Basics
The IRMAA Part D surcharge
If your income puts you in an IRMAA tier, you pay a monthly Part D surcharge on top of your drug plan premium, from $14.50 to $91.00 a month in 2026. It goes to Medicare, not to your plan, so it applies even if your plan costs $0 and whether your drug coverage is a stand-alone plan or part of a Medicare Advantage plan.
The 2026 amounts
The Part D surcharge uses the same income tiers and the same two-year lookback as the Part B surcharge. The amounts are smaller, but they are easy to overlook because they do not appear on your drug plan bill.
| Individual MAGI | Joint MAGI | Part D add-on / mo | Per person / yr | Couple / yr |
|---|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $0.00 | $0 | $0 |
| $109,001 – $137,000 | $218,001 – $274,000 | $14.50 | $174 | $348 |
| $137,001 – $171,000 | $274,001 – $342,000 | $37.50 | $450 | $900 |
| $171,001 – $205,000 | $342,001 – $410,000 | $60.40 | $724.80 | $1,449.60 |
| $205,001 – $499,999 | $410,001 – $749,999 | $83.30 | $999.60 | $1,999.20 |
| $500,000 or more | $750,000 or more | $91.00 | $1,092 | $2,184 |
Married people who file separately and lived together pay $83.30 a month from $109,001 to $390,999 and $91.00 from $391,000. The couple column assumes both spouses have Part D coverage.
Why a $0 plan does not mean $0
Your drug plan premium is set by the private insurer and paid to the plan. The IRMAA surcharge is set by law and paid to Medicare. They are separate charges. A person in tier two with a $0 stand-alone drug plan still pays $37.50 a month to Medicare, or $450 a year. A Medicare Advantage member whose plan includes drug coverage at no extra premium pays it too.
The surcharge is tied to your income, not to the plan you pick, so shopping for a cheaper plan does not change it. It does make the total cost of drug coverage higher than plan comparison tools usually show, which is worth remembering when you compare plans.
How it is collected
If you receive Social Security benefits, the Part D surcharge is normally deducted from your monthly payment along with your Part B premium. The deduction shows on your benefit statement. If you do not receive benefits yet, or the payment is too small, Medicare sends a separate bill. Federal retirees with benefits from the Office of Personnel Management and Railroad Retirement Board beneficiaries have it withheld from those payments instead.
Paying the plan premium on time does not cover the surcharge. Not paying the surcharge can end your Part D coverage, so if you are billed directly, set up automatic payment if you can.
A worked example
George, single, has 2024 MAGI of $150,000, which is tier two for 2026. He picked a stand-alone drug plan with an $8 monthly premium.
The surcharge is more than four times his plan premium. If George's MAGI had been $137,000 or less, he would pay $14.50 a month instead, and at $109,000 or less, nothing extra.
Can you avoid it by dropping Part D?
Technically, yes: no Part D coverage, no Part D surcharge. In practice it is rarely wise. If you go without creditable drug coverage for 63 days or more and enroll later, you pay a late enrollment penalty for as long as you have Part D, on top of IRMAA. And a single new prescription can cost far more than the surcharge. People who have creditable drug coverage from an employer or retiree plan do not need Part D and do not pay the Part D surcharge.
Lowering the surcharge
Because the Part D surcharge moves with the same tiers as Part B, anything that lowers MAGI lowers both. Staying one dollar under a limit saves the Part B and Part D steps together. Our IRMAA calculator includes the Part D surcharge by default and lets you switch it off if you have other drug coverage. The guide to 10 ways to lower IRMAA lists the main levers.
When the surcharge changes during the year
Your IRMAA is set once for the calendar year, but it can change mid-year in two cases. If Social Security approves a Form SSA-44 request or a reconsideration, the new, lower amount applies to the whole premium year and any overpayment is credited back. And if you join or leave Part D during the year, the surcharge starts or stops with your coverage. Changing from one drug plan to another during open enrollment does not change the surcharge at all, because it is tied to your income tier and not to the plan.
See your Part B and Part D surcharge together for 2026 and 2027.
Open the IRMAA calculatorFrequently asked questions
Do I pay the Part D surcharge with a Medicare Advantage plan?
Is the surcharge paid to my drug plan?
Does choosing a cheaper plan lower the surcharge?
What if I have drug coverage from a former employer?
Sources
- CMS: 2026 Medicare Parts B premiums and deductibles, including Part D IRMAA
- Medicare.gov: Monthly premium for drug plans
- Social Security: Premiums, rules for higher-income beneficiaries