Medicare Part D

How IRMAA Adds to Part B and Part D in Kansas City

Kansas City, Mo. — If you're on Medicare and your income has climbed in recent years, you may be one of the millions of Americans who pay a little extra each month for Part B and Part D. That extra charge is called IRMAA — the Income-Related Monthly Adjustment Amount — and the income thresholds will shift again for 2027.

Here's what Kansas City-area beneficiaries need to know before Medicare's Annual Enrollment Period closes on Dec. 7.

What IRMAA actually is

IRMAA isn't a penalty. It's an extra amount that higher-income Medicare beneficiaries pay on top of the standard Part B premium and their Part D plan's premium. Social Security handles the billing, and the surcharge is usually pulled straight from your monthly benefit.

Roughly 8% of people with Medicare pay IRMAA. If your income is below the first threshold, this doesn't apply to you — you'll pay the standard Part B premium like everyone else.

The income thresholds for 2026 and 2027

IRMAA is based on your modified adjusted gross income (MAGI) from two years earlier. So your 2026 surcharge is based on your 2024 tax return.

For 2026, the first IRMAA tier kicks in when income tops:

• $109,000 for single filers
• $218,000 for married couples filing jointly

Above those numbers, there are five surcharge tiers that step up as income rises, with the highest tier hitting single filers with incomes at or above roughly $500,000 and joint filers at or above $750,000. The higher your MAGI, the higher the add-on for both Part B and Part D.

The exact dollar surcharge for each tier is set by CMS every fall. The 2026 chart is on Medicare.gov under "Costs," and the 2027 chart will be posted there after CMS releases it.

How the Part D piece works

Part D IRMAA is separate from your drug plan's premium. If you owe it, Social Security bills you directly — even if your Part D premium is otherwise paid to a private insurer.

This matters going into 2027 because Part D continues to change:

• The $2,100 annual out-of-pocket cap on covered drugs continues.
• The maximum Part D deductible is $615.
• The old "donut hole" is gone; Part D now has just three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments.

None of those changes affect whether you owe IRMAA — but they do affect what you'll actually spend at the pharmacy.

If your income has dropped, you can appeal

This is the part many people miss. If a "life-changing event" cut your income after that 2024 tax year, you can ask Social Security to recalculate your IRMAA using more recent numbers.

Qualifying events include:

• Retirement or reduced work hours
• Loss of a spouse
• Divorce
• Loss of pension income
• A one-time income event (like selling a business or property) that won't repeat

The form is SSA-44, available at ssa.gov. Bring documentation — a retirement letter, death certificate, or divorce decree — and file it with your local Social Security office.

Why this matters during AEP

Annual Enrollment runs Oct. 15 through Dec. 7. IRMAA itself isn't something you shop for — you can't switch plans to avoid it. But knowing whether you'll owe it changes how you compare Part D coverage, because the surcharge is added on top of any plan's premium.

Kansas City is in Jackson County, where beneficiaries have a broad set of stand-alone Part D and Medicare Advantage options to review each fall. If you're weighing a change, factor in the IRMAA you'll owe alongside the plan's own costs.

Medicare Advantage Open Enrollment follows from Jan. 1 through March 31, giving Advantage enrollees one more window to switch if a plan isn't working out.