How to not pay Irmaa?


Editorial team Published on

To avoid the Income-Related Monthly Adjustment Amount (IRMAA) surcharge on your Medicare Part B and Part D premiums, you must manage and lower your Modified Adjusted Gross Income (MAGI). Medicare looks at your MAGI from two years prior (for example, 2026 premiums are based on your 2024 tax return), meaning proactive planning is essential.

Key Strategies to Reduce MAGI and Avoid IRMAA

  • Use Qualified Charitable Distributions (QCDs): If you are age 70½ or older, you can transfer up to $111,000 directly from your traditional IRA to a qualified charity. This counts toward your Required Minimum Distributions (RMDs) without adding to your taxable income or MAGI.
  • Draw from Roth Accounts and HSAs: Withdrawals from Roth IRAs, Roth 401(k)s, and Health Savings Accounts (HSAs) do not count toward your MAGI. Structuring your retirement withdrawals to lean on these accounts can keep your reported income below the IRMAA thresholds.
  • Spread Out Large Income Events: Avoid large, one-time spikes in taxable income—such as selling a home, realizing major capital gains, or executing large traditional IRA withdrawals—in a single calendar year. Spread these transactions across multiple years or harvest capital losses to offset your gains.
  • Mind "Hidden" Income: Remember that tax-exempt interest, such as interest from municipal bonds, is included in the Medicare MAGI calculation even though it is not taxed on your federal return.
  • Watch Out for Roth Conversions: Doing Roth conversions in your early retirement years (before RMDs start) can reduce future taxable income, but conversion-year income can temporarily trigger an IRMAA surcharge. Keep conversion amounts carefully mapped below the threshold "cliffs".

How to Appeal an IRMAA Surcharge

If your income has dropped due to a major life-changing event, you do not have to wait two years for your premiums to adjust. Qualifying events include:

  • Retirement or work stoppage
  • Marriage, divorce, or the death of a spouse
  • Loss of income from property, a pension, or work

To request a reduction, file Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event) with the Social Security Administration along with proof of your qualifying event and current income. You can review guidance and get official details directly from the Social Security Administration.