Does Social Security Count for IRMAA?

Social Security retirement benefits are not reduced by your savings or investment income, but they can still affect Medicare costs. The taxable part of your benefits is included in the income Medicare reviews for IRMAA surcharges two years later, and higher income may also make more of your benefits taxable. Both effects depend on your whole tax return.

Rules reflect information as of November 2026.

If you are 5 to 10 years from retirement, or recently retired, the question is rarely only about the benefit check. Income you report in your early 60s may set Medicare premiums at 65, and the way Social Security is taxed may change how much of that income counts. This guide explains the links in plain language. It is educational and does not recommend a claiming age, a withdrawal order or any specific strategy for any person.

Is Social Security means-tested?

Not in the way many people expect. SSA bases retirement benefits on your work history, and the amount is not cut because you have savings or investment income. Three income tests still touch the same household, and each works differently:

1. The earnings test. If you claim before full retirement age and keep working, SSA may withhold benefits once earnings pass a yearly limit. For 2026 that limit is $24,480, per SSA's page on receiving benefits while working (as of November 2026). SSA recalculates your benefit at full retirement age to credit the months it withheld. The trade-off is tighter cash flow while you work.
2. Taxation of benefits. The IRS says your benefits are not taxable unless your modified adjusted gross income (MAGI) plus one half of your benefits is more than a base amount for your filing status, per IRS Topic 423. SSA gives the base amounts as $25,000 for individuals and $32,000 for joint filers, per its tax withholding page. Up to 85% of benefits can be taxable when one half of benefits plus other income is above $34,000, or $44,000 for joint filers, per IRS Publication 915. All figures are as of November 2026.
3. IRMAA. The income-related monthly adjustment amount is an added Medicare Part B and Part D premium for higher-income households. It does not reduce your Social Security benefit, but SSA says it deducts the Part D adjustment from your monthly Social Security payment, per SSA's Medicare premiums page.

So Social Security is not means-tested in the sense of losing benefits to income from savings, yet income can raise the tax on your benefits and the cost of your Medicare coverage. Each of these is a separate rule with a separate calculation.

What counts toward IRMAA income?

SSA defines the income it reviews as modified adjusted gross income, which it describes as your total adjusted gross income plus tax-exempt interest income, per SSA's Medicare premiums page. For 2026, the first surcharge applies above $109,000 for individuals and above $218,000 for married couples filing jointly, per that page (as of November 2026).

That answers the common question about Social Security. The taxable portion of your benefits flows into adjusted gross income, so it counts. The portion that is not taxable does not.

Source: SSA, Premiums: Rules for Higher-Income Beneficiaries (MAGI definition and 2026 thresholds); IRS Topic 423 (taxable benefits are reported on Form 1040); IRS Publication 590-B (qualified distributions from designated Roth accounts are not included in income). Rules reflect information as of November 2026.

The test looks at the whole return. A large capital gain, a Roth conversion or a final year of wages may matter more than the benefit itself. Our IRMAA brackets guide shows each 2026 tier, and the IRMAA planning guide explains how the pieces fit together.

How do the two-year look-back, claiming age and withdrawal order interact?

SSA generally uses the most recent federal tax return the IRS provides, which for 2026 premiums is usually the return for tax year 2024, per SSA's Medicare premiums page. Premiums for 2027 are generally based on 2025 income. As of November 1, 2026, we have not found a CMS announcement of the 2027 thresholds, so this article does not state them. Our IRMAA two-year look-back guide walks through the timing year by year.

Two planning choices connect Social Security to that timing:

• Claiming age. Benefits you start at 62 add to income for those tax years, and may count toward premiums two years later. Waiting may leave lower-income years before benefits begin, which some households use for planned withdrawals or Roth conversions. The trade-off is that the same withdrawals and conversions raise income in those years, and a delayed benefit means drawing more from savings first. Our Social Security claiming strategies guide covers the claiming trade-offs.
• Withdrawal order. Pulling from pre-tax accounts adds taxable income, while qualified Roth distributions are generally not included in income. Leaning on Roth or taxable accounts in one year may keep MAGI lower that year, but may leave larger pre-tax balances and required minimum distributions later. Our withdrawal order guide explains these trade-offs.

Neither choice is free of cost, and neither can be judged without a projection of several years of income.

What does a hypothetical example look like?

Hypothetical example for illustration only. A married couple files jointly, both are enrolled in Medicare, and they receive $60,000 of Social Security benefits in the same tax year. This example uses the 2026 premium table, which is based on 2024 income, because CMS has not announced 2027 figures. Scenario B adds a $15,000 IRA withdrawal.

Source: SSA, Medicare premiums (2026 first tier adds $81.20 to Part B and $14.50 to Part D per person per month, so two people pay about $2,297 over 12 months; our calculation). Taxable benefits are our calculation using the maximum 85% described in IRS Publication 915, which applies because the couple's income is well above $44,000. Figures are as of November 2026.

In this example, the extra $15,000 adds $15,000 to income, and the benefit was already taxed at the 85% maximum, so the benefit's taxable part does not rise further. At lower income levels, an added dollar of income can also raise the taxable part of benefits by up to 85 cents, which may make the combined effect larger.

The trade-offs run in both directions. Keeping income below the $218,000 line in this example would avoid the surcharge, but it may mean skipping a withdrawal or conversion that has its own value, such as filling a lower tax bracket or reducing later required minimum distributions. The surcharge applies to the full tier, so one dollar over the line triggers the whole amount. Some households may decide a surcharge is a reasonable cost for another goal. This example shows the mechanics only and does not suggest what any household should do.

What should we review before choosing a path?

These prompts are educational, not individualized advice:

1. What is your expected MAGI, including tax-exempt interest, in each of the two years before Medicare begins?
2. Which income events fall in those years, such as a final year of wages, equity compensation, a Roth conversion or a large capital gain?
3. How much of your Social Security benefit may be taxable at your expected income?
4. If your income drops after retirement, does a qualifying life-changing event apply? Our guide to appealing an IRMAA determination explains Form SSA-44, and approval is not guaranteed.

If you want to test a rough number first, the IRMAA calculator shows the 2026 tiers.

Frequently Asked Questions About Social Security and IRMAA

Sources

SSA: Premiums, Rules for Higher-Income Beneficiaries (2026 thresholds, premium table and MAGI definition; read November 1, 2026)

SSA: Receiving Benefits While Working (2026 earnings limit; read November 1, 2026)

SSA: Request to withhold taxes ($25,000 and $32,000 combined income amounts; read November 1, 2026)

IRS Topic 423, Social Security and equivalent Railroad Retirement benefits and IRS Publication 915 (taxation of benefits; read November 1, 2026)

IRS Publication 590-B, Distributions from Individual Retirement Arrangements (Roth distributions; read November 1, 2026)

Talk Through Medicare and Social Security Planning

If you are approaching Medicare and are not sure how Social Security, withdrawals, Roth conversions and future premiums fit together, a conversation with Patrick Thompson may help you see the trade-offs before you decide. We offer a complimentary 20-minute Fit Call to learn what you are trying to solve and to determine whether our planning approach is a good fit.

Sentient Financial, LLC is a state-registered investment adviser in California. This information is for educational purposes only and does not constitute individualized investment, tax, or legal advice. Nothing here should be taken as a recommendation to buy or sell securities or to implement a specific strategy. Investing involves risk, including the potential loss of principal. Hypothetical examples are for illustration only and are not guaranteed. For more information about our services and fees, please review our Form ADV Part 2A. Rules reflect information as of November 2026.