How to avoid IRMAA: timing, thresholds, and what actually works

IRMAA surcharges are avoidable mainly through timing and income management. The thresholds are cliffs, not phase-ins: one dollar of MAGI above the tier-1 boundary costs the full $95.70 per person per month in 2026 ($1,148.40 per year). There is no partial surcharge. That asymmetry is what makes planning worth the effort. The full bracket and surcharge tables are at /irmaa-brackets/.

What each tier costs in 2026

The surcharge above the standard premium, per person per year, Part B and Part D combined:

The ladder is front-loaded in planning terms: tier 1 is both the cheapest crossing and the one a bracket-filling conversion is most likely to brush against, so most of the levers below are about the $109,000 single / $218,000 MFJ tier-1 line.

Lever 1: finish large conversions before 63

IRMAA is determined from the tax return two years prior. MAGI in 2024 sets 2026 premiums; MAGI in 2025 sets 2027 premiums. That two-year lag has a practical implication: conversions completed before age 63 do not touch the Medicare lookback window at all. A 62-year-old who converts $80,000 will see that income on a return filed in 2025, but will not be on Medicare until 65, by which point the two-year window has passed.

Large conversions belong in the pre-63 window whenever possible. The full case for this timing is at /roth-conversion-window-60-72/. The boundary is a calendar-year line, not a birthday: converting in December of the year you turn 62 rather than the following January keeps the conversion out of the lookback entirely.

Lever 2: fill below the IRMAA threshold, not just below the tax bracket

The IRMAA threshold can bind before the tax bracket does. Take a single filer, age 64, with $40,000 of other income. The 2026 standard deduction of $16,100 puts taxable income at $23,900, leaving $81,800 of room to the top of the 22% bracket ($105,700 taxable). Converting the full $81,800 produces MAGI of $121,800, which is $12,800 over the $109,000 IRMAA threshold and costs $1,148.40 per year in surcharges at 66. Capping the conversion at $69,000 instead fills most of the bracket and stays under the line. The calculator flags exactly this crossing per scenario.

Lever 3: use QCDs after 70.5 to satisfy RMDs without raising MAGI

A qualified charitable distribution (QCD) allows IRA owners aged 70.5 or older to transfer up to $111,000 per person in 2026 (indexed annually) directly from a traditional IRA to a qualified charity. The distribution satisfies the RMD requirement but is excluded from AGI under IRC section 408(d)(8). It does not appear in MAGI. For charitably inclined retirees with RMDs that would otherwise push them into a higher IRMAA tier, a QCD can eliminate the surcharge entirely for the amounts directed to charity.

Lever 4: appeal only for life-changing events

SSA will recalculate IRMAA using more recent income if a qualifying life-changing event reduced your income after the base year. Qualifying events include marriage, divorce, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, and receipt of an employer settlement payment.

A Roth conversion does not qualify. Converting a large IRA balance in one year is a deliberate financial transaction, not an involuntary income shock, and SSA draws that line explicitly. The surcharge from a conversion year stands. The appeal process is explained in detail at /learn/irmaa-appeal-ssa-44/.

Lever 5: one bad year costs one year

IRMAA is recalculated annually from the two-year-prior return. If you cross a tier threshold in one year and your income returns to normal the next, the surcharge applies for exactly one premium year: the year two years after the high-MAGI year. After that it drops.

Sometimes crossing a threshold knowingly is still the right trade. If the tax savings from a large conversion exceed the one-year IRMAA cost, the math still favors converting. The strategy comparison at /bracket-filling-strategy/ shows the engine’s computed lifetime tax and IRMAA totals across four scenarios for a representative couple; the same logic applies to your numbers in the calculator.

Lever 6: do not file separately to dodge it

Married filing separately looks like it should split the exposure. It does the opposite. For an MFS filer who lived with their spouse at any point in the year, the graduated ladder disappears: MAGI of $109,000 or less pays the standard premium, and one dollar more jumps directly to the second-highest tier, a surcharge of $6,355.20 per person per year in 2026. That is 5.5 times the cost of the same dollar crossing tier 1 on a joint return. The full MFS schedule is on the IRMAA brackets page; for conversion planning the rule is simple: the MFS thresholds make bracket filling near the $109,000 line untenable, so model filing status before modeling the conversion.

to model any conversion size against the IRMAA thresholds and see the two-year premium impact per scenario.