Medicare Part D

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

West Jordan, Utah — As open enrollment runs through Dec. 7, higher-income Medicare beneficiaries here are getting a closer look at something that often catches people off guard: an income-based surcharge added to their Part B and Part D premiums. For 2026, that surcharge — called IRMAA — kicks in above $109,000 in yearly income for a single filer, and it's based on the tax return you filed two years ago.

If you're planning your Medicare coverage this fall, understanding how IRMAA works can help you avoid an unwelcome surprise in January.

What IRMAA Actually Is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added on top of the standard Part B premium and, separately, on top of whatever Part D drug plan premium you pay. It is not a penalty. It's simply how Medicare asks higher-income beneficiaries to pay a larger share of their coverage.

Most people on Medicare do not pay IRMAA. According to the Centers for Medicare & Medicaid Services (CMS), the surcharge only applies once your income crosses set thresholds.

The 2026 Income Thresholds

For 2026, IRMAA begins at:

• More than $109,000 in modified adjusted gross income (MAGI) for a single filer
• More than $218,000 in MAGI for a married couple filing jointly

Above those amounts, the surcharge climbs in tiers. The higher your income, the higher the adjustment for both Part B and Part D. Married couples who file separately have their own, much tighter thresholds — worth knowing if that applies to you.

One important detail: Social Security uses your 2024 tax return to set your 2026 IRMAA. So the income that matters for next year has, in most cases, already been reported.

How You'll Be Notified

If IRMAA applies to you, the Social Security Administration will mail you a determination notice, usually in late fall. The notice will spell out:

• The income figure they used
• The tier you fall into
• The extra amount added to your Part B premium
• The extra amount added to your Part D premium (paid to Medicare, not your drug plan)

The Part B surcharge is typically taken directly from your Social Security check. The Part D surcharge is billed separately, even if your drug plan premium itself is paid another way.

Life Changes That May Let You Appeal

Because IRMAA is based on a two-year-old tax return, your current situation may look very different. CMS allows you to request a reconsideration if you've had a qualifying "life-changing event," including:

• Retirement or reduced work hours
• Loss of a spouse
• Divorce or annulment
• Loss of pension income
• An employer settlement payment

You'd file Form SSA-44 with Social Security, along with proof of the change. If approved, your IRMAA can be recalculated using more recent income.

Where Local Coverage Fits In

West Jordan is in Salt Lake County, where Medicare beneficiaries choose between Original Medicare (with or without a stand-alone Part D drug plan) and Medicare Advantage plans that bundle drug coverage in. IRMAA applies the same way regardless of which path you pick — it's tied to your income, not your plan choice.

It's also worth remembering two other 2026 program-level changes that affect drug costs for everyone with Part D:

• The annual out-of-pocket cap for Part D is $2,100 in 2026.
• The maximum Part D deductible is $615.
• The old coverage gap (the "donut hole") is gone; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments, at no extra charge.

Timing Matters This Fall

The Annual Enrollment Period runs October 15 through December 7, and Medicare Advantage Open Enrollment runs January 1 through March 31. IRMAA itself isn't something you enroll in or out of — but knowing whether it will apply to you can shape which coverage makes the most sense.