Avoiding IRMAA surcharges — the income-related amounts Medicare adds to Part B and Part D premiums — comes down to keeping modified adjusted gross income at or below $109,000 for a single filer or $218,000 for a joint filer, per the Social Security Administration, in the tax year Medicare measures. That measurement runs two years ahead of the premium year, so for premiums that begin at age 65, the watching usually starts in the year you turn 63.
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
The everyday levers are source and timing. A withdrawal from a Roth account adds nothing to measured income; the same dollars from a traditional IRA add in full. Capital gains can often be realized across two or three tax years instead of one. Charitable gifts made directly from an IRA never appear in your income at all.
Respect the cliffs. Every threshold is all-or-nothing — finishing a year at $109,001 instead of $109,000 triggers the entire first-tier surcharge. Near a line, small year-end moves matter more than big strategies.
And keep the goal in perspective: the point is not a perfect record of never paying a surcharge. Deliberately crossing a line once — for a Roth conversion that shrinks decades of future withdrawals, say — can be worth far more than years of skimming just underneath it. Avoid the accidental surcharges; weigh the deliberate ones.
Printed from JasonKnowsMedicare.com — “How to Avoid IRMAA Surcharges”. 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.