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IRMAA and Medicare Part D: The Extra Drug Plan Charge

Higher-income people owe an extra amount for Medicare drug coverage, paid to Medicare and not to the plan. Here is how it works, and what happens if it goes unpaid.

Medicare4 min readReviewed 2026-10-14

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Short answer

If your income is above the IRMAA limits, you pay an extra monthly amount for Medicare drug coverage on top of your plan's own premium. The extra amount goes to Medicare, not to the plan, and it applies even if your drug coverage is part of a Medicare Advantage plan. If you do not pay it, Medicare can disenroll you from the drug coverage.

Use this before you call.

Want to compare drug plans before December 7? Call GetFastRates.com and a licensed agent will go over your options.

Find your Part D IRMAA on your Social Security notice or Medicare bill.

Confirm how you are paying it (deducted from Social Security or billed).

Make sure the amount is paid every month so your drug coverage stays active.

If you think the income used is wrong or has dropped, follow the steps in our appeal guide.

Call us if you want to compare drug plans before the open enrollment deadline.

Two bills, one coverage

You pay your plan's premium to the plan. You pay the Part D IRMAA to the government. The plan does not see or collect it, and it does not change which plan you should choose.

Stand-alone Part D plans and Medicare Advantage plans with drug coverage are treated the same way.
The income steps are the same ones used for Part B.

If you do not pay it

Not paying the Part D IRMAA can lead to Medicare ending your drug coverage, even if you paid the plan's own premium on time. Missing coverage can also mean a late-enrollment penalty when you re-enroll. If a bill is hard to pay, call Medicare or Social Security right away.

Reviewing your plan with IRMAA in mind

The extra charge does not change how plans compare, so you still compare drug lists, pharmacies and costs. It does change your total yearly budget. Open enrollment runs October 15 to December 7, which is a good time to check that your plan still fits.

Common questions about this topic

Does a Medicare Advantage plan with drug coverage have this too?

Yes. If your Medicare Advantage plan includes drug coverage, the Part D IRMAA still applies and is still paid to the government.

Can switching plans lower it?

No. It depends on your income, not on the plan. Only a change to the income Social Security uses can change it.

Where do I see the amount?

On your Social Security notice or your Medicare bill. If you are unsure, call us or Medicare and we can point you to the line.

Tools that can help

Medicare Enrollment Period CalculatorFind your Medicare enrollment window and what it means for your timing.Medicare Part B Late Enrollment Penalty CalculatorEstimate whether a Part B late enrollment penalty could apply to you.Medicare Plan Ending FinderCheck your carrier and ZIP code against current, verified plan-ending records.

Trusted public sources

These links are provided for general public information. They do not replace a personal coverage review.

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