What year's income does my 2026 IRMAA use?

Your 2024 tax return — a 2-year MAGI lookback. Medicare uses the most recent IRS-finalized data, which for 2026 is your 2024 return (filed in 2025). Your 2025 income will determine 2027 IRMAA. This delay means recent income changes don't immediately affect IRMAA; you generally have planning time.

Are Roth IRA distributions counted in IRMAA MAGI?

Generally no — qualified Roth IRA distributions don't count toward AGI or MAGI for IRMAA purposes. This makes Roth accounts a major IRMAA management tool for Ohio retirees. Traditional IRA, 401(k), 403(b), and pension distributions do count toward MAGI. Strategic Roth conversions before Medicare eligibility (or during low-MAGI years) can dramatically reduce future IRMAA exposure — though the conversion itself increases MAGI in the conversion year.

Can I appeal IRMAA after retiring?

Yes, retirement is a qualifying life-changing event. File Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event) with documentation of your retirement date and an estimate of your expected MAGI for the current year. Submit to your local Social Security office. If approved, your IRMAA is recalculated based on your post-retirement income estimate. This typically results in significantly lower IRMAA the first year or two after retirement, while your high working-year income still appears in the 2-year lookback.

Does selling my house affect IRMAA?

Possibly. Capital gains from selling a primary residence can push MAGI into higher IRMAA tiers. Federal tax law excludes $250,000 (single) / $500,000 (joint) of primary residence gain from taxable income — those excluded amounts DON'T count toward MAGI. Gains above the exclusion ARE taxable and DO count toward MAGI. For Ohio retirees with appreciated homes, the IRMAA impact of selling can be significant. Time the sale carefully or plan to use SSA-44 appeal in subsequent years (loss of income-producing property qualifies).

If I made a Roth conversion this year, will it affect IRMAA?

Yes — but with a 2-year delay. The conversion adds to your current year's MAGI. That higher MAGI affects IRMAA two years later. Example: $50,000 Roth conversion in 2024 raises your 2024 MAGI by $50,000, affecting your 2026 IRMAA. Plan conversions carefully — large conversions can produce significant IRMAA increases, especially if they push you across a bracket cliff. Spreading conversions across multiple years can sometimes optimize IRMAA exposure.

Does the IRMAA notice come from Medicare or Social Security?

From Social Security. CMS calculates IRMAA based on IRS data, and Social Security sends the Notice of Medicare Premium Payment each fall (typically September-October) for the following year's IRMAA. If you disagree with the determination or have a qualifying life event, file Form SSA-44 with your local Social Security office — not with CMS or Medicare directly.

Medicare IRMAA Bracket Calculator 2026 (Ohio)

On this page

Calculator
How IRMAA brackets work
The cliff effect — why $1 matters
Married Filing Separately rules
Appeals after a life event (SSA-44)
Ohio retiree-specific considerations
Common questions

Calculator

2026 IRMAA Bracket Calculator

Enter your 2024 MAGI and filing status to see your 2026 Medicare premium with IRMAA.

2024 filing status How you filed your 2024 federal tax return.

2024 MAGI (estimate) Adjusted Gross Income plus tax-exempt interest, from your 2024 tax return.

Your 2026 Medicare premium

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—/month total

Enter your 2024 MAGI above to see your tier and total cost. (Part D IRMAA is added to whatever your specific Part D or MA-PD plan premium is.)

This calculator uses official 2026 IRMAA brackets based on 2024 MAGI. CMS publishes adjusted brackets each fall. Part D IRMAA is added to your specific Part D or MA-PD plan's premium; the dollar amount shown above is the IRMAA surcharge alone, not the total Part D premium.

How IRMAA brackets work

IRMAA (Income-Related Monthly Adjustment Amount) is a premium surcharge for higher-income Medicare beneficiaries. Key features:

2-year MAGI lookback: Your 2026 IRMAA is based on your 2024 Modified Adjusted Gross Income — AGI plus tax-exempt interest plus foreign income exclusions plus a few smaller adjustments. CMS gets this data from the IRS automatically.
Two separate surcharges: Part B IRMAA adjusts your Part B premium; Part D IRMAA is added to your Part D plan's premium. Both apply if you're in any tier above Standard.
Annual recalculation: IRMAA brackets shift slightly each year based on inflation, and your tier can change as your income changes. CMS sends a "Notice of Medicare Premium Payment" each fall with your next year's IRMAA determination.
Automatic application: If you receive Social Security, IRMAA is deducted from your monthly check. If not, you're billed directly by CMS (typically quarterly).

See our IRMAA deep-dive for the full 2026 bracket table.

The cliff effect — why $1 matters

IRMAA brackets are cliffs, not phase-ins. There's no gradual transition between tiers — crossing a threshold by $1 moves you up the entire tier.

Example: A married couple has $217,999 MAGI in 2024. In 2026, each spouse pays the standard $202.90/month — total $405.80/month. If their MAGI had been $218,001 instead, each spouse would pay $284.10/month — total $568.20/month. $2 of additional income costs $1,948/year in additional Part B premium (and that's before Part D IRMAA's $14.50/month per spouse = $348/year additional).

Cliff management for income near a threshold

If your MAGI is approaching a bracket boundary, tax planning matters disproportionately. Common tactics: Qualified Charitable Distributions (QCDs) from IRAs to reduce MAGI; Roth conversions in lower-income years before Medicare-eligibility; timing capital gains for years below a threshold; tax-loss harvesting to offset gains; coordinating large distributions across years. Work with a tax advisor familiar with IRMAA. Even modest planning can save thousands per year for retirees near cliffs.

Married Filing Separately rules

Married Filing Separately (MFS) filers who lived with their spouse during the tax year face a punitive IRMAA structure:

No middle tiers: MFS goes from Standard ($202.90 at ≤$109K) directly to Tier 4 ($649.20 at $109K-$391K). There's no equivalent of the Single Tier 1, 2, or 3.
The penalty effect: An MFS filer with $130,000 MAGI pays $649.20/month — same as a Joint filer with $400,000+ MAGI. A Single filer with $130,000 MAGI pays only $284.10/month (Tier 1).
When MFS makes sense: rarely. Specific situations include income-driven student loan repayment strategies, certain estate planning scenarios, or when one spouse has tax issues you want to isolate. For most retired couples, Married Filing Jointly is dramatically better for IRMAA purposes.

Appeals after a life event (SSA-44)

If you've experienced a qualifying life-changing event that reduced your income from the 2-year-prior tax return, you can appeal IRMAA using Form SSA-44. Qualifying events:

Marriage, divorce, or annulment.
Death of spouse.
Work stoppage (retirement, layoff).
Work reduction (partial retirement, reduced hours).
Loss of income-producing property (other than through sale).
Loss of pension income.
Receipt of a settlement payment from a former employer.

Market losses, investment declines, and other non-event-driven income changes don't qualify. You must have experienced one of the specific listed events.

Submit Form SSA-44 with documentation of the life-changing event plus your estimated reduced MAGI for the current year. Decision timeline is typically several weeks. If approved, IRMAA is adjusted and any overpaid amounts refunded.

Ohio Medicare beneficiary facing IRMAA after retirement or another life event?A licensed Ohio Medicare agent can help you understand which life events qualify for SSA-44 appeals and walk you through the documentation. No cost to you.

Find a Medicare Agent in Ohio

Ohio retiree-specific considerations

IRMAA brackets are federal and identical nationwide, but several Ohio-specific factors interact with IRMAA:

Ohio public pensions count toward MAGI: OPERS, STRS Ohio, SERS, OP&F, and HPRS pension income is fully includable. Long-service Ohio public retirees with substantial pensions may face IRMAA from pension income alone.
Major Ohio employer retiree benefits: Goodyear (Akron), Timken (Canton), P&G (Cincinnati), NCR (Dayton historical), Marathon Petroleum (Findlay), and similar pension/retiree income contributes to MAGI.
FEHB/PSHB retirees from Wright-Patt, NASA Glenn, DSCC: FERS/CSRS annuities count toward MAGI. Federal civilian retiree pensions can be substantial — particularly for 30-40 year careers.
Roth IRA distributions don't count toward MAGI: For Ohio retirees who did pre-retirement Roth conversions or accumulated Roth balances, tax-free Roth distributions are a major IRMAA management tool.
Ohio state taxes are not deductible from MAGI for IRMAA purposes — federal MAGI rules apply.