Medicare Supplement
2026 IRMAA Brackets: What Higher-Income Filers Pay
Gresham, Ore. — As Medicare's Annual Enrollment Period runs through Dec. 7, some higher-income retirees here are getting a fresh look at a line item that surprises a lot of people: the income-related monthly adjustment amount, or IRMAA. It's the surcharge tacked onto Part B and Part D premiums when your income crosses certain thresholds. For 2026, the entry point for a single filer is $109,000. Here's what that means, and why it matters right now.
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Key takeaways
- IRMAA is a surcharge added to Part B and Part D premiums for people whose income is above certain limits.
- For 2026, the surcharge starts above $109,000 in income for a single filer and above $218,000 for a married couple filing jointly, based on 2024 income.
- IRMAA is calculated using a two-year-old tax return, but you can file Form SSA-44 to ask Social Security to use more recent income if you had a life-changing event like retirement or losing a spouse.
- Switching Medicare drug or Advantage plans during Open Enrollment does not remove the IRMAA surcharge, since it's separate from your plan's premium and drug coverage.
What IRMAA is, in plain English
IRMAA stands for Income-Related Monthly Adjustment Amount. If your income is above a set threshold, you pay your regular Part B premium plus a surcharge. The same idea applies to Part D — you pay your plan's drug premium plus an IRMAA surcharge sent to Medicare.
Two important points people often miss:
- IRMAA is billed by Medicare, not your plan. Your Part D plan doesn't set it and can't waive it.
- Medicare uses your tax return from two years ago to decide. So your 2026 IRMAA is based on your 2024 IRS return.
The 2026 income thresholds
For 2026, IRMAA begins above $109,000 for a single filer (and above $218,000 for a married couple filing jointly), based on your 2024 modified adjusted gross income. Income above those first thresholds moves you into higher tiers, each with a larger surcharge on both Part B and Part D.
Married couples filing separately have their own, much tighter rules — the surcharge can kick in at a far lower income level. If that's your situation, it's worth a call to Social Security or your local SHIP before assuming.
For the exact dollar amounts at each tier, check the official IRMAA table at Medicare.gov — it's updated each fall.
Why this hits in Gresham right now
Gresham is in Multnomah County, where Medicare beneficiaries choose among a full slate of stand-alone Part D drug plans and Medicare Advantage plans during Open Enrollment. Premiums, formularies, and pharmacy networks are all changing for 2026 — and if IRMAA applies to you, the surcharge sits on top of whatever Part D premium your plan charges.
That's the piece worth planning around: switching plans doesn't get rid of IRMAA. But understanding it helps you compare drug plans on the parts you actually control — the plan premium, deductible (up to the $615 maximum in 2026), and covered drug list.
The bigger 2026 drug-cost picture
IRMAA doesn't exist in a vacuum. A few program-wide changes are reshaping what people pay at the pharmacy counter in 2026:
- Part D out-of-pocket cap: $2,100. Once your covered drug spending hits that ceiling, you pay $0 for covered drugs the rest of the year.
- Part D deductible: up to $615. Plans can charge less, but not more.
- The "donut hole" is gone. As of 2025, Part D has three phases — deductible, initial coverage, and catastrophic — with no coverage gap.
- Medicare Prescription Payment Plan. This optional program lets you spread your out-of-pocket drug costs across the calendar year in monthly bills instead of paying big amounts upfront at the pharmacy. It doesn't lower your costs, but it smooths them.
If IRMAA applies to you, these Part D changes still apply the same way — the surcharge is separate from your drug benefits.
What to do if your income has dropped
The two-year lookback is the part that catches people. If you retired, sold a business, lost a spouse, or had another qualifying "life-changing event" since 2024, you can ask Social Security to use more recent income by filing Form SSA-44. Qualifying events include:
- Marriage, divorce, or death of a spouse
- Work stoppage or work reduction
- Loss of pension income
- Loss of income-producing property (in certain cases)
You'll need documentation. If approved, Social Security recalculates your IRMAA using the newer income.
Deadlines to keep in mind
- Annual Enrollment Period: Oct. 15 – Dec. 7. This is when most people can change Part D or Medicare Advantage plans for coverage starting Jan. 1.
- Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance in this window to switch to another MA plan or return to Original Medicare.
Neither window changes IRMAA itself — that's driven by your tax return — but it's the time to make sure your Part D or Advantage choice fits the coming year.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Multnomah County
(MA penetration in Multnomah County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Key dates
Medicare enrollment periods at a glance
- Around your 65thInitial Enrollment PeriodA 7-month window around the month you turn 65 — your first chance to sign up.
- October 15 – December 7Annual Enrollment PeriodAnyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan.
- January 1 – March 31Medicare Advantage Open EnrollmentIf you're already in a Medicare Advantage plan, you can make one change.
- January 1 – March 31General Enrollment PeriodFor people who missed their first chance to sign up for Part B.
- VariesSpecial Enrollment PeriodTriggered by life events like moving or losing other coverage.
Dates are set by Medicare and apply nationwide. Confirm your personal windows at Medicare.gov or 1-800-MEDICARE.
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The parts of Medicare
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When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Does IRMAA go away if I switch to a cheaper Part D plan?
I just retired. Do I really have to pay a surcharge based on my old salary?
Is the $2,100 out-of-pocket cap affected by IRMAA?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.