Medicare Part D

2026 Medicare IRMAA: Who Pays More, Starting at $109,000

Essex Junction, Vt. — As Medicare's fall enrollment window runs through Dec. 7, higher earners in Chittenden County are getting a fresh look at something that catches many retirees off guard: the income-related monthly adjustment amount, better known as IRMAA. For 2026, the surcharge kicks in once a single filer's income tops $109,000, or $218,000 for a couple filing jointly.

Here's a plain-language guide to how the surcharge works, whose income counts, and what to do if your paycheck days are behind you.

What IRMAA actually is

IRMAA is not a separate bill or a penalty. It's an extra amount added to your standard Part B premium and, if you have drug coverage, to your Part D premium. Social Security handles the math and deducts the surcharge automatically, usually from your monthly benefit.

The idea is simple: most people pay the standard Part B premium, and Medicare picks up the rest. If your income is above the threshold, you cover a larger share of that cost yourself.

The 2026 income thresholds

For 2026, IRMAA surcharges begin above:

• $109,000 for individuals (single, head of household, or qualifying surviving spouse)
• $218,000 for married couples filing jointly

From there, the surcharge climbs through several income tiers, with the highest amounts reserved for individuals with income above roughly $500,000 (or $750,000 for joint filers). Married people who file separately hit the top surcharge much sooner — typically above about $394,000.

Both Part B and Part D surcharges use the same income brackets, but they're calculated separately and added to each premium.

Which year's income counts

This is the part that trips people up. IRMAA for 2026 is based on your 2024 tax return — the most recent one the IRS has on file when Social Security does the calculation. Medicare uses your modified adjusted gross income (MAGI), which is your AGI plus any tax-exempt interest.

That two-year lookback means a one-time event in 2024 — selling a house, cashing out a large retirement account, or receiving a lump-sum payout — can push you into IRMAA territory in 2026, even if your income is much lower now.

When you can appeal

The good news: if your income has dropped because of a specific life event, you can ask Social Security to use more recent numbers. Qualifying "life-changing events" include:

• Marriage, divorce, or the death of a spouse
• Stopping work or reducing hours (retirement counts)
• Loss of income-producing property through no fault of your own
• Loss or reduction of a pension
• A settlement from a former employer

You file Form SSA-44 with documentation. If Social Security agrees, they'll recalculate — sometimes eliminating the surcharge entirely for the year.

How this fits with other 2026 changes

The IRMAA thresholds are moving in a year when Part D drug coverage is also shifting. For 2026:

• The out-of-pocket cap on covered Part D drugs is $2,100.
• The maximum Part D deductible is $615.
• The old "donut hole" is gone; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs over monthly installments instead of paying at the pharmacy counter.

If you have Part D and IRMAA applies, remember the drug surcharge is billed on top of whatever premium your plan charges — even if that premium is otherwise low.

What Essex Junction readers should do this fall

Essex Junction is in Chittenden County, where a full range of stand-alone Part D and Medicare Advantage options is available during the Oct. 15 – Dec. 7 Annual Enrollment Period. IRMAA doesn't change which plans you can pick, but it can meaningfully change your total monthly cost — so it's worth knowing where you stand before you enroll.

A few practical steps:

1. Pull your 2024 tax return and find your MAGI. That's the number Medicare will use. 2. Watch the mail in late fall. Social Security sends a determination letter if IRMAA will apply to you next year. 3. If a life event has changed your finances, ask about Form SSA-44 sooner rather than later. 4. Talk to Vermont's SHIP (the State Health Insurance Assistance Program) for free, unbiased help. In Vermont, that's the Area Agencies on Aging's Senior HelpLine at 1-800-642-5119.