Medicare Part D

2027 Medicare IRMAA: Charleston, W.Va. Guide

CHARLESTON, W.Va. — If you're on Medicare and your income has climbed in recent years — maybe from a Roth conversion, the sale of a home, or a pension bump — a letter from Social Security this fall could catch you off guard. It's called IRMAA, and for 2026 it starts nudging monthly Part B and Part D premiums higher once a single filer's income crosses $109,000.

Here's a plain-English look at how those surcharges work, who they hit, and what Kanawha County residents can do about them during this fall's Annual Enrollment Period.

What IRMAA actually is

IRMAA stands for the Income-Related Monthly Adjustment Amount. It's not a penalty — it's an extra amount added to your standard Part B and Part D premiums if your income is above certain thresholds. Most people on Medicare pay the standard premium and never see an IRMAA charge at all. But higher earners pay more, and the surcharge grows in tiers as income rises.

The number Social Security uses is your Modified Adjusted Gross Income (MAGI) from your tax return two years back. So your 2027 IRMAA is based on what you reported for the 2025 tax year.

The 2026 income thresholds

For 2026, IRMAA begins at these MAGI levels:

• Single filers: above $109,000
• Married filing jointly: above $218,000
• Married filing separately: a much lower threshold kicks in — check medicare.gov for the exact figure

Above those starting points, there are five surcharge tiers. The higher your income, the higher the add-on to both your Part B premium and your Part D premium. If you're right around a threshold, even a small income difference can bump you into the next bracket — something worth talking through with a tax preparer before year-end.

How you'll be notified

Social Security mails an initial IRMAA determination letter, usually in late fall or early winter. It will show which bracket you landed in and what your Part B premium (and Part D add-on, if applicable) will be for the coming year. Part B IRMAA is deducted from your Social Security check. Part D IRMAA is billed separately by Medicare or Social Security — it's not paid to your drug plan.

That surprise billing catches a lot of people. If you have a stand-alone Part D plan or a Medicare Advantage plan with drug coverage, the Part D IRMAA comes on top of whatever premium your plan charges.

Life changes can lower your IRMAA

This is the part many people miss. If your income dropped after a life-changing event, you can ask Social Security to recalculate. Qualifying events include:

• Retirement or reduced work hours
• Death of a spouse
• Marriage or divorce
• Loss of pension income
• Loss of income-producing property (not from a sale you chose)

You'd file Form SSA-44 with proof of the change. If approved, Social Security uses a more recent — and more accurate — income figure. This is one of the most under-used tools in Medicare, and it's free to request.

Charleston context: what's changing in 2027

Charleston is in Kanawha County, where residents choose from a range of Medicare Advantage and stand-alone Part D options each fall. The 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. Two program-wide changes matter for anyone paying IRMAA:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your drug spending hits that ceiling, you pay nothing for covered drugs the rest of the year.
• The Part D deductible maximum is $615 in 2026 and $700 in 2027.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments instead of paying big pharmacy bills up front.

None of those change IRMAA itself, but they do change the total picture of what Medicare costs you.

Key dates to remember

• October 15 – December 7: Medicare Annual Enrollment Period. Change your Part D or Medicare Advantage plan for 2027.
• January 1 – March 31: Medicare Advantage Open Enrollment Period. If you're in an Advantage plan, you can switch once or return to Original Medicare.