Medicare Part D

Earn Over $109K? Medicare's 2026 IRMAA Rules Explained

DENTON, Texas — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-earning retirees in Denton County are getting a fresh look at how their income will shape what they pay for Part B and Part D in 2027. The income thresholds that trigger extra charges — known as IRMAA — are set each fall by CMS, and understanding where you land can prevent a surprise on next year's Social Security statement.

What IRMAA actually is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's not a separate bill — it's an extra charge added to your standard Part B premium and, if you have drug coverage, to your Part D costs. Most people with Medicare pay only the standard Part B amount. IRMAA kicks in only for the roughly 8% of enrollees whose income crosses the first threshold.

The surcharge is set by the Social Security Administration using data from the IRS. That means it's based on your modified adjusted gross income (MAGI) from two years earlier. For your 2027 premiums, Social Security is looking at what you reported on your 2025 tax return.

The 2027 income brackets

For 2026, the first IRMAA tier starts above $109,000 for individuals and above $218,000 for married couples filing jointly. From there, the surcharges climb in five steps as income rises, with the top tier reserved for individuals earning $500,000 or more (or $750,000 for joint filers).

Each step up in the income ladder adds a set dollar amount to both your Part B premium and your Part D premium. CMS publishes the 2027 tiers later in the fall, and the figures appear on Medicare.gov once released.

Why Part D counts too, even in an Advantage plan

Many people in Denton County get their prescription coverage bundled inside a Medicare Advantage plan. Even so, if you owe a Part D IRMAA, Medicare bills you directly for the surcharge — it doesn't get folded into your plan's premium. That can catch people off guard, so it's worth checking your Social Security notice each January.

This matters more than usual heading into 2026, because Part D itself is changing. The new out-of-pocket cap for covered drugs is $2,100 for the year, and the maximum Part D deductible is $615. There's also an optional Medicare Prescription Payment Plan that lets you spread your drug costs across monthly installments instead of paying big amounts at the pharmacy counter.

If your income has dropped

Retirement, a spouse's death, divorce, or the loss of a pension or a business can all shrink your income well below what your 2024 tax return shows. If that describes you, you don't have to accept an IRMAA bill based on outdated income.

File Social Security form SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event." You'll list the qualifying event and provide documentation, such as a letter from a former employer. Social Security can then set your premium based on your current, lower income.

Where Denton fits in

Denton is in Denton County, where retirees have a broad selection of Medicare Advantage and stand-alone Part D plans to choose from during Annual Enrollment. The IRMAA rules, however, are set at the federal level — they don't change based on where you live in Texas. What can vary locally is the plan and premium landscape, so when you're comparing options for 2027, focus on how each plan handles the drugs you actually take. The 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder.