Medicare Supplement

2026 IRMAA Brackets: What LA Seniors Should Know

LOS ANGELES — As Medicare's Annual Enrollment Period runs through Dec. 7, higher-income beneficiaries in Los Angeles are getting a fresh look at what they'll pay next year — and for many, the biggest surprise isn't the premium itself. It's the income-related surcharge known as IRMAA.

For 2026, IRMAA surcharges kick in above $109,000 in income for a single filer (and above $218,000 for a couple filing jointly), according to CMS. If your income is under those thresholds, you can stop reading and enjoy your afternoon. If it's over — even by a dollar — here's what to know before you make a costly mistake.

What IRMAA actually is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added to your Part B (doctor visits, outpatient care) and Part D (prescription drugs) premiums when your income is above a set line.

A few things trip people up:

• IRMAA is not a tax and it's not part of your plan premium. It's a Medicare surcharge billed by the Social Security Administration, usually deducted from your Social Security check.
• It applies whether you have Original Medicare or a Medicare Advantage plan.
• It applies to Part D even if your drug coverage is bundled into a Medicare Advantage plan.

The lookback: why 2024 income determines your 2026 bill

This is the part that catches Angelenos off guard. Social Security sets your 2026 IRMAA using your 2024 tax return — a two-year lookback. So a big one-time event in 2024 (selling a home in Silver Lake, converting a traditional IRA to a Roth, taking a large capital gain) can raise what you pay in 2026, even if your income has since dropped.

The income figure Medicare uses is your MAGI — modified adjusted gross income — which for most people is your AGI plus any tax-exempt interest.

The 2026 income brackets (single filer starting point)

IRMAA is tiered. Above the $109,000 single / $218,000 joint entry point, there are additional, higher tiers as income rises — five tiers in total, with the top tier reserved for the highest earners. Each tier adds a set dollar amount to both your Part B and your Part D premium.

Because the exact tier amounts for 2026 are published by CMS on medicare.gov, it's worth checking there directly rather than relying on last year's figures. Small income differences can push you into the next tier and change your monthly cost meaningfully.

If your income has dropped: you can appeal

This is the single most missed step. If you had a life-changing event since 2024, you can ask Social Security to recalculate your IRMAA using more recent income. Qualifying events include:

• Marriage, divorce, or death of a spouse
• Work stoppage or work reduction (retirement counts)
• Loss of pension income
• Loss of income-producing property (not from your own decisions, e.g., a disaster)

You file Form SSA-44 with documentation. If you retired in 2025 and your 2026 IRMAA is based on your still-working 2024 income, this form is how you fix it. Many Los Angeles retirees don't know it exists.

What else changes in 2026 (context that matters)

Even if IRMAA doesn't apply to you, two Part D changes affect nearly every Medicare beneficiary:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your drug spending hits that, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible is $615.
• The old coverage gap ("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 evenly across the calendar year instead of paying big bills up front. It's optional and free to opt into.

Local context for Los Angeles

Los Angeles is in Los Angeles County, where Medicare beneficiaries typically have a wide range of stand-alone Part D plans and Medicare Advantage plans to compare during AEP. Plan availability, provider networks, and drug formularies are all set at the county level — not the city level — so two neighbors in different counties (say, LA County vs. Orange County) may see different options even if they live 15 minutes apart.

For personalized comparisons, the Plan Finder tool at medicare.gov lets you enter your ZIP code and your prescriptions to see what's available where you live.