Your TRS-Care premium is only one part of your retirement health insurance bill. You also pay Medicare Part B, and a higher income can trigger an additional charge for both Part B and Medicare prescription drug coverage. That income-based charge is called IRMAA.
For a retired Texas teacher, the confusing part is that these amounts can be collected separately. A low TRS-Care premium does not mean Medicare will charge you the standard amount. And a pension that is smaller than your former salary does not necessarily mean Social Security has already recalculated your Medicare premium.
Quick answer: what should you check first?
Check the tax year, filing status, and modified adjusted gross income on your Social Security notice. Then separate your TRS-Care premium from your federal Medicare charges.
If you or your spouse stopped working or reduced work and household income fell, you may qualify to request a new IRMAA determination. Approval depends on the event, evidence, and income information. It is not an automatic benefit of retirement.
This guide uses 2026 federal Medicare amounts. The TRS-Care plan premium shown in its worked example is also for 2026. Do not use these amounts as a 2027 quote.
TRS-Care, Part B, and IRMAA are separate charges
| Charge | What it represents | What to check |
|---|---|---|
| TRS-Care Medicare Advantage premium | Your TRS retiree plan premium, including its Medicare Rx coverage | Coverage tier and plan year |
| Medicare Part B premium | Federal premium for Part B coverage | Standard amount or income-adjusted total |
| Part B IRMAA | Income-based addition to the standard Part B premium | SSA notice and applicable income bracket |
| Part D IRMAA | Income-based charge for Medicare prescription drug coverage | Separate federal charge, even when the retiree plan includes drug coverage |
Takeaway: Do not add the standard Part B premium a second time if your notice already shows the total income-adjusted Part B premium.
TRS explains that participants pay Part B separately and must maintain it to retain TRS-Care Medicare Advantage. Its included prescription coverage does not remove the federal Part D income adjustment. See TRS Medicare enrollment and premiums and SSA's higher-income premium rules.
Which income does Social Security use?
For Medicare IRMAA, SSA defines modified adjusted gross income, or MAGI, as adjusted gross income plus tax-exempt interest income. This is not simply your pension payment, take-home pay, or account balance.
For 2026, SSA generally uses your 2024 tax return, filed in 2025. It may initially use an earlier return if the more recent information was unavailable. The notice identifies the information behind its decision.
That delay matters when a teacher retires. Your Medicare bill may reflect a year with employment income even though you are now living on a pension. Conversely, stopping work does not guarantee a lower bracket if other taxable income keeps household MAGI high.
Keep the tax calculation separate from the pension payment record. Our guide to taxes on Social Security benefits discusses a different income test; its thresholds are not the Medicare IRMAA thresholds.
2026 IRMAA brackets for individual and joint returns
The following table covers single filers and married couples filing jointly with full Part B coverage. Married filing separately has different rules, particularly if spouses lived together during the tax year; use the separate table in the CMS source rather than applying these joint-return ranges.
| Individual-return MAGI | Married filing jointly MAGI | Total Part B premium per person/month | Part D IRMAA per person/month |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Over $109,000 through $137,000 | Over $218,000 through $274,000 | $284.10 | $14.50 |
| Over $137,000 through $171,000 | Over $274,000 through $342,000 | $405.80 | $37.50 |
| Over $171,000 through $205,000 | Over $342,000 through $410,000 | $527.50 | $60.40 |
| Over $205,000 but below $500,000 | Over $410,000 but below $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Source: CMS, 2026 Medicare premiums and income adjustments.
Takeaway: A joint tax return determines the income bracket, but these Medicare charges apply to each enrolled individual. The Part D column is an addition, not the person's entire prescription plan premium.
Example: a retired Texas teacher with $120,000 MAGI
Assume a single retiree has $120,000 of MAGI for the tax year used for the 2026 determination, full Part B coverage, Medicare prescription coverage, and retiree-only TRS-Care Medicare Advantage. Assume no late-enrollment penalties or other adjustments.
The 2026 TRS-Care guide lists a $75 monthly retiree-only premium.
The illustrative monthly premium budget is:
$75 TRS-Care + $284.10 total Part B + $14.50 Part D IRMAA = $373.60.
With no IRMAA, the same simplified 2026 premium budget would be $75 + $202.90 = $277.90. The difference is $95.70 per month, or $1,148.40 over 12 months.
These figures exclude medical cost-sharing, optional dental and vision premiums, any Part A premium, and other personal adjustments. They illustrate the billing structure, not a coverage recommendation.
The 2027 TRS-Care guide lists a different retiree-only plan premium. Do not combine a 2027 plan premium with 2026 federal amounts and label the result a 2027 estimate.
Can retirement reduce your IRMAA?
SSA recognizes work stoppage and work reduction among the life-changing events that may support a new determination. Your spouse's qualifying event can also matter. However, an income decline alone is not a promise of relief.
| Situation | Appropriate next step | Important distinction |
|---|---|---|
| You or your spouse stopped working and household income fell | Ask SSA about a life-changing-event request using SSA-44 | Include evidence of the event and income |
| SSA used an older return because newer information was unavailable | Contact SSA with the applicable newer return | This is an information update, not automatically an appeal |
| You amended the relevant tax return | Contact SSA with the amended return and IRS acknowledgment | Do not substitute a guessed income figure |
| You disagree with the determination | Follow the reconsideration instructions in your notice | A formal appeal differs from requesting a new decision after an event |
Takeaway: Identify why the bill is wrong or outdated before choosing the request. SSA explains these routes in its premium rules and IRMAA reduction instructions.
Prepare the evidence before submitting SSA-44
Use the current SSA-44 form and instructions. The form asks about the event, income already reduced, anticipated income changes, and supporting documents.
| Record | Why it helps |
|---|---|
| SSA premium determination notice | Identifies the decision and tax information used |
| Employer letter confirming retirement or reduced work | Supports the work-related event and date |
| Relevant tax return, if filed | Documents income for the year under review |
| Supported income estimate when requested | Reflects the pension and other expected income after the event |
| Evidence relating to another qualifying event | Supports the specific reason for the request |
Do not omit pension income when estimating the year after employment ends. Keep a copy of everything submitted and follow SSA's instructions if your estimate changes. Use the payment instructions in your Medicare notice while the request is pending; this article does not establish a suspension of billing.
For the separate question of getting care away from home, see TRS-Care Medicare Advantage outside Texas.
Frequently asked questions
Does TRS-Care pay my Medicare Part B premium?
No. TRS states that participants pay Part B separately. Maintaining Part B is required for TRS-Care Medicare Advantage.
Can Part D IRMAA apply if prescription coverage is included?
Yes. Included TRS-Care Medicare Rx coverage does not eliminate the federal income-based Part D charge for higher-income participants.
Does SSA use my current pension to decide the charge?
Not by itself. SSA generally uses tax-return MAGI from an earlier year. For 2026 that is usually the 2024 tax return, subject to updates and applicable new-determination rules.
Does retiring automatically remove IRMAA?
No. Work stoppage may support a request, but SSA must evaluate the event and income information. Other household income may keep you in an IRMAA bracket.
Do both spouses pay IRMAA on a joint return?
When both have the relevant Medicare coverage, the joint-return income bracket can result in separate charges for each person. The table amounts are per person, not per household.
Are the figures in this article for 2027?
No. The federal brackets and worked premium example are explicitly for 2026. Use the official amounts and plan documents for the year you are budgeting.
