Medicare Help in Chesterfield, MO

Chesterfield is a city of about 50,000 in West St. Louis County. Per the Census Bureau, about 25.5% of residents are 65 or older. That's 1 in 4.

So Medicare is a big topic in West County. And there's one piece of it that surprises Chesterfield folks more than anything else.

The income surcharge. IRMAA.

Think of it like a rearview mirror

Here's the mental model.

IRMAA stands for income-related monthly adjustment amount. It's an extra charge on your Part B and Part D premiums if your income is above a certain level.

But here's the trick. It doesn't look at your income today. It looks in the rearview mirror.

Social Security generally uses your tax return from two years back. So your 2026 premiums are based on your 2024 return.

That's why it catches people. You retire, your paycheck stops, and your Medicare bill still reflects your last big working year.

How IRMAA works in 2026

Here's what we know from CMS, Social Security and Medicare.gov for 2026:

• The standard Part B premium is $202.90 a month.
• IRMAA applies if your modified adjusted gross income on that 2024 return was above $109,000 filing single, or $218,000 filing jointly.
• Above that line, your total Part B premium steps up in brackets. In 2026, those brackets run from $284.10 up to $689.90 a month per person.
• There's a matching surcharge on Part D drug coverage too.

What about 2027? The 2027 Part B premium and IRMAA brackets aren't out yet. CMS usually announces them each fall. The 2026 numbers came out in November 2025. We'll update as soon as the new ones are published.

What if your income dropped?

This is the part I want every Chesterfield retiree to know.

If your income went down because of a life-changing event, you can ask Social Security to use a more recent year. You do it with Form SSA-44. Social Security lists events like:

• You or your spouse stopped working, or cut back your hours
• Marriage, divorce, or the death of a spouse
• Loss of income-producing property from a disaster
• Your employer's pension plan ended or was reorganized

Retiring is the big one. If you stopped working and your income dropped, look into it.

3 things I'd do about IRMAA

1. Look at your tax return from two years ago. That's the year Social Security is probably using.
2. If you retired recently, check Form SSA-44. It may lower your surcharge.
3. Talk to your tax person before big moves. Big IRA withdrawals or a property sale can raise your income for that year. That can show up in your Medicare premiums two years later.

I'm not a tax advisor. But I can show you how the brackets work, so you can have a better talk with yours.

Lots of plans in St. Louis County

The flip side of West County? You've got plenty of choices.

Per the CMS CY2027 Landscape file, St. Louis County has 46 Medicare Advantage plans (not counting special needs plans) from 8 parent organizations. That's more than any county around our Springfield office.

• 34 have a $0 monthly plan premium. You still pay your Part B premium.
• 38 include drug coverage.
• 23 HMOs, 21 PPOs, and 2 PFFS plans.

Lots of choice is good. It also means more fine print to compare. See more on our St. Louis County plans page, or run your drugs through our plan finder.

Where Chesterfield folks get care

• St. Luke's Hospital, 232 S Woods Mill Rd, right here in Chesterfield.
• Mercy Hospital St. Louis, 615 S New Ballas Rd. Mercy lists 715 staffed beds.
• Missouri Baptist Medical Center, 3015 N Ballas Rd, Town and Country. It also has outpatient services in Chesterfield.

Plenty of West County folks have doctors in more than one of these systems. If you look at a Medicare Advantage plan, check every doctor and hospital you use against the network.

Signing up from Chesterfield

You sign up for Part A and Part B through Social Security. Online at ssa.gov is easiest.

The nearest office is in Creve Coeur at 1215 Fern Ridge Pkwy, Suite 100. Call 1-800-772-1213 for an appointment, or check ssa.gov/locator.

Free help in West County

• Missouri SHIP (formerly CLAIM): free, unbiased Medicare counseling. 1-800-390-3330.
• Aging Ahead: the area agency on aging for St. Louis County. 14535 Manchester Rd. Call (636) 207-0847 or (800) 243-6060.
• West County Senior Center (Aging Ahead): (636) 227-3882.

Let's look in the rearview mirror together

Bring your Medicare card, your drug list, and a rough idea of your income from two years ago. We'll walk through your costs and your plan choices.

Call us at (844) 348-4138, or stop by our Wildwood office at 2638 Missouri 109, Suite 103. Open Monday through Friday, 9 to 5.

— Matt

Frequently asked questions

What income triggers IRMAA in 2026?

Modified adjusted gross income above $109,000 for single filers or $218,000 for joint filers, based on your 2024 tax return.

When will the 2027 IRMAA brackets come out?

CMS usually announces Part B premiums and IRMAA brackets each fall. The 2026 figures were released in November 2025.

Can I appeal IRMAA if I just retired?

You can ask Social Security to use more recent income if you had a life-changing event, like stopping work. Use Form SSA-44.

How many Medicare Advantage plans are in St. Louis County for 2027?

46 plans from 8 parent organizations, not counting special needs plans, per the CMS CY2027 Landscape file.

How far is your Wildwood office from Chesterfield?

About 20 minutes. We're at 2638 Missouri 109, Suite 103, in Wildwood.