Yes, Social Security does count as income for Medicare, but only the taxable portion feeds into the figure Medicare uses to set your premiums. That figure, called Modified Adjusted Gross Income, decides whether you pay the standard Part B and Part D amounts or a surcharge on top. At the other end of the income scale, your full Social Security benefit counts when Medicare checks whether you qualify for programs that reduce those costs.
How Medicare Counts Your Social Security
Medicare uses Modified Adjusted Gross Income (MAGI) to decide what you pay. For Medicare, MAGI is your adjusted gross income from line 11 of your federal tax return plus any tax-exempt interest, such as interest on municipal bonds.1Social Security Administration. HI 01101.010 Modified Adjusted Gross Income (MAGI)
Social Security fits into that formula through your AGI. Depending on your total income, up to 85 percent of your benefits can be taxable, and whatever is taxable is already sitting inside your AGI.2Internal Revenue Service. IRS Reminds Taxpayers Their Social Security Benefits May Be Taxable The nontaxable portion is not added back separately, but the taxable share raises your MAGI and can push you into a higher premium tier.
When Higher Income Raises Your Premiums
Most enrollees pay the standard 2026 Part B premium of $202.90 per month. If your MAGI is above the threshold, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top. About 8 percent of Part B enrollees pay it.3Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles
The 2026 Part B surcharge kicks in above $109,000 for an individual filer or $218,000 for a joint filer. The tiers rise from an added $81.20 per month to a top surcharge of $487.00 per month at $500,000 (individual) or $750,000 (joint), which brings the total Part B premium to $689.90.3Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles
Part D uses the same income brackets, with smaller surcharges added to whatever your drug plan already charges. They range from $14.50 to $91.00 per month in 2026.3Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles Both surcharges are usually withheld from your monthly Social Security payment. If your benefit is too small to cover them, Medicare bills you directly.4Medicare.gov. Fact Sheet 2026 Medicare Costs
Filing status matters. Married couples who filed separately and lived together at any point in the year face a compressed bracket structure: separate-return MAGI between $109,001 and $390,999 jumps straight to a $446.30 monthly Part B surcharge, and above $391,000 the surcharge is $487.00.5Social Security Administration. Form SSA-44 Medicare Income-Related Monthly Adjustment Amount Life-Changing Event The lower IRMAA tiers other filers use are not available to you.
The Two-Year Lookback
Medicare does not use your current income. It uses the tax return you filed two years earlier, so your 2026 premiums come from your 2024 return. If that return was not yet available when the determination was made, Social Security may use your 2023 return instead.5Social Security Administration. Form SSA-44 Medicare Income-Related Monthly Adjustment Amount Life-Changing Event
A one-time income spike — selling a home, converting a traditional IRA to a Roth, or receiving a lump-sum payout — can raise your premiums two years down the line, long after the money is gone. Unless you ask for a reduction, your premium will still reflect that older return.
Asking for a Lower IRMAA After a Life Change
If your income has dropped since the tax year Medicare is relying on, you can ask Social Security to use a more recent or estimated figure by filing Form SSA-44.6Social Security Administration. Request to Lower an Income-Related Monthly Adjustment Amount (IRMAA) The request has to be tied to a qualifying life-changing event:
- Marriage, divorce or annulment, or the death of a spouse
- Work stoppage, including full retirement or job loss
- Work reduction, such as moving to part-time or lower-paying work
- Loss of income-producing property due to disaster or fraud
- Loss of pension income
- An employer settlement payment resulting from employer bankruptcy
Bring documentation: a signed statement from a former employer, a certified divorce decree, or a pension administrator’s letter explaining reduced benefits. If you cannot get employer documentation, Social Security will accept your signed statement on the SSA-44 itself, made under penalty of perjury.5Social Security Administration. Form SSA-44 Medicare Income-Related Monthly Adjustment Amount Life-Changing Event
When Social Security Is Low Enough to Lower Your Costs
At the other end of the scale, Social Security counts differently. For Medicare Savings Programs and the Extra Help prescription-drug subsidy, your full Social Security benefit — the amount before any deduction for Medicare premiums, tax withholding, or overpayment recovery — is treated as unearned income.7Social Security Administration. What You Need To Know About Extra Help With Medicare Prescription Drug Plan Costs The first $20 of monthly unearned income is disregarded when eligibility is calculated.
The two most common Medicare Savings Programs are:
- Qualified Medicare Beneficiary (QMB) covers Part A and Part B premiums, deductibles, and coinsurance. The 2026 monthly income limit is $1,350 for an individual or $1,824 for a married couple, with a resource limit of $9,950 or $14,910.
- Specified Low-Income Medicare Beneficiary (SLMB) covers the Part B premium only. The 2026 monthly income limit is $1,616 for an individual or $2,184 for a married couple, with the same resource limits as QMB.
Extra Help reduces Part D premiums, deductibles, and copayments. In 2026, annual income generally cannot exceed $23,475 for an individual or $31,725 for a married couple living together.9Social Security Administration. Understanding the Extra Help With Your Medicare Prescription Drug Plan Costs For the full benefit, resources cannot exceed $16,590 as an individual or $33,100 as a couple, with higher limits if you set aside funds for burial expenses.10Centers for Medicare & Medicaid Services. Calendar Year 2026 Resource and Cost-Sharing Limits for Low-Income Subsidy Your primary home, one vehicle, and most personal belongings are not counted.
Some states apply higher income limits or have dropped the asset test, so check with your state Medicaid office even if you look slightly over the federal thresholds.