Medicare Part D

How Your 2024 Income Shapes 2026 Medicare Part B & D Costs

North Augusta, S.C. — As Medicare's Annual Enrollment Period runs through Dec. 7, higher earners in the Central Savannah River Area are getting a fresh reminder that income — not just plan choice — plays a real role in what you pay. For 2026, the income threshold that triggers extra Medicare premiums starts at $109,000 for a single filer, and Social Security uses your 2024 tax return to decide.

Here's what that means for households in and around North Augusta, and how to think it through before the deadline.

What IRMAA is, in plain English

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

A few important things to know:

• IRMAA is set by the Social Security Administration, not by your insurance company.
• It applies to Original Medicare Part B and to Part D drug coverage — including the drug portion of a Medicare Advantage plan.
• Social Security looks at your modified adjusted gross income (MAGI) from two years ago. For 2026 premiums, that means your 2024 federal tax return.

If your income is at or below the threshold, you simply pay the standard Part B premium and whatever your Part D plan charges — no surcharge.

The 2026 income thresholds

For 2026, IRMAA surcharges begin when income (MAGI) is above:

• $109,000 for a single filer
• $218,000 for a married couple filing jointly

Above those points, surcharges rise in tiers. The higher your income, the higher the added amount on both Part B and Part D. Married couples who file separately have their own, much tighter thresholds, so if that's your situation, check the current tables at Medicare.gov before assuming anything.

Exact tier amounts are published each year by CMS on Medicare.gov's "Costs" page — that's the source to trust for the current dollar figures.

Why this matters right now

Two things make this the right season to pay attention:

1. AEP runs Oct. 15 – Dec. 7. This is when you can change your Part D or Medicare Advantage coverage for 2026. Your monthly plan premium is only part of the story — if you'll owe IRMAA, that's an additional cost layered on top. 2. Part D is changing for the better in 2026. The out-of-pocket cap for covered drugs is $2,100, the maximum Part D deductible is $615, and the old "donut hole" is gone (replaced by three simpler phases as of 2025). There's also the Medicare Prescription Payment Plan, which lets you spread your drug costs across the year in monthly installments instead of paying at the pharmacy counter.

Put together: your drug costs may look different in 2026, but if your 2024 income pushed you over an IRMAA line, you'll want to plan for the surcharge as part of your total budget.

If your income has dropped, you can ask for a review

This is the piece a lot of people miss. Because IRMAA is based on a tax return from two years back, it can feel unfair if your life has changed since then.

Social Security allows you to request a new decision after certain life-changing events, including:

• Retirement or reduced work hours
• Marriage, divorce, or the death of a spouse
• Loss of pension income
• Loss of income-producing property (not due to sale)

You file Form SSA-44 with documentation. If approved, your surcharge is recalculated using your more recent income. If you got an IRMAA notice and one of these events applies to you, don't just accept the bill — appeal it.

How to decide what to do this fall

North Augusta is in Aiken County, where residents have a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage to choose from during AEP. A practical approach:

• Estimate whether IRMAA applies to you using your 2024 MAGI. If you're comfortably below $109,000 single / $218,000 joint, IRMAA isn't your concern this year.
• If you're close to a threshold, remember that going even $1 over bumps you into the next tier. Talk with a tax professional about legal ways to manage MAGI — timing Roth conversions, charitable distributions from IRAs (QCDs), or capital gains.
• Review your drug list against the plans available in Aiken County using the Plan Finder at Medicare.gov. The 2026 $2,100 cap changes the math for people on expensive medications.
• Ask about the Prescription Payment Plan if a large pharmacy bill early in the year would be hard to handle.