Medicare Part D

Cross $109,000? Here's How IRMAA Hits Your 2026 Medicare

FEDERAL WAY, Wash. — With Medicare's Annual Enrollment Period running through Dec. 7, higher earners in south King County are getting a clearer picture of what their 2026 Part B and Part D bills will look like. The reason: income-related surcharges, known as IRMAA, kick in above $109,000 for single filers in 2026 — and they apply on top of standard premiums.

If your income has changed recently, or if you're new to Medicare this year, understanding these thresholds can help you avoid a surprise letter from Social Security.

What IRMAA actually is

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

Most people on Medicare pay the standard Part B premium. But if your income crosses a threshold, Social Security adds a surcharge on top. The same idea applies to Part D drug coverage: the surcharge is added to whatever your plan already charges.

How Medicare decides what you owe

Medicare looks at your modified adjusted gross income (MAGI) from two years earlier. For 2026 IRMAA, that means your 2024 tax return.

For 2026, the first surcharge tier begins above $109,000 for a single filer. Married couples filing jointly hit the first tier at roughly double that amount. Above the first threshold, there are additional tiers — the higher your income, the higher the surcharge.

Social Security mails a letter each fall telling you if IRMAA will apply for the coming year and how much you'll pay. If you get one, don't toss it — that letter is also your notice of appeal rights.

Why the two-year lookback matters

The two-year lag catches a lot of people off guard, especially near retirement. If you sold a home, took a large IRA withdrawal, converted to a Roth, or had a strong year of self-employment income in 2024, that income can push you into IRMAA territory for 2026 — even if you're now living on a modest fixed income.

The good news: Social Security allows appeals when a life-changing event has cut your income. Qualifying events include:

• Retirement or reduced work hours
• Marriage, divorce, or annulment
• Death of a spouse
• Loss of a pension
• Loss of income-producing property (not from a sale)

You file the appeal using Form SSA-44, along with documentation of the event and your expected new income.

Part D and IRMAA together

Part D IRMAA is easy to overlook because it's separate from your plan's premium. If you owe it, Medicare typically deducts it from your Social Security check — not from your drug plan bill. So even if your Part D plan premium looks the same as last year, your total drug-coverage cost can go up if your income changed.

This matters more in 2026 because Part D has a new $2,100 annual out-of-pocket cap on covered drugs, a maximum deductible of $615, and the old coverage gap is gone. Those changes help control drug spending — but IRMAA still stacks on top for higher earners.

What Federal Way readers can do now

Federal Way is in King County, where beneficiaries have a range of Part D and Medicare Advantage options during Annual Enrollment (Oct. 15 – Dec. 7). A few practical steps:

• Check your 2024 tax return and estimate whether you're near a threshold.
• Open any Social Security mail promptly this fall — the IRMAA notice has a short appeal window.
• Plan large withdrawals carefully. A single Roth conversion or capital gain can bump you into a higher tier for a full year.
• Talk to a tax professional before year-end if you're close to a bracket.

For personalized help, Washington's SHIBA program (the state's SHIP) offers free Medicare counseling, and no one there is trying to sell you a plan.