Medicare Part D

How Your Income Affects 2026 Medicare Part B and D Costs

Goose Creek, S.C. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees in the Lowcountry are getting a fresh look at what they'll pay next year. For most people, Medicare Part B and Part D premiums stay predictable. But if your income crossed certain lines two years ago, the Social Security Administration may add a monthly surcharge in 2026 — and the rules changed at the edges this year.

Here's a plain-English guide to how income affects your Part B and Part D costs in 2026, and where Goose Creek residents can get one-on-one help.

What IRMAA is, in plain terms

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added to your standard Part B premium and, separately, to your Part D premium if your income is above a set threshold.

A few key points that trip people up:

• IRMAA is not a penalty. It's a sliding surcharge based on income.
• It's billed monthly. Part B IRMAA is usually pulled from your Social Security check. Part D IRMAA is billed by Medicare, not by your drug plan — even though the base premium goes to the plan.
• It's recalculated every year using the most recent tax return Medicare has on file.

The income Medicare looks at (and the two-year lookback)

For 2026, Medicare uses your 2024 tax return — specifically your Modified Adjusted Gross Income (MAGI). That's your adjusted gross income plus any tax-exempt interest.

Because of the two-year lookback, a one-time bump in 2024 — selling a house, cashing out an IRA, taking a lump-sum payment — can push you into an IRMAA bracket in 2026, even if your income is lower now.

The 2026 income thresholds

According to the Centers for Medicare & Medicaid Services, IRMAA surcharges in 2026 begin when your 2024 MAGI is:

• Above $109,000 if you filed as an individual
• Above $218,000 if you filed jointly

Below those numbers, you pay the standard Part B premium and just your plan's Part D premium — no surcharge.

Above them, the surcharges rise in tiers. The highest tier applies to individuals with MAGI at or above $500,000 (or $750,000 for joint filers). Both Part B and Part D have their own surcharge amounts at each tier, and they're added on top of what you'd otherwise pay.

For the current dollar figures at each tier, the most reliable source is medicare.gov's "Costs" page, which is updated by CMS.

If your income has dropped, you can appeal

This is the part many people miss. If a "life-changing event" reduced your income since 2024, you can ask Social Security to recalculate your IRMAA using more recent numbers. Qualifying events include:

• Retirement or reduced work hours
• Loss of a pension
• Death of a spouse
• Marriage or divorce
• Loss of income-producing property (not from a normal market drop)

You'll file Form SSA-44 with proof of the event. If approved, the surcharge is adjusted — sometimes eliminated — going forward.

What else is changing in 2026 for Part D

Even if you're not affected by IRMAA, Part D has meaningful updates worth knowing:

• The out-of-pocket cap for prescriptions is $2,100 in 2026. Once you hit that, you pay nothing more for covered drugs the rest of the year.
• The maximum Part D deductible is $615.
• The old coverage gap (the "donut hole") is gone as of 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly payments at no added cost. You have to opt in through your drug plan.

A local snapshot for Goose Creek

Goose Creek is in Berkeley County, where Medicare plan availability is set at the county level. That means Goose Creek residents choose from the same slate of Medicare Advantage and stand-alone Part D plans as the rest of Berkeley County. Whether IRMAA applies to you, though, depends only on your income — not where you live.

For personalized help, South Carolina's SHIP program (called SC SHIIP) offers free, unbiased Medicare counseling. You can reach them at 1-800-868-9095. Counselors can walk through your specific situation, including whether an IRMAA appeal makes sense.