IRMAA and Medicare Premium Surcharges Explained for North Carolina Retirees
Retirees around Cary and the Triangle area sometimes notice their Medicare bills rise more than they expected. One common reason is IRMAA. This guide explains what it is, how the amounts are set, and how to verify details with official sources.
What is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge added to standard Medicare Part B and Part D premiums for beneficiaries whose modified adjusted gross income exceeds set levels. The charge applies whether you choose Original Medicare or a Medicare Advantage plan.
Medicare calculates the adjustment using your tax data from two years earlier. For 2026, it generally uses 2024 information. The extra amount is billed monthly and can be deducted from Social Security checks or sent as a bill.
How IRMAA brackets and premiums are determined
The standard Part B premium for 2026 is $202.90 per month. IRMAA can raise the total Part B amount to $689.90 in the highest bracket, according to the CMS 2026 fact sheet. Part D plans receive an add-on from $14.50 to $91.00 per month on top of the plan's own premium.
Brackets are based on modified adjusted gross income, or MAGI. MAGI equals your adjusted gross income from Form 1040 line 11 plus tax-exempt interest from line 2a. Only the taxable portion of Social Security counts through the AGI line. Filing status matters: single, married filing jointly, or married filing separately each have their own thresholds.
The 2026 brackets begin above $109,000 for single filers and above $218,000 for married couples filing jointly. Amounts rise in steps as income increases. Every year the dollar thresholds and surcharges are updated, so check your personal notice each fall.
Who may be affected by IRMAA
About 8 percent of Medicare beneficiaries pay an IRMAA charge. It most often affects households with incomes above the first threshold. The two-year lag can surprise people who retired recently but had higher earnings a few years back.
Income from investments, pensions, or part-time work after retirement can still count if it shows up on the tax return that Medicare uses. The calculation is the same for Original Medicare and Medicare Advantage plans.
How to check your IRMAA status and appeal
The Social Security Administration mails notices when IRMAA applies. These letters list the amount, the income year used, and your rights to review the decision. Keep the notice with your tax records.
If your income dropped because of a qualifying life event, you can request a lower amount. Qualifying events include retirement, marriage, divorce, or the death of a spouse. File Form SSA-44 with supporting documents, usually within 60 days of the notice. If the tax data itself looks wrong, a separate reconsideration process is available. Any approved change can affect premiums going forward or retroactively in some cases.
North Carolina and Triangle verification steps
Free, unbiased help on Medicare costs is available through NC SHIIP. Call the statewide line at 1-855-408-1212 or contact a counselor in Wake County. They can walk through general questions about premium notices and IRMAA without offering personalized planning.
Local residents in Cary, Apex, Morrisville, or Holly Springs should review their own SSA notice first. ZIP code or plan details still require direct verification through Medicare.gov or SHIIP.
Questions to ask a licensed professional
- How does my filing status affect the brackets that apply?
- What documents would support a request to lower my IRMAA determination?
- Where do I locate my MAGI on the prior year's tax return?
For more on Medicare basics, visit the Medicare & Social Security section. To read about enrollment windows or plan type differences, see the related guides there. If you have a specific question about your records, use the Ask a Question page or speak with a licensed professional who can review your full situation.
