Medicare Part D

IRMAA & Medicare Costs in Concord, N.H. (2027)

CONCORD, N.H. — As Medicare's Annual Enrollment Period runs through Dec. 7, some Concord retirees are opening letters from Social Security that mention a surcharge called IRMAA — the Income-Related Monthly Adjustment Amount. If your income crossed a certain line two years ago, you may pay more for Part B and Part D in 2027 than your neighbor down the street. Here's how that works, and what to expect for the 2027 thresholds.

What IRMAA is, in plain English

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

Two important things to know up front:

• IRMAA is set by the Social Security Administration, not by your insurance company.
• It's based on your modified adjusted gross income (MAGI) from two years ago. For 2027, that means your 2025 tax return.

The 2026 income thresholds

For 2026, IRMAA kicks in when your 2024 MAGI was above $109,000 for a single filer or $218,000 for a married couple filing jointly. Below those numbers, you pay the standard Part B premium and no Part D surcharge.

Above those numbers, there are five income brackets. The higher your income, the higher the surcharge — and it applies to both Part B and Part D at the same time. The very top bracket applies to single filers with MAGI at or above $500,000 (or $750,000 for joint filers).

For the exact bracket amounts and the surcharge in each tier, check the current chart at medicare.gov/basics/costs. Those figures are updated by CMS each year.

Why a Concord reader might get hit unexpectedly

IRMAA surprises tend to come from one-time events in 2024, such as:

• Selling a home with a large capital gain
• Converting a traditional IRA to a Roth
• Taking a big required minimum distribution
• Cashing out stock or receiving a severance package

Because Medicare looks back two years, an unusual 2025 tax year can raise your 2027 premiums even if your income has since returned to normal.

You can appeal after a "life-changing event"

If your income has dropped because of a specific life event, you can ask Social Security to use more recent numbers. Qualifying events include:

• Marriage, divorce, or the death of a spouse
• You or your spouse stopping work or cutting hours
• Loss of a pension
• Loss of income-producing property from a disaster or other event outside your control

The form is SSA-44, available at ssa.gov. Bring documentation — a tax return, a letter from a former employer, or a death certificate, depending on the event. The Concord Social Security office on Pleasant Street can help you file it.

How this connects to other 2027 Medicare changes

Even for people who don't owe IRMAA, 2027 brings meaningful updates to prescription costs:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old coverage gap (the "donut hole") is gone — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs into monthly installments instead of paying big amounts at the pharmacy counter.

These changes apply regardless of income. IRMAA is separate — a surcharge on top of premiums, not on what you pay for drugs at the register.

Local help in Concord

Concord is in Merrimack County, and New Hampshire's ServiceLink Aging and Disability Resource Center is the state's SHIP (State Health Insurance Assistance Program). SHIP counselors are trained, unbiased, and free. They can walk through an IRMAA letter with you, help you decide whether to appeal, and explain how income changes might affect next year.

You can reach ServiceLink at 1-866-634-9412 or visit servicelink.nh.gov.