No — qualified Roth IRA distributions do not count towards IRMAA. Because a qualified Roth withdrawal is excluded from adjusted gross income, it never enters the modified adjusted gross income (MAGI) figure Medicare uses to decide who pays income-based premium surcharges.
Revised: 7/24/26
Jason Baar
Fee-Only Medicare Advisor
NPN #2033715
It covers Roth conversions, capital gains, home sales, filing status, and HSAs — with the 2026 bracket lines and worked examples.
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The long answer
“Qualified” carries two conditions from the IRS: the Roth account has been open at least five years, and you are past age 59½. For most people on Medicare, both were met long ago, and Roth withdrawals of any size are invisible to the IRMAA calculation.
The distinction people mix up is conversions versus distributions. Converting money from a traditional IRA into a Roth is taxable income in the conversion year, and it absolutely counts toward IRMAA. Taking money out of a Roth you already own does not.
This is what makes Roth dollars quietly valuable in retirement. The 2026 surcharges begin once MAGI passes $109,000 for a single filer or $218,000 for a joint filer, per the Social Security Administration. In a year when one more traditional-IRA withdrawal would cross a line, spending from the Roth instead covers the same expense without moving your premium at all.
Printed from JasonKnowsMedicare.com — “Do Roth Distributions Count Towards IRMAA?”. The free “Before You Sell the House or Convert That IRA” guide is available at tally.so/r/0QgAAZ · Questions: (850) 810-1000
This page is educational information, not personal financial, tax, or legal advice. For decisions about your own situation, talk with a qualified professional.