How IRMAA works
Social Security gets your modified adjusted gross income (MAGI) from the IRS: your adjusted gross income plus tax-exempt interest, generally from two years before the premium year. If it is above the first bracket line, you pay a higher Part B premium and a Part D surcharge on top of your drug plan's premium. There are five income brackets above the standard premium, and they work as cliffs: one dollar over a line moves you to the next amount for the whole year.
| 2024 MAGI, single | 2024 MAGI, joint | 2026 Part B (monthly) | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | None |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | $14.50 |
| $500,000 or more | $750,000 or more | $689.90 | $91 |
The full table, including married filing separately, is on Medicare costs in 2026. The 2027 brackets, which will use 2025 income, hadn't been published as of November 13, 2026.
What pushes Ohioans over the line
- Two public pensions. A couple with OPERS, STRS Ohio, SERS, OP&F or HPRS pensions can cross the joint line with little other income.
- A DROP or lump-sum payout. A DROP balance taken as cash instead of rolled over counts as income that year, so cashing out a large balance can trigger IRMAA two years later.
- Required minimum distributions, Roth conversions and one-time sales of a business, farmland or a second home.
Your Ohio return doesn't matter. Only your federal MAGI does.
What to do if you get an IRMAA notice
Social Security mails a notice explaining the amount and the income it used. If you retired, cut back work, lost a pension or your spouse died, file Form SSA-44 to ask Social Security to use a newer, lower year; see how to lower IRMAA after you retire. If you don't get Social Security, Medicare bills the Part B IRMAA every 3 months and the Part D IRMAA monthly; pay them on time. Estimate your amount with the IRMAA calculator. For questions about plan choices at your income, you can request a call from a licensed insurance agent.
Related questions
How do I lower IRMAA after I retire?
Form SSA-44, step by step.
How much is Part B in 2027?
Where the 2027 amounts stand.
What does Medicare cost per month in Ohio?
All the monthly pieces.
Sources
- Social Security — Premiums: rules for higher-income beneficiaries
- CMS — 2026 Medicare Parts A & B premiums and deductibles (IRMAA tables)
- Social Security POMS HI 01101.010 — MAGI and the tax year used
- Medicare.gov — Pay Medicare premiums (IRMAA bills)
- SERS — 2027 Member Health Care Guide (Part D IRMAA) (PDF)
More questions in this guide
- Do I have to pay a premium for Medicare Part A?
- How do I lower my IRMAA after I retire?
- How much does Medicare cost per month in Ohio?
- How much is Medicare Part B in 2027?
Part of the guide: Medicare costs in 2026 for Ohioans · All questions
Frequently asked questions
Does my Ohio state tax return affect IRMAA?
No. Social Security uses only the income the IRS reports from your federal return. Ohio deductions and credits don't change it.
Do I pay the Part D IRMAA if my drug coverage comes from STRS Ohio or SERS?
Yes. The group plans STRS Ohio and SERS offer include Part D, so the Part D IRMAA applies to members over the income line. Medicare bills it, and SERS warns that its coverage can end if a member doesn't pay it.
Is IRMAA permanent?
No. Social Security looks at your income again every year. If your income falls, your IRMAA falls or ends, usually two years later, or sooner if you report a life-changing event on Form SSA-44.
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