMAA is one piece of a bigger 2026 picture for Part D in particular. Next year, the out-of-pocket drug cap moves to $2,100, the maximum Part D deductible is $615, and the coverage gap ("donut hole") remains eliminated, with three coverage phases instead of four. The optional Medicare Prescription Payment Plan also continues, letting you spread drug costs across the calendar year in monthly installments rather than paying big amounts at the pharmacy counter.

None of those changes erase IRMAA — but they do change the math on total drug spending, especially for people managing several prescriptions.

Local context for Warwick

Warwick is in Kent County, where Medicare Advantage and stand-alone Part D plan availability is set at the county level. If you're comparing coverage during Annual Enrollment (through Dec. 7) or the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31), remember that IRMAA is separate from any plan premium. It's added on top, based solely on your income — the same amount no matter which Part D plan you pick.