Selling a house affects IRMAA only if the sale produces a taxable gain. For a primary residence, the IRS lets you exclude up to $250,000 of gain — $500,000 for a married couple filing jointly — so only gain above the exclusion counts toward the income Medicare measures; a second home, rental, or investment property gets no exclusion at all.
Revised: 7/24/26
Jason Baar
Fee-Only Medicare Advisor
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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
Any taxable gain flows into adjusted gross income and from there into modified adjusted gross income, the figure Medicare checks when setting IRMAA — the income-based surcharge added to Part B and Part D premiums. The 2026 thresholds are $109,000 for single filers and $218,000 for joint filers, per the Social Security Administration, and the timing is delayed: a 2024 sale shows up in 2026 premiums.
Two cautions. Selling your home is not a qualifying life-changing event, so form SSA-44 cannot undo a surcharge caused by a sale. And before assuming a big taxable gain, work out your real cost basis — the purchase price plus documented improvements over the years — because many long-held homes clear the exclusion by less than their owners fear.
If a surcharge does hit, it lasts one year. The following year Medicare reads a newer return, the gain is gone, and premiums reset on their own.
Printed from JasonKnowsMedicare.com — “Does Selling a House Affect 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.