Medicare Supplement

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

SILVER SPRING, Md. — As Medicare's Annual Enrollment Period runs through Dec. 7, many people here are opening letters from Social Security that mention a term they've never had to think about before: IRMAA. It stands for the Income-Related Monthly Adjustment Amount, and for 2026 it kicks in at a lower income level than some retirees expect.

If your income crosses a certain line, you'll pay more for Medicare Part B (doctor visits and outpatient care) and Part D (prescription drugs). Here's what Silver Spring readers should know before the enrollment window closes.

What IRMAA is, in plain English

Most people on Medicare pay the standard Part B premium and whatever their Part D plan charges. But if your income is above a set threshold, Medicare adds a surcharge on top of both. That extra amount is IRMAA.

A few key points:

• IRMAA is set by Social Security, not by your insurance plan.
• It's based on your modified adjusted gross income (MAGI) from two years earlier. For 2026, that means your 2024 tax return.
• It applies to both Part B and Part D — even if you get Part D through a Medicare Advantage plan.
• You'll get a letter each fall if you're affected.

The 2026 income thresholds

For 2026, IRMAA surcharges begin when a single filer's 2024 MAGI is above $109,000. For married couples filing jointly, the starting point is roughly double that. The surcharges climb in tiers — the higher your income, the larger the add-on to your Part B and Part D premiums.

If you're right at the edge of a bracket, even a small change in income (a Roth conversion, a big capital gain, a bonus) can push you into a higher tier. It's worth checking with a tax professional before year-end.

For the exact tier amounts, the official chart lives at medicare.gov/basics/costs.

Life changes can lower your surcharge

IRMAA looks backward at your tax return, but life doesn't always cooperate. If your income has dropped since 2024 because of a "life-changing event," you can ask Social Security to use more recent numbers instead.

Qualifying events include:

• Retirement or reduced work hours
• Marriage, divorce, or the death of a spouse
• Loss of a pension
• Loss of income-producing property (not from your own decisions like selling)

You file Form SSA-44 with proof of the change. This is one of the most overlooked steps in Medicare — many people quietly pay a surcharge they could have appealed.

What's new for Part D in 2026

Even if IRMAA doesn't apply to you, Part D itself is changing in ways worth knowing:

• The annual out-of-pocket cap for covered drugs is $2,100 in 2026. Once you hit it, you pay $0 for covered prescriptions the rest of the year.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap is gone. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter. It's optional and free to join.

These changes apply nationally — they aren't specific to Silver Spring or Maryland.

What Silver Spring residents can do this fall

Silver Spring is in Montgomery County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are offered. County-level availability is set by CMS, and you can compare what's offered by ZIP code using the Plan Finder at medicare.gov.

A few practical steps before Dec. 7:

1. Look at your 2024 tax return. If your MAGI was above $109,000 (single) or the joint equivalent, expect an IRMAA letter. 2. Read your plan's Annual Notice of Change (ANOC). Premiums, formularies, and pharmacy networks can shift year to year. 3. If you had a big income drop, gather documents for Form SSA-44. 4. Call SHIP. Maryland's State Health Insurance Assistance Program offers free, unbiased counseling. In Montgomery County, SHIP is run through the county's Aging & Disability Services.