IRMAA by State
IRMAA is federal, so the rules are identical in every state. What changes from state to state is how many retirees earn enough to be affected. Here is how that plays out in Florida, Texas, and Arizona.
IRMAA is the same in all 50 states
IRMAA is set by the Social Security Administration using federal income thresholds, so the brackets and surcharge amounts do not change when you cross a state line. A single filer with the same Modified Adjusted Gross Income pays the same Part B and Part D surcharge whether they live in Miami, Houston, or Phoenix. You can see those uniform figures on our 2026 IRMAA brackets page.
Even moving to a state with no income tax does not change your IRMAA, because the surcharge is based on your federal MAGI, not your state tax return. So the real state-to-state difference is not the rule — it is the share of retirees whose incomes are high enough to trigger it. States with large retiree populations simply contain more high-income households who reach the brackets.
How it looks in three big retirement states
The figures below describe each state’s broader Medicare market — total population over 65, typical Medigap premiums, and Medicare Advantage enrollment. They are not IRMAA-specific counts, but they help explain why a larger or wealthier retiree base tends to mean more residents hitting the IRMAA thresholds.
In Florida
- Residents 65 and older: roughly 4,500,000. A large retiree base means more high-income households who can cross the federal IRMAA brackets.
- Average Medigap premium: about $175/month — a sense of typical out-of-pocket premium costs that IRMAA stacks on top of for higher earners.
- Medicare Advantage enrollment: about 54% of beneficiaries. Whether you choose Advantage or Original Medicare, any IRMAA surcharge is the same federal amount, because it applies to Part B and Part D regardless of how you get your coverage.
In Texas
- Residents 65 and older: roughly 3,800,000. A large retiree base means more high-income households who can cross the federal IRMAA brackets.
- Average Medigap premium: about $165/month — a sense of typical out-of-pocket premium costs that IRMAA stacks on top of for higher earners.
- Medicare Advantage enrollment: about 47% of beneficiaries. Whether you choose Advantage or Original Medicare, any IRMAA surcharge is the same federal amount, because it applies to Part B and Part D regardless of how you get your coverage.
In Arizona
- Residents 65 and older: roughly 1,400,000. A large retiree base means more high-income households who can cross the federal IRMAA brackets.
- Average Medigap premium: about $155/month — a sense of typical out-of-pocket premium costs that IRMAA stacks on top of for higher earners.
- Medicare Advantage enrollment: about 52% of beneficiaries. Whether you choose Advantage or Original Medicare, any IRMAA surcharge is the same federal amount, because it applies to Part B and Part D regardless of how you get your coverage.
In all three states, the takeaway is identical: IRMAA itself does not differ, but a deep, often affluent retiree population — Florida’s snowbirds, Texas’s large metros, Arizona’s retirement communities — means plenty of residents who land in a surcharge tier.
What to do wherever you live
Because the rules travel with you, the planning is the same in every state. Check where your income lands using our 2026 brackets, and if you are near a threshold, explore our IRMAA planning strategies for managing your MAGI across tax years. Start with the IRMAA overview if you are new to the surcharge.
Frequently Asked Questions
Does IRMAA vary by state?
No. IRMAA is a federal calculation, so the income thresholds and surcharge amounts are identical in all 50 states. The only thing that differs by state is how many local retirees have incomes high enough to trigger it.
Why do some states seem to have more IRMAA payers?
States with large or higher-income retiree populations naturally have more residents who cross the IRMAA thresholds. The rule is the same everywhere; the share of people affected reflects local incomes, not different Medicare rules.
If I move to a no-income-tax state, will my IRMAA change?
Not because of the move itself. IRMAA is based on your federal MAGI, which does not depend on your state. State income taxes are separate from how Medicare calculates your surcharge.
Where can I see the actual IRMAA amounts?
The federal brackets apply to your state. See our 2026 IRMAA brackets page for the exact thresholds and monthly Part B and Part D amounts.
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Get My Free ReviewThis information is for educational purposes only and is not legal, tax, or insurance advice. Medicare rules, premiums, and income thresholds change annually — confirm current figures with Medicare.gov, the Social Security Administration, or a licensed advisor. HealthPlan Connect is not affiliated with or endorsed by the federal Medicare program or any government agency. Last reviewed 2026-06-11 by Lynsey Brennan, Licensed Medicare Advisor (FL #G007269).