Medicare Part D
Higher Medicare Costs Kick In Above $109,000 in 2026
TACOMA, Wash. — As Medicare's fall Annual Enrollment Period runs through Dec. 7, higher earners in Pierce County are getting a fresh look at how their income shapes what they'll pay for Part B and Part D next year. The extra charge, called IRMAA, will apply in 2026 to single filers who reported more than $109,000 in income — and it can add up quickly if you're not expecting it.
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Key takeaways
- The Annual Enrollment Period runs through Dec. 7, and coverage changes made by then take effect Jan. 1.
- For 2026, an extra charge called IRMAA applies to Part B and Part D premiums for single filers with income over $109,000 and married couples filing jointly with income over $218,000, based on 2024 tax returns.
- If a life-changing event like retirement, divorce, or the death of a spouse lowered your income, you can file Form SSA-44 with Social Security to have your IRMAA recalculated.
- After Dec. 7, the Medicare Advantage Open Enrollment Period from Jan. 1 to Mar. 31 offers another, more limited chance to switch plans.
Here's a plain-English guide to how the income rules work, what the 2026 thresholds look like, and where Tacoma readers can turn for help.
What IRMAA actually is
IRMAA stands for the Income-Related Monthly Adjustment Amount. It's an extra amount that some people pay on top of the standard Part B premium and, separately, on top of their Part D drug plan premium. It is not a penalty and it is not tied to your health — it's tied to your tax return.
Social Security decides whether IRMAA applies based on your Modified Adjusted Gross Income (MAGI) from two years earlier. So your 2026 Medicare bills are based on the tax return you filed for 2024.
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. If your income sits at or below those lines, you pay the standard Part B premium and just your plan's Part D premium — no surcharge.
Above those thresholds, there are several tiers. The higher your income, the higher the surcharge on both Part B and Part D. Married couples who file separately have their own, tighter rules. You can see the full 2026 tables on Medicare.gov under "Costs."
Why the two-year lookback matters
Because IRMAA uses income from two years back, a one-time bump — selling a home, cashing out an investment, taking a large IRA distribution, or the year a spouse passed away — can push you into a surcharge tier long after the money is gone.
That's especially common in the South Sound, where longtime homeowners in neighborhoods like North End Tacoma, Proctor, or University Place may see a big paper gain when they sell.
The good news: if you've had a life-changing event — retirement, work reduction, marriage, divorce, the death of a spouse, or loss of pension income — you can ask Social Security to use more recent income instead. The form is SSA-44, and you file it with documentation. Many Tacoma retirees who stopped working in 2024 or 2025 qualify to have their IRMAA reconsidered.
How the Part D piece works in 2026
The Part D surcharge is separate from your drug plan's monthly premium and is paid directly to Medicare, usually deducted from your Social Security check.
It's worth knowing what's changing in the underlying Part D benefit for 2026, because those changes apply to everyone regardless of income:
- The annual out-of-pocket cap for Part D is $2,100 in 2026. Once you hit it, you pay $0 for covered drugs the rest of the year.
- The maximum Part D deductible is $615.
- The old "donut hole" coverage gap is gone as of 2025 — Part D now has three phases instead of four.
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.
What to do this fall in Tacoma
Tacoma is in Pierce County, where a wide range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are offered. You can compare them side-by-side using the Plan Finder at Medicare.gov by entering your ZIP code and your prescriptions.
A few practical steps during the Oct. 15 – Dec. 7 window:
1. Check your income tier. Pull your 2024 tax return and see where your MAGI lands relative to the 2026 thresholds. 2. Watch the mail. Social Security sends an initial IRMAA determination letter, usually in late fall. If your income has dropped since 2024, respond with Form SSA-44. 3. Reassess your drug plan. Even without an IRMAA change, the 2026 benefit redesign may make a different plan a better fit for your prescriptions. 4. Mark the calendar. Coverage changes made by Dec. 7 take effect Jan. 1. The Medicare Advantage Open Enrollment Period (Jan. 1 – Mar. 31) offers a second, more limited chance to switch.
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 Pierce County
(MA penetration in Pierce 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
Does IRMAA ever go away on its own?
I just retired. Do I have to wait two years for relief?
Does IRMAA affect my Medicare Advantage plan premium?
- CMS — Medicare costs & IRMAA (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.