I never heard about IRMAA until I innocently converted $100,000 from my Traditional IRA to my Roth IRA.

IRMAA ( Income-Related Monthly Adjustment Amounts) are a surcharge on Medicare premiums for people whose MAGI is higher than a certain amount.

2026 Medicare Parts A & B Premiums and Deductibles2026 Medicare Part D Income-Related Monthly Adjustment AmountsOn November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the 2026 premiums, deductibles, and coinsurance amounts...

This really bites because it applies to all taxable income including Roth conversions and IRA RMDs (required minimum distributions) which don’t bring fresh money into the household but are simply shifting the same money from one pocket into a different pocket.

wsj.com - What is irmaa medicare social security


The Medicare Charge That’s Taking a Bigger Bite Out of Social Security Checks
Nearly six million seniors owe extra Medicare premiums called Irmaa, and these charges are set to rise

By Laura Saunders, The Wall Street Journal, Jan. 23, 2026

…
Seniors see the rising cost of Medicare Part B premiums (for doctors and outpatient care) and Part D premiums (for drugs) reduce their Social Security payments. This is especially true for those who are affluent and owe charges called “income-related monthly adjustment amounts,” or Irmaa…

Medicare Irmaa charges for about six million, higher-earning Americans today are projected to rise significantly. According to the 2025 Medicare Trustees Report, overall Part B Irmaa charges alone are expected to increase 30% from 2026 to 2030…

Like basic premiums for Medicare, Irmaa charges are calculated annually based on the expected costs of the program—not the inflation increases used by Social Security.

For 2026, five income tiers of earners who pay for Part B or Part D are subject to Irmaa. Medicare recipients in these tiers are expected to pick up 35%, 50%, 65%, 80% or 85%, respectively, of their projected Medicare cost through premiums, rather than 25%… [end quote]

Every word of this article is useful but I can’t copy it due to copyright infringement.

If you are in a higher income range try to spread out your income.

One possible way is to do an IRA QCD annuity. This is a fairly new law which some charities (including universities) offer. There are lots of rules.

A life event (such as divorce or death of a spouse) can qualify for escaping IRMAA. Form SSA-44. This is important because the “widow’s penalty” of changing from Married Filing Jointly to Single can hit at the same time as IRMAA which is based on income from 2 years earlier.

Wendy