Basics
IRMAA and your Social Security check
If you receive Social Security, your Part B premium, including any IRMAA, and your Part D IRMAA are normally deducted before your benefit is deposited. In a higher tier that can take hundreds of dollars a month out of your check, and the hold-harmless rule that protects most retirees from premium increases does not apply to people who pay IRMAA.
What gets deducted
When you are on Medicare and receiving Social Security, Social Security withholds your Part B premium from your monthly payment. If you pay IRMAA, the Part B amount withheld is the higher premium for your tier, and the Part D surcharge is withheld too, even though your drug plan premium itself may be billed separately or withheld only if you asked for that. Your deposit is what remains.
If you are not receiving Social Security yet, for example because you are delaying benefits to 70, Medicare bills you directly every month or quarter for the same amounts. The cost is identical; only the payment method differs.
Net benefit by tier
The table takes a gross Social Security benefit of $2,500 a month and subtracts the 2026 Part B premium and Part D surcharge for each tier. It leaves out your drug plan's own premium, which varies by plan.
| Tier (individual MAGI) | Gross benefit | Part B | Part D IRMAA | Net deposit |
|---|---|---|---|---|
| Standard (up to $109,000) | $2,500.00 | −$202.90 | $0.00 | $2,297.10 |
| Tier 1 (to $137,000) | $2,500.00 | −$284.10 | −$14.50 | $2,201.40 |
| Tier 2 (to $171,000) | $2,500.00 | −$405.80 | −$37.50 | $2,056.70 |
| Tier 3 (to $205,000) | $2,500.00 | −$527.50 | −$60.40 | $1,912.10 |
| Tier 4 (to $499,999) | $2,500.00 | −$649.20 | −$83.30 | $1,767.50 |
| Top tier ($500,000 or more) | $2,500.00 | −$689.90 | −$91.00 | $1,719.10 |
Between the standard tier and the top tier, the same $2,500 benefit deposits $578 a month less. For a married couple both on Medicare and in the same tier, double the deductions.
Hold harmless does not cover IRMAA
Social Security's hold-harmless provision prevents most beneficiaries' net checks from shrinking when a Part B premium increase is larger than their cost-of-living adjustment. In those years, their Part B increase is capped at the dollar amount of their COLA. The protection does not apply to three groups: people new to Medicare or Social Security that year, people whose Part B premium is paid by Medicaid, and people who pay IRMAA. If you pay IRMAA, the full premium increase is deducted, even if it uses up your whole COLA.
A worked example
Richard is single with a $2,500 monthly Social Security benefit. His 2024 MAGI of $150,000 puts him in tier two for 2026. His deductions are $405.80 for Part B and $37.50 for Part D IRMAA, a total of $443.30, leaving a deposit of $2,056.70. His drug plan bills him separately for $12 a month. In 2025 his MAGI was $105,000, below the limit, so for 2027 he expects to return to the standard premium, adding more than $240 a month back to his deposit, plus whatever cost-of-living increase applies.
Reading your benefit statement
Your annual benefit letter and the monthly details in your my Social Security account list the gross benefit, each Medicare deduction and the net payment. IRMAA is usually shown within the Part B and Part D amounts rather than as a separate line called "IRMAA," so compare the Part B figure with the standard premium of $202.90. Anything higher is IRMAA. Your Form SSA-1099 at tax time also shows the total Medicare premiums deducted during the year, which matters if you itemize medical expenses.
When a deduction changes
- New year, new decision. Each January the deduction resets to the new year's tier and premium.
- After an appeal. If Form SSA-44 or a reconsideration lowers your tier, future deductions drop and any overpayment is refunded or credited.
- If benefits start mid-year. Direct billing switches to deduction from your check, usually within a few months.
- Not enough benefit to cover it. If your benefit is smaller than the premiums, Medicare bills you for the difference.
Budgeting for the change
Because the deduction comes out before the money reaches your bank, a move into an IRMAA tier shows up as a smaller deposit rather than a bill, and it is easy to miss until a monthly budget stops balancing. If you know a high-income year is coming, such as a Roth conversion or a home sale, mark the premium year two years later on your calendar and lower your planned spending for that year by the difference in the table above. When the income spike passes, the deposit rises again the following January.
Find your tier and see how much Medicare will take from each check.
Open the IRMAA calculatorFrequently asked questions
Is IRMAA taken out of my Social Security check?
Why did my check go down even though I got a COLA?
What if I have not started Social Security?
Where can I see the amount?
Sources
- Social Security: Premiums, rules for higher-income beneficiaries
- CMS: 2026 Medicare Parts B premiums and deductibles
- Medicare.gov: Ways to pay Medicare premiums