Medicare Part D
2026 Medicare IRMAA: What Kicks In Above $109,000
GRAND RAPIDS, Mich. — If your income has crept up in recent years, your 2026 Medicare bill may look different than your neighbor's. The Social Security Administration is finalizing the income brackets that decide who pays an extra amount — called IRMAA — on top of standard Part B and Part D premiums next year. For single filers, those surcharges begin above $109,000 in income, based on a tax return from two years ago.
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Key takeaways
- For 2026, extra Medicare charges called IRMAA start for single filers earning above $109,000, or above $218,000 for married couples filing jointly.
- IRMAA is based on your income tax return from two years earlier, so a big financial event now could raise your Medicare costs later.
- If you owe IRMAA, Social Security sends a notice, usually in November or December, that explains the charge and how to appeal.
- You can use Form SSA-44 to report a life-changing event, like retirement or divorce, that may lower your IRMAA amount.
Here's a plain-English guide to how the surcharge works, who it affects around Grand Rapids, and what to do if your income has changed.
What IRMAA actually is
IRMAA stands for the Income-Related Monthly Adjustment Amount. It's not a separate bill or a penalty — it's an add-on to your regular Medicare Part B (doctor visits) and Part D (prescription drug) premiums when your income is above certain thresholds.
Two things worth knowing up front:
- IRMAA is set by Social Security, using income data from the IRS.
- It uses your Modified Adjusted Gross Income (MAGI) from two years back. So your 2026 surcharge is based on your 2024 tax return.
That two-year lookback is why a big one-time event — selling a home, taking a large IRA distribution, or a Roth conversion in 2024 — can affect what you pay in 2026.
The 2026 income thresholds
For 2026, IRMAA begins for beneficiaries with MAGI above $109,000 (single) or $218,000 (married filing jointly). Above those lines, the surcharge climbs through several brackets, with the highest tier applying to single filers with income at or above $500,000 (or $750,000 for joint filers). Married-filing-separately filers face their own, narrower schedule.
Two important reminders:
- Everyone in the same bracket pays the same Part B surcharge. It doesn't scale gradually — it steps up bracket to bracket.
- The Part D surcharge is added to whatever Part D premium your plan charges. You pay it even if you're in Medicare Advantage with drug coverage built in.
For the exact dollar amounts as they're finalized, check CMS's Medicare costs page at medicare.gov/basics/costs.
Why you might get a letter this fall
If Social Security determines you owe IRMAA in 2026, you'll get a predetermination notice — typically in November or December — explaining the amount and the tax year they used. Read it carefully. The letter also tells you how to appeal.
Common reasons the amount may not fit your current life:
- You retired or cut back your hours.
- You lost a pension or work-related income.
- You divorced or lost a spouse.
- A one-time event (home sale, inheritance-related income) made 2024 look unusually high.
If any of those apply, you can request a review.
How to appeal — the "life-changing event" form
Social Security uses Form SSA-44 to consider a life-changing event. You'll list the event, the date, and your expected income. Supporting documents help — a letter from a former employer, a signed statement about retirement, or divorce/death paperwork.
You can file SSA-44 by mail or in person at a Social Security office. There's a Social Security office on Leonard Street NW in Grand Rapids that serves Kent County residents. Appointments are recommended.
The bigger 2026 picture for drug costs
Even if IRMAA applies to you, other 2026 changes will still shape what you spend on medications:
- The Part D out-of-pocket cap is $2,100 in 2026. Once your covered drug spending hits that amount, you pay $0 for the rest of the year on covered drugs.
- The Part D deductible maximum is $615.
- The old coverage gap ("donut hole") is gone — Part D now has three phases instead of four.
- The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments, at no extra charge. It doesn't lower the total, but it smooths the timing.
These apply to everyone with Part D, regardless of income.
Dates to keep on the fridge
- October 15 – December 7, 2025: Medicare Annual Enrollment. Change Part D or Medicare Advantage for 2026.
- January 1 – March 31, 2026: Medicare Advantage Open Enrollment. If you're already in an Advantage plan, you get one switch.
- Late 2025: Watch for the IRMAA predetermination letter if you expect to be affected.
Grand Rapids is in Kent County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are offered. IRMAA is separate from your plan choice — it follows your income, not your plan.
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 Kent County
(MA penetration in Kent 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.
Higher-income surcharges
2026 IRMAA income brackets
If your income is above a threshold, you pay an income-related surcharge (IRMAA) on top of your Part B and Part D premiums. Your 2026 surcharge is based on your 2024 tax return.
| Income — single filer | Income — married, joint | Part B monthly premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | Plan premium only |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | + $14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | + $37.40 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | + $60.40 |
| $205,001 – $500,000 | $410,001 – $750,000 | $649.30 | + $83.30 |
| Above $500,000 | Above $750,000 | $689.90 | + $91.00 |
Standard Part B premium is $202.90/month. Part D surcharges are added to your drug plan’s premium. Married-filing-separately uses a different, compressed schedule. Confirm current amounts at Medicare.gov.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Q: I'm just barely over $109,000. Do I pay a huge surcharge?
Q: I already retired. Why is Social Security using my 2024 income?
Q: Does IRMAA apply if I'm in a Medicare Advantage plan?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.