Medicare Part D
How Your Income Affects Medicare Costs in 2026
Eugene, Oregon — If you're reviewing your Medicare choices this fall, there's one detail that catches many people off guard: your income from two years ago can change what you pay for Part B and Part D in 2027. It's called IRMAA, and understanding it now — during the Annual Enrollment Period running October 15 through December 7 — can help you avoid a costly surprise when your first 2027 bill arrives.
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Click to call 855-729-3240Key takeaways
- IRMAA is an extra charge added to Part B and Part D premiums for people whose income is above a certain level, based on your tax return from two years earlier.
- The Annual Enrollment Period runs October 15 through December 7, and reviewing your IRMAA status now can help you avoid surprises on your 2027 bill.
- If your income has dropped due to a life-changing event like retirement or loss of a spouse, you can file form SSA-44 anytime to ask Social Security to recalculate your IRMAA using more recent income.
- Part D IRMAA surcharges are billed separately by Medicare, not by your drug plan, and skipping Part D coverage when first eligible can trigger a separate lifelong late-enrollment penalty.
What IRMAA Is, in Plain Language
IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra charge added on top of the standard Medicare Part B and Part D premiums for people whose income sits above a certain level. It isn't a penalty for doing anything wrong — it's simply Medicare's way of asking higher earners to pay more.
The Social Security Administration decides whether IRMAA applies to you. They look at your most recent tax return on file, which for 2027 usually means your 2025 return.
The 2027 Income Thresholds
For 2026, IRMAA kicks in once your modified adjusted gross income (MAGI) crosses these lines:
- Single filers: above $109,000
- Married filing jointly: above $218,000
- Married filing separately: a much lower threshold applies
If you're below those numbers, you'll pay the standard Part B premium and whatever your Part D plan charges — no surcharge. Above those numbers, IRMAA is tiered: the higher your income, the higher the added amount. There are five income brackets in total, with the top bracket reserved for the highest earners.
Because these figures can shift year to year, always confirm the current tiers on medicare.gov before making decisions based on them.
How the Surcharge Reaches You
IRMAA shows up in two places:
1. Part B: The surcharge is added to your monthly Part B premium. Most people have this pulled directly from their Social Security check. 2. Part D: Even though you pay your Part D plan directly for the plan's premium, the IRMAA surcharge for drug coverage is billed separately by Medicare — not by your plan. This trips up a lot of people who assume everything drug-related comes from the insurer.
If you have a Medicare Advantage plan that includes drug coverage, the Part D IRMAA still applies the same way.
Common Mistakes to Avoid
Assuming last year's letter still applies. Social Security sends a new IRMAA determination letter each fall. Read it carefully. If your income has dropped, you may qualify for relief.
Ignoring a life-changing event. If you retired, lost a spouse, divorced, or had another major income change since 2024, you can ask Social Security to recalculate using more recent figures. The form is SSA-44, and you can file it any time — you don't have to wait.
Overlooking the appeal option. If you believe the income data is wrong or outdated, you have the right to appeal. Don't just pay a surcharge you think is incorrect.
Forgetting Part D even when you're healthy. Skipping Part D when you're first eligible can trigger a separate late-enrollment penalty that lasts for life — a different issue from IRMAA, but one that also raises your monthly costs.
Other Numbers Worth Knowing
While you're looking at income-related costs, keep these program-level figures in mind for 2026:
- Part D out-of-pocket cap: $2,100. Once you spend that much on covered drugs, you pay nothing more for the rest of the year.
- Part D maximum deductible: $615, though many plans set theirs lower.
- The coverage gap ("donut hole") is gone as of 2025. Part D now has three simpler phases.
- Medicare Prescription Payment Plan: You can spread your drug costs across the year in monthly installments instead of paying large amounts at the pharmacy counter.
Eugene is in Lane County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are available. For 2027, Lane County has 31 Medicare Advantage plans from 8 carriers, with 7 new plans, 15 not returning, and 5 renamed. The number of options can change each year, which is why the Annual Enrollment Period matters even if you're happy with your current coverage.
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 Lane County
(MA penetration in Lane 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
2027 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 2027 surcharge is based on your 2025 tax return. CMS publishes the 2027 brackets and surcharge amounts later in the fall; the 2026 figures below are shown for reference until then.
| 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: Why does Medicare use my 2025 income for my 2027 premium?
Q: Does IRMAA ever go away?
Q: I have a Medicare Advantage plan. Do I still pay IRMAA?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.