What happens if my dad’s income changes? Can his Medicare plan or costs change too?

Question

Caroline Johnson · Accepted Answer

The short answer: income changes don't affect his coverage itself, but they can affect what he pays, in both directions.

Here's how it works.

If his income goes up, his premiums can too. Medicare charges higher-income folks an extra amount on top of the standard premiums for Part B and drug coverage. Here's the part that catches people off guard: Medicare looks at his tax return from two years ago, not this year. So a spike in income, even a one-time event like selling a property or a large retirement account withdrawal, can show up as higher premiums two years later.

The good news is there's an appeal for life changes. If his income dropped because of something like retirement, the death of a spouse, or a reduction in work hours, he doesn't have to wait two years for Medicare to catch up. He can file a form with Social Security asking them to use his current, lower income instead. I've seen this save people a meaningful amount, and many folks have no idea it exists.

If his income goes down, help may open up. This is the part families miss most often. If his income is limited, two programs are worth checking. Extra Help lowers prescription drug costs significantly. Medicare Savings Programs, which run through the state, can help pay the Part B premium and sometimes more. Lots of people qualify for these and never apply, either because they don't know about them or because they assume they won't qualify. It costs nothing to check.

What income changes don't do: they don't kick him off his plan, don't change his benefits, and don't affect his eligibility for Medicare itself. Medicare isn't like some programs where earning too much gets you removed. His coverage stays. Only the price tag moves.

My suggestion: if your dad has had a real income change, up or down, that's worth a quick review. Checking whether he owes a premium surcharge he could appeal, or qualifies for help he isn't getting, is a short conversation. And it costs nothing to have it with me.

Lilyana Uzdenova-Gomez · Answer

Yes, both Medicare plan and costs could change based on someone’s income. If your dad’s income goes up and he was on a Dual Special needs plan, he could lose his Medicaid and eventually lose his qualification for his DSNP plan. During the deeming period he could be held responsible for higher copays or coinsurance as defined by his plan. After his “deeming period” he could be disenrolled from his current plan and lose coverage all together unless he chooses another plan before the end of his deeming period. 
  If your dad’s income goes down, and he now qualifies for Low Income Subsidy (extra help paying for prescription drugs) or even Medicaid, then a whole new set of plans may become available to him now (DSNP) depending on the are he lives. 
   In either case, whether losing or gaining Medicaid qualification, your dad qualifies for a special election period to choose a new plan that meets his current needs. 
 On the other hand, if your dad’s income goes up from under $100,000 a year to over $106,000 as a single individual, he may be imposed an IRMAA, which can significantly raise his Medicare part B premium, and his Medicare part D Premiums. The higher the income-the higher the Income Related Monthly Adjustment. If the income goes down again he could then request a reconsideration by filling out the proper form with SS.

Jeremy Wassermann · Answer

Yes, if your dad's income changes significantly, it can affect his Medicare costs—primarily through higher premiums for Parts B and D—but it won't typically change his underlying Medicare plan coverage or eligibility.

How Income Impacts Costs
Medicare uses your modified adjusted gross income from your tax return two years prior to set premiums. For example, 2026 premiums are based on 2024 income. Higher income triggers the Income-Related Monthly Adjustment Amount (IRMAA), adding surcharges to Part B (medical insurance) and Part D (drug coverage).

IRMAA Thresholds
For 2025 (affecting current 2026 premiums), thresholds start at:

$106,000+ (single) or $212,000+ (joint): +$74/month Part B, +$13.70 Part D.

Surcharges rise in tiers up to $500,000+ (single), potentially adding $400+/month.

Christopher Boyd RICP, CLTC, LTCP, APP, MAML · Answer

It is possible for both higher and lower incomes. There is a IRMAA high income penalty which changes each year:

In 2026, higher-income beneficiaries will pay increased premiums for Medicare Part B and Part D based on their modified adjusted gross income (MAGI). For individuals, the income thresholds start at $109,000, and for married couples, it begins at $218,000, with premiums increasing based on higher income levels.
 rrb.gov Social Security Administration
Medicare Income Limits for 2026
In 2026, Medicare beneficiaries with higher incomes will face increased premiums for both Medicare Part B and Part D. The income thresholds that determine these increased premiums are based on modified adjusted gross income (MAGI).

Income Thresholds
The following table outlines the income thresholds for Medicare beneficiaries in 2026:

Filing Status	Income Threshold (MAGI)	Monthly Part B Premium Amount
Individual	≤ $109,000	$202.90
> $109,000 - ≤ $137,000	$284.10
> $137,000 - ≤ $171,000	$364.30
> $171,000 - ≤ $500,000	$444.50
> $500,000	$689.90
Married Filing Jointly	≤ $218,000	$202.90
> $218,000 - ≤ $274,000	$284.10
> $274,000 - ≤ $342,000	$364.30
> $342,000 - ≤ $750,000	$444.50
> $750,000	                        $689.90

Also, if income goes down, each State offers different levels of income assistance for Medicare/Medicaid reduced charges program.

Tamela Clayton · Answer

If your dad’s income changes, it usually doesn’t change his basic Medicare card or the plan he’s already in right away. His standard Part B premium and any Medicare Advantage or Part D plan premiums are generally set for the year, but a big income change can affect things like the high‑income surcharge (IRMAA) the Social Security Administration adds to Part B or D later, once they see the new tax return.

Income changes matter a lot more for ‘extra help’ programs. If his income goes up or down, it can change whether he qualifies for things like Extra Help/LIS for drug costs, Medicare Savings Programs that help pay his Part B premium, or Medicaid. If his income changes, it’s a good idea to report it to Social Security or his state Medicaid office so they can review whether his costs or help with costs should change.”

Susan O&#039;Kelley · Answer

Yes - if your Dad's income changes (ie due to job income increases or decreases), the cost of Medicare Part B AND Part D could increase or decrease. This comes from the Modified Adjusted Gross Income, MAGI, which then affects the annual Income Related Monthly Adjustment Amount (IRMAA). If your Dad was paying MORE for his Part B/Part D and has a reduction in income, he can appeal to get the premium reduced. Note: MAGI is not on your tax return. Check back for additional resources on calculating MAGI as well as more info on IRMAA.

Answered by Susan O'Kelley on October 6, 2025

Broker Licensed in CO, AL, AZ & 20 other states

Answered by Susan O'Kelley Medicare Insurance Agent

Mark Bilgere · Answer

The only costs based on your dad's income are his Part B and Part D premium. These costs are based on his income from two years prior. If it exceeds  specific thresholds, the premiums could be higher and if it drops they could be lower. However they will not go below the base level unless he qualifies for Medicaid.

ANy Advantage plan or supplement he has will not change price based on his income.

Carly Cusack · Answer

If your dad's income  goes down past the poverty level, he may eligible for Medicaid. This is a state program that can help with health care costs and othe costs associated with daily living. If his income goes up due to the selling of a house or inheritance, then his Part B premium can increase. This is called an income related monthly adjustment amount or IRMAA. 

Generally an income change doesn't impact the premium of a Medicare Advantage plan or a Medicare Supplement plan that they are enrolled in. Those premiums are not income driven.

Vonda Peralez · Answer

That's a good question. Most people pay the standard premium for Part B. However, if Modified Adjusted Gross Income (MAGI) from two years prior is above certain thresholds, Income-Related Monthly Adjustment Amount (IRMAA) applies. This adds a surcharge to both Part B and Part D premiums. So if you father is in a higher tier now and his income changes, it is a good idea to appeal the amount with Social Security. You can use form SSA-44 to request a lower IRMAA. You can also call your local Social Security office for help.

Answered by Vonda Peralez on December 15, 2025

Broker Licensed in CA & WA

Answered by Vonda Peralez Medicare Insurance Agent

Karen Murray · Answer

Yes — if your dad’s income changes, his Medicare costs can change too.

Medicare premiums, especially for Part B (medical) are based on income. If his income goes up, he may pay an Income-Related Monthly Adjustment Amount (IRMAA). If his income drops, he may qualify for lower premiums or extra help with drug costs.

He should report income changes to Social Security as soon as possible so they can adjust his Medicare costs accurately.

Zachary Swiger · Answer

Income changes can affect some costs associated with Medicare. If you have a small income you can apply for Medicare Extra-Help which is a program that gives a Low-Income Subsidy (LIS) to qualifying individuals. A change in income can also lead to a change in LIS level, meaning premiums and copayments can change as well. For individuals that don't qualify for LIS, slight income changes don't affect much. If you have a large income or have a large increase in income it can lead to and increase in Medicare Part B Premiums.

Answered by Zachary Swiger on October 6, 2025

Broker Licensed in MO

Answered by Zachary Swiger Medicare Insurance Agent

Carl Lishing · Answer

Income changes would could impact how much he pays for Income Related Monthly Adjustment Amount (IRMAA)on Medicare Part B & Part D. There is a two year look back to determine the amount of IRMAA. If there is a qualifying event the (Like retirement) and the income is coming down it can be appealed so you don't have to wait two years.

Answered by Carl Lishing on July 21, 2026

Broker Licensed in OH, FL, NC & SC

Answered by Carl Lishing Medicare Insurance Agent

Mike Odle · Answer

It depends which direction his income is going. Individuals making more than 109,000, $218,000 for married couples, will typically see an increase in their part B and D premiums. Individuals with incomes below $19,000 a year, $26,000 for couples, would be eligible to apply for a reduction in their part b Medicare premiums. All income points in between will pay the standard rate

Answered by Mike Odle on April 6, 2026

Broker Licensed in IN & IL

Answered by Mike Odle Medicare Insurance Agent

J Scott Burke · Answer

Yes. Your Medicare part B is definitely affected by his income. People who have a higher than average income (based on your taxes two years prior) you will pay a much higher rate for your Medicare part B premiums. 
People who have a very very low income will get assistance with their Medicare and can be exempted from paying their Medicare part B premium at all. 
Your father should always have a meeting with his agent if his income substantially changes in either direction. 
Even without a change in income, he should be having a short meeting every year with his agent to review any rate increases coverage changes and changes in his situation.

Jeremy Purse · Answer

When income levels rise, costs for MAPD, MedSup and Rx plans remain the same.  However, Part B could increase through an IRMAA and is assessed on an annual basis through Medicare itself.  Please refer to Part B IRMAA to determine if your Part B premiums will increase:

 https://www.medicare.gov/publications/11579-medicare-costs.pdf

Esther Miller · Answer

Your Medicare Part B premium is based on your income tax statement from 2 years prior to signing up for Medicare. That income can decrease after you stop working, so if that is what has happened, you can file a form with Social Security to show your income has decreased, and your Medicare Part B premium may go down as well or you may even be eligible for extra help through State Medicaid options. Again, talk to your Medicare Insurance Advisor to find out your options.

Answered by Esther Miller on June 15, 2026

Agent Licensed in WA

Answered by Esther Miller Medicare Insurance Agent

Ray McCauley · Answer

yes, if it drops to a substantial amount, he may be eligible for Medicaid or Medi-Cal in California that will lower his cost by possibly eliminating his Medicare part B premium and co-pays on a plan as well as his prescription drug cost could be eliminated. On the other hand, if it raises substantially, it could increase his part B premium.

Answered by Ray McCauley on December 8, 2025

Broker Licensed in CA, AZ, FL & ID, NV, SC & TN

Answered by Ray McCauley Medicare Insurance Agent

Terry Salak · Answer

That depends on how much it changes AND if was a one-time change or something that will contrite over years to come. Please keep in mind that Medicare Part B premiums adjust annually. These premiums are based off the MAGI from two years prior. Since we are moving into plan year 2026, Medicare Part B/IRMAA payments will adjust in January.

Answered by Terry Salak on October 6, 2025

Agent Licensed in FL, AL, AZ & 11 other states

Answered by Terry Salak Medicare Insurance Agent

Mike Alexander · Answer

YES HE MAY BE SUBJECT TO IRMMA ADJUSTMENT TO HIS PART B AND PART D PREMIUMS, HOWEVER IF HIS INCOME IS LOWER, HE CAN FILE AND SSA-44 FORM TO APPEAL HIS IRMMA ADJUSTMENT, THEY USUALLY APPROVE ABOUT 70% OF IRMMA APPEALS.

Answered by Mike Alexander on October 6, 2025

Broker Licensed in TX, AL, AR & 16 other states

Answered by Mike Alexander Medicare Insurance Agent

Deborah Krump · Answer

Medicare can charge an IRMAA surcharge on Part B and Part D premiums if a Medicare beneficiary's income changes. This can be adjusted annually based upon taxes filed in the period two years back.

Carol Conner · Answer

Yes sometimes this can affect the cost. It’s called Irma IRMAA and is done through Social Security administration they determine by using your tax return from two years ago and if it’s above certain amounts you can pay more than standard premium for parts B and part D prescription drug plan.

Answered by Carol Conner on March 10, 2026

Broker Licensed in TX

Answered by Carol Conner Medicare Insurance Agent

Pete Kelly · Answer

Yes, if your dad's income changes, his Medicare costs (specifically Part B and Part D premiums) can change too. However, his core Medicare plan and benefits will not change.

John Messler · Answer

Medicare plans don’t change price based on income. But your cost for part B are based on the IRMAA chart. Yes there can be changes if someone continues to work and yet their income level fluctuates from previous years.

Answered by John Messler on October 6, 2025

Agent Licensed in NH, ME, NC, OH, PA & TX

Answered by John Messler Medicare Insurance Agent

Nick Sarant · Answer

No one’s income is tied to Medicare unless he make a lot of money. There’s an adjustment to part B and D for those with high income. If he’s above that threshold his premium goes up if he’s below it his premium drops. If he’s on Medicaid based on poverty level guidelines then he could lose his Medicaid, not Medicare.

Answered by Nick Sarant on March 30, 2026

Agent Licensed in SC

Answered by Nick Sarant Medicare Insurance Agent

Karen Ansell · Answer

If your Dad's income changes and he qualifies for Medicaid he can change his current plan to a plan that works best with his level of Medicaid. This can drop his out of pocket expenses or even eliminate them depending on his income and assets.

Answered by Karen Ansell on December 30, 2025

Agent Licensed in FL, GA, KY & OH

Answered by Karen Ansell Medicare Insurance Agent

Phillip Davis · Answer

There are some solutions to the costs associated with Medicare depending on income. If the beneficiary makes above a certain amount, they may pay more for their premium. Depending on state minimum income requirements, they may qualify for extra help programs as well.

Answered by Phillip Davis on October 6, 2025

Broker Licensed in WV, AZ, FL & 5 other states

Answered by Phillip Davis Medicare Insurance Agent

Jennifer Wesolek · Answer

Medicare Part B premiums are based off of income and can be assessed IRMAS if his or his joint spousal income goes above the threshold and there is a two year look back.

Sharri Crawford · Answer

When your Dad's social security income changes usually the PART B Premium usually also goes up.  If he is only getting Social Security benefits then his Part B primum will change small percentage too.

Marcie Barnes · Answer

If his income drastically increased then he may assessed what is called an IRMAA.  You can find more information on this subject at medicare.gov

Shelly Hefley · Answer

Yes, since I’m instances if his income goes up, he may not qualify for assistance from the state. Or if his income goes down, then he may qualify for assistance when he previously didn’t. It’s always good to talk to a licensed agent that will sit down with you and explain The nuances of this wonderful program.

Answered by Shelly Hefley on December 1, 2025

Broker Licensed in IN, AL, IL, KY & TN

Answered by Shelly Hefley Medicare Insurance Agent

James Carlson · Answer

A medicare beneficiary can request finacial help to pay for drugs, but premiums still must be paid. Due to many changes in Medicare it is usually better to stay with the current plan. I One Advantage plans, but hard to find a low cost plan. You have to also look at ones health. It is important to have better coverage if ill. SS can assit locally as can drug companies.

Answered by James Carlson on July 28, 2026

Broker Licensed in MN

Answered by James Carlson Medicare Insurance Agent

ShaLane Hertel · Answer

Yes it can! It can go up significantly or can be eliminated should he qualify for a Medicare Savings Program.

Lorraine Reeves · Answer

There’s a yearly policy/plan review and if there’s changes to be made, then that would definitely be the time to make sure all information is correct to make the necessary changes/adjustments to the plan.

Answered by Lorraine Reeves on October 6, 2025

Agent Licensed in MO, MI & NC

Answered by Lorraine Reeves Medicare Insurance Agent

Daniel Brechin · Answer

Yes, I personally help low-income seniors to obtain assistance.   with their state to qualify for additional help.   I can move that person into a great program with low income,

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