The way to avoid IRMAA — Medicare’s income-based surcharge on Part B and Part D premiums — is to keep your modified adjusted gross income at or below $109,000 as a single filer or $218,000 filing jointly, per the Social Security Administration. Because Medicare measures income from two years earlier, avoiding a surcharge on your 2026 premiums means that line mattered on your 2024 tax return, but don’t worry — many people can appeal it.
Revised: 7/24/26
Jason Baar
Fee-Only Medicare Advisor
NPN #2033715
It shows where Medicare’s five income lines sit in 2026, what counts toward them, and the timing moves that can keep you under.
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The long answer
Modified adjusted gross income, or MAGI, is your adjusted gross income plus tax-exempt interest. Almost everything you would call income feeds it: wages, IRA and 401(k) withdrawals, Roth conversions, capital gains, pensions, and the taxable part of Social Security.
The practical levers are timing and source. Spend from Roth accounts, which do not add to MAGI, in years when a traditional-IRA withdrawal would push you over the line. Spread large stock sales or Roth conversions across several years instead of stacking them into one. If you give to charity, giving directly from an IRA keeps that money out of your income entirely.
Two caveats worth naming. First, the planning has to start early — the income year that sets your first premiums at age 65 is usually the year you turn 63. Second, avoiding IRMAA is not always the winning move. A large Roth conversion that triggers one year of surcharges can still come out well ahead over a full retirement. Treat IRMAA as a cost to weigh, not a wall.
Printed from JasonKnowsMedicare.com — “How to Avoid IRMAA”. The free IRMAA Planning Guide is available at tally.so/r/81gEEA · 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.