How IRMAA works
IRMAA stands for income-related monthly adjustment amount. Most people pay the standard Part B premium of $202.90 a month in 2026. If your income is above the first bracket line, Social Security adds an amount to your Part B premium and a separate surcharge for Part D drug coverage. The Part D surcharge applies whether you have a stand-alone drug plan, a Medicare Advantage plan with drug coverage or a retiree group plan with Part D, and it is paid to Medicare, not to the plan.
Three things surprise people:
- It looks back two years. Your 2026 premium uses your 2024 tax return. A big income year in your last year of work can raise your premium in your first years of retirement.
- The brackets are cliffs. Going one dollar over a line raises the premium for the whole year. It is not a tax on the dollars above the line.
- It is recalculated every year. If your income falls, your premium falls too, two years later or sooner if you file Form SSA-44.
What pushes Texas retirees into a bracket?
IRMAA uses federal modified adjusted gross income: the adjusted gross income on your federal Form 1040 plus tax-exempt interest. Texas doesn't tax personal income, so there is no state return in the picture at all. These are the income sources that most often push Texas retirees over a line:
- Public pensions. The taxable part of a pension counts in full. That includes annuities from the Teacher Retirement System of Texas (TRS) for retired school employees, the Employees Retirement System of Texas (ERS) for retired state employees, city and county retirement systems, and police and fire plans. A couple with two public pensions can cross the joint line without much other income.
- Military retired pay and private pensions. Taxable retired pay and private pension payments count the same way.
- Required minimum distributions. Withdrawals from traditional IRAs, 401(k)s and 403(b) or 457 plans are taxable income, and they grow as you age.
- Roth conversions. The converted amount counts in the year you convert. Spreading conversions over several years can keep you under a line.
- Selling a home, land or investments. Capital gains above the home-sale exclusion count. That matters for Texans who sell family land or a house in a fast-growing metro area, or who sell a home elsewhere when they move to Texas.
- Taxable Social Security. The taxable part of your benefit is included in adjusted gross income.
Tip: If you are 70½ or older and give to charity, a qualified charitable distribution sent straight from your IRA to the charity can count toward your required minimum distribution without being added to your adjusted gross income. The 2026 limit is $111,000 per person. Ask a tax professional whether it fits your situation.
What are the 2026 IRMAA brackets?
Income is 2024 MAGI. The Part B amount is the full monthly premium; the Part D amount is added to whatever your drug plan charges.
| Single (and head of household) | Married filing jointly | Part B premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | +$14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | +$37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | +$60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 | +$83.30 |
| $500,000 or more | $750,000 or more | $689.90 | +$91.00 |
If you are married, lived with your spouse at any time in 2024 and filed separately, the brackets are different: $109,000 or less pays the standard premium, $109,001 to $390,999 pays $649.20 (Part D +$83.30), and $391,000 or more pays $689.90 (Part D +$91.00). The calculator handles this when you pick "Married filing separately".
Does IRMAA apply if I'm in TRS-Care or an ERS retiree plan?
Yes. Retiree health plans for Texas public employees that build on Medicare expect you to keep Part B, and you pay the Part B premium, including any IRMAA, to Social Security, not to TRS or ERS. TRS says Medicare-eligible TRS-Care participants must enroll in and pay for Part B, and ERS requires Part A and Part B for its Medicare Advantage plan for retirees. If the retiree plan includes Part D drug coverage, the Part D surcharge applies to you as well. For how these plans fit with Medicare, see TRS-Care, ERS retirees and Medicare.
How do I ask Social Security to use newer income?
If your income has dropped because of a life-changing event, you can ask Social Security for a new decision with Form SSA-44. The events Social Security accepts are marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, and an employer settlement payment. Retiring from a school district, a state agency or any other job counts as a work stoppage, which is the most common reason retirees file.
- Fill out Form SSA-44 with the event, its date, and your estimated income for the year.
- Attach proof, such as a letter from your employer showing your last day of work, or a death certificate.
- Send it to Social Security or bring it to a local office. If Social Security agrees, it recalculates your premium from your newer income.
If you disagree with the income Social Security used, for example because the IRS data was wrong or you amended your return, you can also ask for a reconsideration. More on premiums and the rest of 2026's amounts is on Medicare costs in 2026 and Medicare Part B. If you're still working, see working past 65. Questions about plan choices at your income can go to a licensed insurance agent with Benefits Life at (512) SENIORS (512-736-4677), TTY 711.
Sources
- CMS — 2026 Medicare Parts A & B premiums and deductibles (IRMAA tables)
- Social Security — Premiums: rules for higher-income beneficiaries
- Social Security — Form SSA-44, Medicare income-related monthly adjustment amount, life-changing event (PDF)
- IRS — Retirement plan and IRA required minimum distributions FAQs (qualified charitable distributions)
- TRS — 2026 FAQs for TRS-Care participants with Medicare (Part B requirement) (PDF)
- ERS — Medicare Advantage coverage for retirees (eligibility)
Frequently asked questions
Which year's income sets my 2026 IRMAA?
Social Security uses the modified adjusted gross income (MAGI) on your 2024 federal tax return, the most recent one the IRS gives it. MAGI is your adjusted gross income plus any tax-exempt interest. If the 2024 return isn't available, Social Security may use 2023 and update it later.
Does my TRS or ERS pension count toward IRMAA?
Yes, the taxable part of a pension counts, whether it comes from the Teacher Retirement System of Texas (TRS), the Employees Retirement System of Texas (ERS), a city or county plan, the military or a private employer. So do required minimum distributions, Roth conversions, capital gains and taxable Social Security.
Texas has no income tax. Does that lower my IRMAA?
No. IRMAA is based only on your federal tax return. Living in a state without an income tax doesn't change your MAGI, and there is no Texas deduction or exemption that could lower it.
What if I just retired and my income dropped?
Retirement counts as a work stoppage, one of the life-changing events that let you ask Social Security to use a newer, lower income year. You file Form SSA-44 with proof of the event and an estimate of your current income.
Is IRMAA a sliding scale?
No. The brackets are cliffs: one dollar over a bracket line moves you to the next premium for the whole year. That is why the calculator shows how far over the line you are.
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