Calculate your Medicare IRMAA surcharge based on income. See how MAGI affects Part B and Part D premiums.
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⚠️ IRMAA Surcharge Applies
Your MAGI of $250,000 exceeds the $206,000 threshold by $44,000. You pay an extra $82.80/month ($994/year).
| MAGI (2 years prior) | $250,000 |
|---|---|
| IRMAA Threshold | $206,000 |
| Standard Part B | $174.7/mo |
| Part B Surcharge | +$69.90/mo |
| Total Part B | $244.60/mo |
| Part D Surcharge | +$12.90/mo |
| Total Monthly Premium | $312.50/mo |
| Annual IRMAA Cost | $994 |
| Total Annual Premiums | $3,750 |
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IRMAA is an extra charge on top of your standard Medicare Part B and Part D premiums. It's essentially a means test — higher-income Medicare beneficiaries pay more for the same coverage.
The standard Part B premium for 2024 is $174.70/month. With IRMAA, it can go as high as $594.00/month — more than 3x the standard amount.
IRMAA uses your tax return from 2 years prior. For 2024 premiums, Medicare looks at your 2022 tax return. This is important for planning:
• A large capital gain in 2024 affects your 2026 Medicare premiums
• A Roth conversion in 2024 increases your 2026 IRMAA
• Selling a business in 2024 could trigger IRMAA surcharges in 2026
If your income dropped significantly due to a qualifying life-changing event, you can file Form SSA-44 to use more recent income instead of the 2-year lookback. Qualifying events include:
• Marriage, divorce, or death of spouse
• Work stoppage or reduction
• Loss of income-producing property
• Loss of pension
• Employer settlement payment
For 2024, IRMAA starts at MAGI above $103,000 (single) or $206,000 (married filing jointly). These thresholds are adjusted annually.
Per person. If both spouses are on Medicare and income exceeds the threshold, BOTH pay the surcharge. This doubles the impact for couples.
Yes, if you had a qualifying life-changing event (retirement, divorce, etc.), file Form SSA-44 to request a redetermination using more current income.
No. Roth IRA withdrawals don't count toward MAGI for IRMAA purposes. This makes pre-retirement Roth conversions a powerful IRMAA avoidance strategy.
Medicare uses your tax return from two years prior to determine IRMAA. Your 2024 income determines your 2026 premiums. Plan large income events like Roth conversions or property sales with this delay in mind.
At the lowest IRMAA tier, you pay an extra $69.90 per month for Part B plus $12.90 for Part D per person. At the highest tier, the surcharge reaches $419.30 for Part B plus $81.00 for Part D monthly.
Qualifying events include marriage, divorce, death of a spouse, work stoppage or reduction, loss of income-producing property, and loss of pension income. File Form SSA-44 with documentation to request a new determination.
Capital gains from selling stocks, real estate, or other investments increase your Modified Adjusted Gross Income and can push you into a higher IRMAA tier. Consider spreading large sales across multiple tax years to minimize the impact.
Yes. Strategies include completing Roth conversions before Medicare enrollment, using tax-loss harvesting to offset capital gains, timing asset sales across years, and drawing from Roth accounts instead of traditional IRAs to keep MAGI low.
Yes. Social Security benefits are included in Modified Adjusted Gross Income for IRMAA purposes. Combined with other retirement income sources, benefits can push your total MAGI above IRMAA thresholds.
IRMAA is based on MAGI from 2 years prior
2024 thresholds: $103,000 (single) / $206,000 (MFJ). Surcharge increases in 5 tiers up to $419.30/month for Part B.
Standard Part B premium: $174.70/month. Maximum with IRMAA: $594.00/month.
Every formula on this page traces to a federal agency, central bank, or peer-reviewed institution. We cite the rule-makers, not secondhand blogs.
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Calculations are for educational purposes only. Consult a qualified financial advisor for personalized advice.