Medicare Part D

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

Rock Springs, Wyo. — As the Medicare Annual Enrollment Period runs through Dec. 7, higher-income retirees in Sweetwater County are getting a fresh look at how their tax returns from two years ago shape what they'll pay for Part B and Part D in 2026. The rule at the center of it all is called IRMAA — the Income-Related Monthly Adjustment Amount — and for 2026 it kicks in once a single filer's modified adjusted gross income climbs above $109,000.

If that sounds like a small detail, it isn't. IRMAA can add a meaningful monthly surcharge on top of your standard Part B premium and your Part D plan premium, and Social Security typically pulls it straight out of your benefit check. Here's what Rock Springs readers should know before the enrollment window closes.

What IRMAA actually is

IRMAA stands for Income-Related Monthly Adjustment Amount. It is not a separate program or a penalty for doing something wrong — it's simply an extra amount added to your Part B and Part D premiums when your income is above a certain threshold.

Everyone on Medicare pays the same standard Part B premium at the base level. But if the Social Security Administration sees that your income is higher than the first IRMAA bracket, you'll pay that base amount plus a surcharge. The same idea applies to Part D: your plan sets its own premium, and then Medicare adds an IRMAA amount on top, collected separately.

The 2026 income thresholds

For 2026, IRMAA begins above:

• $109,000 for individuals filing a single return
• $218,000 for married couples filing jointly

Above those first thresholds, there are additional brackets that step upward. The higher your income, the higher the surcharge — up to a top tier for the highest earners. The exact dollar amount added at each tier is published by CMS on medicare.gov, and it's updated each fall.

One important quirk: Medicare uses your modified adjusted gross income from two years ago. So your 2026 IRMAA is based on your 2024 tax return. That two-year look-back catches a lot of new retirees by surprise, especially those whose final working year pushed their income unusually high.

How the surcharge gets collected

If you receive Social Security benefits, the Part B surcharge — and the base premium — come directly out of your monthly check. The Part D surcharge is billed separately by Medicare, even if your drug plan premium itself is paid to your plan. You cannot ask your Part D plan to bundle the IRMAA amount; it's a federal charge.

If you're not yet drawing Social Security, you'll get a bill from Medicare directly.

What to do if your income has dropped

This is the part many Rock Springs retirees miss. If you had a "life-changing event" that lowered your income after the tax year Medicare is using, you can ask for a reconsideration. Qualifying events include:

• Retirement or reduced work hours
• Loss of a pension
• Death of a spouse
• Marriage or divorce
• Loss of income-producing property

To request a review, file Form SSA-44 with the Social Security Administration, along with documentation of the change. If approved, Social Security will recalculate your surcharge using your more recent — and lower — income.

Other 2026 numbers worth knowing

While you're thinking about income and Medicare costs, a few other 2026 program figures are worth having in mind:

• The Part D out-of-pocket cap is $2,100 for the year. Once your prescription spending reaches that amount, you pay $0 for covered drugs the rest of the calendar year.
• The Part D maximum deductible is $615, though plans can set lower deductibles.
• The old coverage gap or "donut hole" is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs into monthly installments across the year instead of paying large sums at the pharmacy counter.

None of these change your IRMAA, but they affect the total picture of what you'll pay.

A note for Rock Springs readers

Rock Springs is in Sweetwater County, where Medicare beneficiaries have access to a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage. IRMAA applies the same way no matter which route you take — if your income is above the threshold, the Part D surcharge follows you whether you're in a stand-alone plan or an Advantage plan that includes drug coverage.

The Annual Enrollment Period ends Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 through March 31 if you're already in an Advantage plan and want to switch.