2026 Medicare IRMAA Brackets: What Triggers Higher Premiums and How to Avoid

Medicare IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to Medicare Part B and Part D premiums when your income exceeds certain thresholds. These surcharges are based on your Modified Adjusted Gross Income (MAGI) from two years prior. At Greenbush Financial Group, our analysis shows that proactive tax and withdrawal planning can help retirees avoid or minimize IRMAA and significantly reduce long-term healthcare costs.

What Is Medicare IRMAA and How Does It Work?

IRMAA is an additional premium Medicare beneficiaries pay if their income exceeds specific limits.

Key Facts

• Applies to Medicare Part B and Part D

• Based on income from two years prior

• Uses Modified Adjusted Gross Income (MAGI)

• Adjusted annually for inflation

Example

Your 2026 Medicare premiums are based on your 2024 income.

This lag creates planning opportunities, especially in early retirement years.

2026 IRMAA Income Limits and Surcharge Brackets

IRMAA is triggered when your income crosses certain thresholds.

2026 Estimated IRMAA Thresholds 

At Greenbush Financial Group, we emphasize that even $1 over a threshold can trigger a significantly higher premium.

What Counts as Income for IRMAA (MAGI)?

IRMAA is based on Modified Adjusted Gross Income, which includes more than just wages.

Included Income Sources

• IRA and 401(k) withdrawals

• Capital gains from investments

• Dividends and interest

• Rental income

• Social Security (partially taxable portion)

• Roth conversions

Important Note

Tax-free municipal bond interest is also included in MAGI for IRMAA purposes.

How Much Are IRMAA Surcharges?

IRMAA increases both Part B and Part D premiums.

Example Impact

• Standard Part B premium (baseline)

• IRMAA can increase premiums by hundreds of dollars per month per person

• Part D surcharges are smaller but still meaningful

Key Insight

Over a 10–20 year retirement, IRMAA can add up to tens of thousands of dollars in additional healthcare costs if not managed properly.

Planning Strategies to Reduce or Avoid IRMAA

Strategic income planning is the most effective way to manage IRMAA.

1. Manage Your Taxable Income Each Year

• Stay below key IRMAA thresholds when possible

• Avoid large one-time income spikes

2. Use Roth Conversions Strategically

• Convert funds in lower-income years before Medicare

• Reduce future taxable income and RMDs

3. Time Large Withdrawals Carefully

• Spread income over multiple years

• Avoid triggering IRMAA in a single year

4. Leverage Roth Accounts

• Roth withdrawals do not increase MAGI

• Provides tax-free income flexibility

5. Consider Capital Gains Timing

• Harvest gains in lower-income years

• Offset gains with losses when possible

At Greenbush Financial Group, we often build multi-year tax projections to help clients stay below IRMAA thresholds.

IRMAA Planning Before and After Retirement

Before Retirement (Ages 55–63)

• Ideal window for Roth conversions

• Lower income years create planning opportunities

• Reduce future IRMAA exposure

Early Retirement (Before Medicare)

• Control income levels carefully

• Balance withdrawals across accounts

After Age 65

• Monitor RMDs and income levels

• Use Roth withdrawals to manage thresholds

• Plan ahead for future income spikes

What Happens If Your Income Drops?

You may be able to appeal IRMAA if your income has decreased due to certain life events.

Qualifying Life-Changing Events

• Retirement

• Marriage or divorce

• Death of a spouse

• Loss of income-producing property

You can file an appeal with Social Security to request a lower premium.

Common IRMAA Mistakes to Avoid

• Ignoring IRMAA when doing Roth conversions

• Taking large IRA withdrawals in a single year

• Not planning for RMDs

• Overlooking capital gains impact

• Assuming Medicare premiums are fixed

At Greenbush Financial Group, we often see that IRMAA surprises retirees who focus only on taxes without considering healthcare costs.

Final Thoughts

IRMAA is one of the most overlooked retirement expenses, yet it can significantly increase your Medicare costs. The key is not just minimizing taxes in a single year but managing income over time to avoid crossing key thresholds.

At Greenbush Financial Group, our analysis shows that proactive planning around withdrawals, Roth conversions, and income timing can help reduce IRMAA and improve overall retirement outcomes.

Rob Mangold

About Rob……...

Hi, I’m Rob Mangold. I’m the Chief Operating Officer at Greenbush Financial Group and a contributor to the Money Smart Board blog. We created the blog to provide strategies that will help our readers personally, professionally, and financially. Our blog is meant to be a resource. If there are questions that you need answered, please feel free to join in on the discussion or contact me directly.

Frequently Asked Questions

1. What does IRMAA stand for?
   Income-Related Monthly Adjustment Amount, a surcharge on Medicare premiums based on income.
2. What income is used to calculate IRMAA?
   Modified Adjusted Gross Income (MAGI) from two years prior.
3. Can Roth withdrawals trigger IRMAA?
   No, qualified Roth withdrawals do not increase MAGI.
4. Can IRMAA be appealed?
   Yes, if you have a qualifying life-changing event such as retirement or loss of income.
5. How can I avoid IRMAA surcharges?
   By managing taxable income, using Roth strategies, and avoiding large income spikes.

2026 Roth IRA Conversions Explained: Smart Timing and Costly Mistakes

Roth conversions can be one of the most powerful tax planning tools in retirement, but they are not always beneficial. A Roth conversion involves moving money from a pre-tax account into a Roth account and paying taxes now to avoid taxes later. At Greenbush Financial Group, our analysis shows that Roth conversions are most effective when done strategically across multiple years, not as a one-time decision.

What Is a Roth Conversion and How Does It Work?

A Roth conversion moves funds from a Traditional IRA or 401(k) into a Roth IRA or 401(k).

Key Mechanics

• Converted amount is taxed as ordinary income

• No early withdrawal penalty if done correctly

• Future growth and withdrawals are tax-free

• No Required Minimum Distributions (RMDs) for Roth IRAs

Example

• Convert $50,000 from an IRA to a Roth IRA

• Pay taxes on $50,000 this year

• Future withdrawals are tax-free

At Greenbush Financial Group, we view Roth conversions as a way to “prepay taxes” at potentially lower rates.

When Roth Conversions Make Sense

There are specific scenarios where Roth conversions can significantly improve long-term outcomes.

1. Low-Income Years in Early Retirement

The period between retirement and starting Social Security or RMDs is often ideal.

• Lower taxable income

• Opportunity to fill lower tax brackets

• Reduce future tax burden

2. Before Required Minimum Distributions (RMDs)**

RMDs can force higher taxable income later in retirement.

• Converting early reduces future RMDs

• Helps avoid higher tax brackets in your 70s

3. Expecting Higher Future Tax Rates

If you believe your future tax rate will be higher:

• Paying taxes now may be beneficial

• Locks in current tax rates

4. Large Pre-Tax Account Balances

High IRA or 401(k) balances can create tax challenges later.

• Large RMDs

• Increased IRMAA surcharges

• Higher Social Security taxation

5. Leaving Assets to Heirs

Roth accounts can be more tax-efficient for beneficiaries.

• Tax-free withdrawals for heirs

• No lifetime RMDs for original owner

At Greenbush Financial Group, Roth conversions are often used as part of a broader estate and tax planning strategy.

When Roth Conversions May Not Make Sense

Roth conversions are not always the right move.

1. Already in a High Tax Bracket

If converting pushes you into a higher bracket:

• You may pay more tax than necessary

• Reduces the benefit of the conversion

2. Short Time Horizon

If you expect to use the money soon:

• Limited time for tax-free growth

• Less benefit from conversion

3. Paying Taxes From the Conversion Itself

Using IRA funds to pay taxes reduces the amount converted.

• Decreases long-term growth potential

• Less efficient overall

4. Expecting Lower Future Tax Rates

If your income will decrease later:

• You may pay more tax now than necessary

5. Impact on Medicare and Social Security

Conversions increase taxable income.

• May trigger IRMAA surcharges

• Can increase taxation of Social Security

At Greenbush Financial Group, we often see Roth conversions backfire when these factors are not considered.

The “Tax Bracket Filling” Strategy

One of the most effective ways to approach Roth conversions is by filling up lower tax brackets.

How It Works

• Identify your current tax bracket

• Convert just enough to stay within that bracket

• Avoid jumping into higher brackets

Example

• Top of 12% bracket = target income level

• Convert enough to reach that limit

• Stop before entering the 22% bracket

This strategy spreads conversions over multiple years, reducing overall tax impact.

Roth Conversions and IRMAA Considerations

Roth conversions increase your income for that year, which can affect Medicare premiums.

Key Impact

• Higher income can trigger IRMAA surcharges

• IRMAA is based on income from two years prior

Planning Tip

Balance Roth conversions with IRMAA thresholds to avoid unnecessary premium increases.

A Multi-Year Roth Conversion Strategy Example

Scenario

• Age 62, recently retired

• $800,000 in IRA

• Low income before Social Security

Strategy

• Convert $40,000–$60,000 annually

• Stay within a lower tax bracket

• Delay Social Security

Outcome

• Reduced future RMDs

• Lower lifetime taxes

• Increased tax-free income later

At Greenbush Financial Group, this type of phased approach is often more effective than a single large conversion.

Common Roth Conversion Mistakes

• Converting too much in one year

• Ignoring tax bracket thresholds

• Overlooking IRMAA impacts

• Not coordinating with Social Security timing

• Failing to plan conversions over multiple years

Final Thoughts

Roth conversions can be a powerful tool, but only when used strategically. The goal is not simply to convert assets, but to reduce lifetime taxes and create more flexibility in retirement income.

At Greenbush Financial Group, our analysis shows that the most successful strategies involve careful timing, tax bracket management, and long-term planning.

Rob Mangold

About Rob……...

Hi, I’m Rob Mangold. I’m the Chief Operating Officer at Greenbush Financial Group and a contributor to the Money Smart Board blog. We created the blog to provide strategies that will help our readers personally, professionally, and financially. Our blog is meant to be a resource. If there are questions that you need answered, please feel free to join in on the discussion or contact me directly.

1. Is it a bad idea to retire in a down market?
   Not necessarily, but it increases sequence of returns risk and requires careful planning.
2. How much cash and short-term fixed income should I have in retirement?
   Typically 1 to 3 years of living expenses.
3. Should I stop withdrawals during a downturn?
   Not entirely, but reducing withdrawals can improve long-term outcomes.
4. Can a market downturn ruin my retirement plan?
   It can if not managed properly, especially in the early years of retirement.
5. What is the best strategy during a market downturn?
   Maintain a cash reserve, adjust withdrawals, stay invested, and focus on long-term planning.