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I never heard about IRMAA until I innocently converted $100,000 from my Traditional IRA to my Roth IRA.

IRMAA ( Income-Related Monthly Adjustment Amounts) are a surcharge on Medicare premiums for people whose MAGI is higher than a certain amount.
cms.gov
2026 Medicare Parts A & B Premiums and Deductibles | CMS

2026 Medicare Parts A & B Premiums and Deductibles2026 Medicare Part D Income-Related Monthly Adjustment AmountsOn November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the 2026 premiums, deductibles, and coinsurance amounts...

This really bites because it applies to all taxable income including Roth conversions and IRA RMDs (required minimum distributions) which don’t bring fresh money into the household but are simply shifting the same money from one pocket into a different pocket.

https://www.wsj.com/personal-finance/taxes/what-is...


The Medicare Charge That’s Taking a Bigger Bite Out of Social Security Checks
Nearly six million seniors owe extra Medicare premiums called Irmaa, and these charges are set to rise

By Laura Saunders, The Wall Street Journal, Jan. 23, 2026

…
Seniors see the rising cost of Medicare Part B premiums (for doctors and outpatient care) and Part D premiums (for drugs) reduce their Social Security payments. This is especially true for those who are affluent and owe charges called “income-related monthly adjustment amounts,” or Irmaa…

Medicare Irmaa charges for about six million, higher-earning Americans today are projected to rise significantly. According to the 2025 Medicare Trustees Report, overall Part B Irmaa charges alone are expected to increase 30% from 2026 to 2030…

Like basic premiums for Medicare, Irmaa charges are calculated annually based on the expected costs of the program—not the inflation increases used by Social Security.

For 2026, five income tiers of earners who pay for Part B or Part D are subject to Irmaa. Medicare recipients in these tiers are expected to pick up 35%, 50%, 65%, 80% or 85%, respectively, of their projected Medicare cost through premiums, rather than 25%… [end quote]


Every word of this article is useful but I can’t copy it due to copyright infringement.

If you are in a higher income range try to spread out your income.

One possible way is to do an IRA QCD annuity. This is a fairly new law which some charities (including universities) offer. There are lots of rules.


A life event (such as divorce or death of a spouse) can qualify for escaping IRMAA. Form SSA-44. This is important because the “widow’s penalty” of changing from Married Filing Jointly to Single can hit at the same time as IRMAA which is based on income from 2 years earlier.

Wendy

If you are in a higher income range try to spread out your income.

Yes indeed. I carelessly ran a touch over the break point a few years ago.

I have been pulling money from my conventional IRA ever since 59 1/2, as pulling smaller amounts sooner, rather than letting the pot build, makes for smaller RMDs in the future. I turn 73 this year, so the RMDs will start. By my calculation, having already taken over $300K out of the IRA, my calculations say that my RMDs will be only slightly more than what I have been taking out all along, so should still be under the break point for the Medicare premiums.

Steve

I'll do my best to avoid IRMAA, but it's inevitable that most all of the readers of this Board will pay IRMAA at some point in time.

But when compared to what the pre Medicare folks are going to be paying, us older people don't have it bad.

2026 IRMAA Brackets
Individual MAGI Couple MAGI Part D
$134,000 – $169,000 $268,000 – $338,000 Premium + $37.50
$169,000 – $202,000 $338,000 – $404,000 Premium + $60.40
$202,000 – $500,000 $404,000 – $750,000 Premium + $83.30

Everybody can do the math. The Part-B charge for 2026 is $283/month,
I believe. Annually, this comes to $3396. If you end up in the
1st IRMAA tier, you're looking at (283+37.50)*12= $3846 annually.

A lot of ACA consumers would luv to have that cost of healthcare.
( and of course there is Part D, and a supplement plan for some ).
Us older folks are not getting gouged nearly as bad as the younger
folks, according to what I'm reading. But the current regime will
be doing everything they can to drive our costs higher, so even the
relatively secure older people need to pay attention to what is going on in Washington.

upnorthjoe,
absolutely, i would gladly take medicare earlier if possible, having paid non-subsidized healthcare since FIRE.
but concerns about any\all of these stealth taxes are magnified because there is so much attraction for gop grift & cronyism.

neither party much wants to touch the 'headline' personal (zero business mix) tax brackets.
but many stealth taxes have a history of getting passed without much worry that enough of the public understands them.
and, scarily, these can have (and some do) have nonlinear thresholds with big leaps, all precedents for more such.

partial list :
irmaa
investment tax
AMT

on the other side, pretty much all significant deductions have become near zero (thus already at a floor) , other than the standard deduction.
so concerns over deductions becomes secondary to retrospective changes to roth and\or IRA and\or nonqualified plans.
and dropping the inheritance tax limit to <$1m in the boomer demise era would reap trillions for a decade plus. (hooray! more for ICE and supercarrier strikes on fishermen)

i guess there is some safety in that trump cant do much here via tweet and EO, but he is not above trying such. my guess is there would need to be an angle that further boosts crypto scams that the gop continue to support as a whole. (e.g., lower tax due for IRA holding crypto assets converted to roth)

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