Medicare Part D

Higher-Income Medicare Beneficiaries in North Charleston Face IRMAA

NORTH CHARLESTON, S.C. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, many Lowcountry retirees are getting a first look at what they'll pay for Part B and Part D in 2027. For most people, the standard Part B premium is the whole story. But for a smaller group of higher-income beneficiaries, an extra charge called IRMAA — the Income-Related Monthly Adjustment Amount — can quietly raise both their Part B and Part D bills.

North Charleston retirees: your tax return may nudge your 2027 Medicare premiums

Here's a plain-English look at how income thresholds work, why the IRS return you filed for 2025 matters now, and where to go for answers.

What IRMAA is (and who pays it)

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's not a penalty. It's an extra amount added to your Part B premium and your Part D premium if your income is above certain limits.

Social Security decides whether you owe IRMAA using your modified adjusted gross income (MAGI) from your tax return two years earlier. So for 2027 premiums, the government looks at your 2025 tax return.

According to Medicare.gov, most people do not pay IRMAA — only about 8% of beneficiaries do. If your income sits below the threshold, you just pay the standard Part B premium and whatever your Part D plan charges.

The IRMAA income thresholds

For 2026, IRMAA surcharges begin above $109,000 for a single filer and above $218,000 for a married couple filing jointly. From there, the surcharges rise in tiers — the higher your income, the higher the add-on.

The surcharge applies to both parts:

• An extra amount added to your Part B premium, and
• An extra amount added to your Part D premium (paid on top of what your drug plan charges).

The Part D surcharge is billed by Medicare, not by your drug plan, even though it relates to prescription coverage.

Why 2027 matters for Charleston-area retirees

A few things make this year worth a closer look:

• A new Part D out-of-pocket cap. In 2026, what you pay out of pocket for covered prescriptions is capped at $2,100. The old "donut hole" was eliminated in 2025, so Part D now has three simpler phases.
• A Part D deductible ceiling of $615 for 2026, rising to $700 for 2027. Plans can charge less, but not more.
• The Medicare Prescription Payment Plan. This optional program lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.

North Charleston is in Charleston County, where beneficiaries choose between Original Medicare (with or without a separate Part D plan) and Medicare Advantage. IRMAA works the same either way — it's tied to your income, not your plan choice.

Got an IRMAA letter? You can appeal

If Social Security sends you a notice saying you owe IRMAA, read it carefully. You can ask for a new decision — called a "reconsideration" — if you've had a life-changing event that dropped your income. Examples include:

• Retirement or reduced work hours
• Loss of a spouse
• Divorce
• Loss of income-producing property
• Loss or reduction of a pension

You file Form SSA-44 with Social Security and include documentation. Many Lowcountry retirees who stopped working in 2024 or 2025 qualify to have their surcharge reduced or removed, because their current income is much lower than what shows on that older tax return.

Planning ahead: income moves have a two-year echo

Because IRMAA looks back two years, a one-time bump in income — selling a home, cashing in an investment, taking a large IRA withdrawal — can raise your Medicare premiums for a single year, then fall back off. Talking with a tax professional before making a big financial move can help you see the Medicare ripple effect ahead of time.