Medicare Part D

How Your Income Sets 2027 Medicare Costs in Wichita Falls, TX

WICHITA FALLS, Texas — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income retirees here are getting a fresh look at a rule that catches many by surprise: the income-related monthly adjustment amount, or IRMAA. For 2026, the surcharge kicks in once a single filer's income tops $109,000 — and it applies on top of the standard Part B and Part D premiums.

If your income has changed recently, or if you're new to Medicare, understanding how IRMAA works can help you plan ahead and avoid a bill that feels like it came out of nowhere.

What IRMAA actually is

IRMAA stands for "income-related monthly adjustment amount." It's an extra charge that higher-income beneficiaries pay on top of the standard Part B premium and, if you have drug coverage, on top of your Part D premium too.

Most people on Medicare do not pay IRMAA. It only applies once your income crosses a set line. For 2026, that line starts at more than $109,000 for a single filer and more than $218,000 for a married couple filing jointly. The higher your income above those amounts, the higher the surcharge, in tiers.

How Social Security decides

Social Security doesn't look at what you're earning right now. It looks at your modified adjusted gross income (MAGI) from your tax return two years ago. So your 2027 IRMAA is based on your 2025 taxes.

That two-year lookback catches a lot of people off guard — especially folks in Wichita Falls who sold a home, cashed out an investment, or took a large IRA withdrawal in 2024. Even a one-time bump in income can push you over the threshold for one year.

If that describes you, you'll get a letter from Social Security explaining the amount and how to appeal.

When you can ask for a lower amount

You can request a reduction if you've had a "life-changing event." Social Security recognizes several, including:

• Marriage, divorce, or the death of a spouse
• You or your spouse stopped working or reduced hours
• Loss of pension income
• Loss of income-producing property from a disaster or other event beyond your control

You file Form SSA-44 to make the request. If your income has dropped since your last tax return, this is often the fastest way to get relief.

What else is changing in Part D for 2027

Even if IRMAA doesn't apply to you, Part D itself is shifting. In 2027, the out-of-pocket cap for covered prescription drugs is $2,400. Once you hit that number in a calendar year, you pay nothing more for covered drugs for the rest of the year. The maximum deductible a Part D plan can charge in 2027 is $700.

The old "donut hole" coverage gap was eliminated in 2025, so Part D now has three phases instead of four. And the Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly installments if a big bill would be hard to handle all at once — you can opt in through your plan.

Local context for Wichita Falls

Wichita Falls is in Wichita County, where Medicare plan availability is set at the county level. IRMAA, though, is a federal rule — it does not change based on where you live in Texas. What can change locally is the mix of Part D and Medicare Advantage plans offered, and those choices matter during the Annual Enrollment Period (Oct. 15 – Dec. 7) and, for Medicare Advantage enrollees, the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31).

Where to get personalized help

IRMAA math can get tricky, especially if your income is close to a threshold or if you had a one-time event in 2024. A few free, trustworthy resources:

• Medicare.gov — official cost and IRMAA tables, updated each year.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7.
• Texas SHIP (State Health Insurance Assistance Program) — free one-on-one counseling from trained volunteers, with no sales pressure.
• Social Security (1-800-772-1213) — for questions about your specific IRMAA letter or to ask about Form SSA-44.