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 to any Part D coverage: a standalone drug plan, a Medicare Advantage plan with drug coverage, or a group plan with Part D such as the State of Florida's group MA-PD plans for retirees. 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 before you moved to Florida, your last year of work, or a lump sum at retirement can raise your premium in your first years here.
- 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.
Pay the Part D surcharge on time. Medicare bills the Part D IRMAA separately from your plan. Under federal rules, CMS disenrolls people from Part D coverage when they don't pay it (42 CFR 423.44(e)). That applies to group coverage with Part D too, such as the State's MA-PD plans, so treat the bill from Medicare as seriously as a premium.
What pushes Florida retirees into a bracket?
IRMAA uses federal modified adjusted gross income: the adjusted gross income on your federal Form 1040 plus tax-exempt interest. Florida doesn't tax individuals' income (Florida Constitution, Article VII, Section 5), so many new residents stop thinking about income tax when they move. Medicare doesn't: these are the income sources that most often push Florida retirees over a line.
- Selling a home before or after the move. Capital gains above the federal home-sale exclusion count in the year of the sale. Selling a house in New York, New Jersey, the Midwest or anywhere else to buy in Florida, or later selling a Florida home that has gained value, can raise your premiums two years later. See does selling a home raise IRMAA?
- Public pensions. The taxable part of a pension counts in full on your federal return. That includes the Florida Retirement System (FRS) Pension Plan, pensions from another state's teacher or public employee system that you bring with you, and federal civil service pensions. A couple with two public pensions can cross the joint line without much other income.
- Military retired pay. Florida has a large military retiree community around installations such as NAS Jacksonville, NAS Pensacola, Eglin and MacDill Air Force Bases. Taxable retired pay counts for IRMAA. VA disability compensation isn't taxable income, so it doesn't count.
- Required minimum distributions. Withdrawals from traditional IRAs, 401(k)s and 403(b) or 457 plans, including FRS Investment Plan accounts, 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.
- Taxable Social Security. The taxable part of your benefit is included in federal adjusted gross income. Most Florida public employees pay into Social Security too: in 2023, 88.5% of the state's state and local government workers had Social Security coverage, according to the Congressional Research Service.
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". The 2027 brackets, based on 2025 income, aren't published yet; see Medicare costs in 2027.
Does IRMAA apply with State Group Insurance?
Yes. Social Security sets and bills IRMAA, not the Division of State Group Insurance or People First, so the Part B part applies to every retiree with Part B. How the Part D part applies depends on which State option you have:
- The State's group MA-PD plans. These Medicare Advantage plans include Part D, so a retiree over a bracket line pays both the higher Part B premium and the Part D surcharge.
- The State Group Insurance PPO or HMO plan, secondary to Medicare. The Division of State Group Insurance describes the prescription coverage in these plans as creditable coverage that is at least as good as Part D, and says you don't need a separate Part D plan. If Social Security sends you a Part D IRMAA notice, ask People First, 866-663-4735, how your drug coverage is set up.
- Local government retirees. Retiree health coverage from a county, city or school district depends on your former employer. IRMAA works the same way whatever that coverage is.
Skipping Part B doesn't avoid the cost: the State says its plan pays as if you had Part B whether or not you enroll, so you would pay the share Medicare would have paid. See Florida state 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 any job counts as a work stoppage, the most common reason retirees file. Moving to Florida, or selling a home, isn't on the list.
- Fill out Form SSA-44. List the event, its date, and your estimated income for the year.
- Attach proof. For example, a letter from your employer or retirement system showing your last day of work or your retirement date, or a death certificate.
- Send it to Social Security. Mail it or bring it to a local Social Security 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. See how to appeal IRMAA after retiring, what is IRMAA and will I pay it? and Medicare Part B. For questions about plan choices at your income, you can request a call from a licensed insurance agent.
Sources
- CMS — 2026 Medicare Parts A & B premiums and deductibles (IRMAA tables)
- Social Security — Premiums: rules for higher-income beneficiaries
- Social Security POMS HI 01101.010 — Modified adjusted gross income and the tax year used
- Social Security — Form SSA-44, Medicare income-related monthly adjustment amount, life-changing event (PDF)
- eCFR — 42 CFR 423.44, Involuntary disenrollment (failure to pay the Part D IRMAA)
- IRS — Retirement plan and IRA required minimum distributions FAQs (qualified charitable distributions)
- Florida Constitution, Article VII, Section 5 — Estate, inheritance and income taxes
- Florida Division of State Group Insurance — Medicare Advantage and Prescription Drug (MA-PD) plans
- Florida Division of State Group Insurance — Frequently asked questions: retirees
- Congressional Research Service — Social Security coverage of state and local government employees (R46961)
Frequently asked questions
What are the IRMAA brackets for 2027?
CMS hasn't published them yet. They come with the 2027 Part B premium announcement in the fall and will apply to income on your 2025 federal tax return. Until then, this calculator uses the 2026 brackets, which apply to 2024 income.
Why is my Part B premium higher than the standard amount?
Most likely because of IRMAA: your modified adjusted gross income two years earlier was above the first bracket line, so Social Security added an income-related amount. It can also be a Part B late enrollment penalty. Social Security's yearly notice explains which, and you can ask for a new decision if your income has dropped.
Does selling my house up north raise my Medicare premiums in Florida?
It can. Capital gains above the federal home-sale exclusion count in your modified adjusted gross income for that year, and IRMAA looks back two years. A sale in 2024 affects 2026 premiums. Selling a house isn't a life-changing event on Form SSA-44, so plan the timing with a tax professional.
Does my FRS pension count toward IRMAA?
Yes. The taxable part of any pension counts on your federal return, whether it comes from the Florida Retirement System, the military, the federal government or a private employer. So do required minimum distributions, Roth conversions, capital gains and the taxable part of your Social Security.
Does IRMAA apply if I'm in a State Group Insurance plan?
Yes for Part B: Social Security sets IRMAA for everyone with Part B, whatever other coverage you have. The State's group Medicare Advantage (MA-PD) plans include Part D, so the Part D surcharge applies too if your income is over a line. Medicare bills it, not the State.
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