If your income is above the IRMAA threshold you pay an extra amount on top of your Part D drug plan premium. It is the Part D IRMAA, you pay it to Medicare (not your plan), and it is based on the income from your tax return two years ago.
Part D IRMAA is a separate surcharge added on top of whatever your Part D drug plan charges. IRMAA stands for income-related monthly adjustment amount. It is not part of your plan premium and it is not set by your plan. Social Security adds it because your income is above the standard tier, and the amount steps up as your income climbs into higher brackets.
Here is the part people miss: the surcharge applies even if your Part D plan has a $0 premium. The plan premium and the IRMAA are two different bills. So you can sign up for a free drug plan and still owe a Part D IRMAA, because the surcharge is tied to your income, not to the price of the plan you picked.
You pay the Part D IRMAA to Medicare, not to your drug plan. For most people it is withheld from their Social Security check. The plan still collects its own premium the usual way, separately. So a higher earner can see two charges for the same drug coverage: the plan premium, and the IRMAA that goes to Medicare.
The tables below show the extra amount you pay each month for Part D in 2026, by your 2024 income (MAGI). The standard tier pays no Part D IRMAA. Above that, the surcharge rises with each bracket.
| 2024 income (MAGI) | Part D / mo |
|---|---|
| $109,000 or less | $0.00 |
| $109,001 – $137,000 | +$14.50 |
| $137,001 – $171,000 | +$37.50 |
| $171,001 – $205,000 | +$60.40 |
| $205,001 – $499,999 | +$83.30 |
| $500,000 or more | +$91.00 |
| 2024 income (MAGI) | Part D / mo |
|---|---|
| $218,000 or less | $0.00 |
| $218,001 – $274,000 | +$14.50 |
| $274,001 – $342,000 | +$37.50 |
| $342,001 – $410,000 | +$60.40 |
| $410,001 – $749,999 | +$83.30 |
| $750,000 or more | +$91.00 |
The amount shown for married filing jointly is per person.
For most people the Part D IRMAA is deducted straight from their Social Security benefit, the same way the Part B premium comes out. You do not get a separate envelope for it. It simply lowers the monthly deposit you receive.
If you are not yet collecting Social Security, Medicare bills you directly for the Part D IRMAA. Either way, this charge is separate from the premium you pay your drug plan. Your plan keeps billing you for its premium, and Medicare collects the IRMAA on top. It helps to think of them as two distinct line items so the second charge does not catch you off guard.
Part D IRMAA and Part B IRMAA use the same income test and the same two-year lookback. The income from your tax return two years ago sets both surcharges, and the same bracket thresholds apply. If your income lands you in a tier, you owe a surcharge on both parts.
But they are two separate surcharges with their own amounts. The Part B surcharge is generally the larger of the two. To see the Part B side and the full bracket layout, read the 2026 IRMAA brackets. For a refresher on the income figure both parts rely on, see what counts as MAGI.
If a life event lowered your income, such as retirement, the loss of a job, or the death of a spouse, you can ask Social Security to use your newer, lower income instead of the return from two years ago. You do not file a separate request for each part. One Form SSA-44 covers both your Part B and your Part D IRMAA at the same time.
For the qualifying events, the documents you need, and how to send the form, read our guide to appealing IRMAA.
Source: 2026 Part D IRMAA amounts (CMS / SSA publication 05-10536), shown from our cited dataset. Informational only, not medical or financial advice. Last verified June 2026.