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IRMAA Cliff Calculator

$1 over the line can cost $2,500/yr.

Medicare's IRMAA surcharges are cliffs, not slopes. Cross one by a dollar and the premium hike applies to the whole year — per beneficiary.

IRMAA (Income-Related Monthly Adjustment Amount) raises your Medicare Part B and Part D premiums based on your MAGI from 2 years prior. The tiers stack, the cliffs are sharp, and the impact compounds if both spouses are on Medicare. This calculator shows your tier, your distance from the next cliff, and the annual surcharge — for each filing status.

IRMAA tier calculator

Input your projected MAGI. We surface your tier, the next cliff, and the annual surcharge per beneficiary. All figures are 2026 estimated (released October 2025).

MAGI = AGI + tax-exempt interest. The Social Security Administration uses your most recent IRS return — typically 2 years back — to set your premium for the current year.
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Source: SSA — Medicare Premiums and IRMAA · Medicare.gov — Part B Costs · CMS — Annual Premium Fact Sheets · Cornell LII — 42 U.S.C. §1395r (Medicare premiums)

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How IRMAA actually works

Medicare Part B (doctor visits, outpatient) and Part D (prescription drugs) are subsidized for the vast majority of beneficiaries. But Congress decided that higher-income retirees should pay an "income-related" surcharge on top of the base premium. That surcharge is IRMAA.

The lookback: SSA uses your IRS tax return from 2 years prior. So your 2026 IRMAA is determined by your 2024 MAGI. Big Roth conversion in 2024? You'll feel it in your 2026 Medicare premiums. Big capital gain in 2024? Same.

Why it's a cliff, not a slope

Real example: MFJ couple at MAGI $264,500 (Tier 1) sells a rental property in November, takes home an extra $4,000 of taxable LTCG, lands at $268,500 (Tier 2). Both on Medicare → both pay the Tier 2 surcharge for all of year T+2. Extra cost: ~$2,800/yr. The $4,000 gain effectively cost them $2,800 in next year's premiums.

What pushes you over a cliff

  • Roth conversions — every dollar converted counts toward MAGI.
  • Realized capital gains — selling appreciated stock, real estate, business interests.
  • RMDs after 73 — once forced, no flexibility.
  • Pension lump-sum distributions — taking pension as lump sum vs annuity stacks a single year.
  • Business sale proceeds — owner who sold the business 2 years ago is paying IRMAA Tier 5 now.
  • Inherited IRA distributions — 10-year rule + RMDs on inherited accounts.
  • Tax-loss recoveries — funds recovering losses can spike distributions.

What keeps you under

  • Roth Conversion bracket-filling — capped at each IRMAA tier. The most common planning move.
  • Tax-loss harvesting in taxable accounts to offset realized gains.
  • QCDs (Qualified Charitable Distributions) up to $108K/yr (2026) — satisfies RMD without counting toward MAGI.
  • Asset location — keep dividend-heavy and high-turnover funds in tax-deferred accounts; growth ETFs in taxable.
  • HSA contributions while still working — reduces MAGI now, distributes tax-free in retirement.
  • Spreading lump sums — pension election, business sale, real-estate carry-over installment sale.
  • Form SSA-44 appeal — if you had a "life-changing event" (retirement, divorce, spouse's death) you can file SSA-44 to use a more recent income year.

Common questions

Why does Medicare use a 2-year lookback?

SSA needs your finalized tax return to determine your IRMAA, and the IRS finalization timeline (return filed → assessed → reported to SSA) takes ~18 months. So your 2026 premium is determined by your 2024 return. The lookback creates planning opportunity — you know what you're dealing with two years before it hits.

Can I appeal IRMAA?

Yes — but only if you had a "life-changing event": marriage, divorce, spouse's death, work stoppage/reduction, loss of pension, or receipt of insurance/settlement. File Form SSA-44 with documentation. Common scenario: you retired in 2024 (income drops), but 2026 IRMAA uses 2024's high earnings. Appeal with SSA-44 → SSA uses a more recent income year. Form SSA-44 (PDF).

What about my spouse — do we both pay?

If both spouses are enrolled in Medicare, both pay IRMAA based on the household MAGI. Double the per-beneficiary surcharge to get the household cost. If only one spouse is on Medicare (the other is younger and still on employer coverage), only that one spouse pays.

Are Roth withdrawals counted in MAGI?

No — qualified Roth IRA distributions are not counted in MAGI for IRMAA purposes. This is one of the most powerful long-term reasons to convert during the pre-RMD window. Once converted, the Roth assets generate retirement income that never touches your IRMAA tier calculation.

How do tax-exempt municipal bonds affect IRMAA?

Counterintuitive: tax-exempt municipal bond interest IS added back into MAGI for IRMAA. So while munis are federal-tax-free, they still push you toward IRMAA cliffs. For high-net-worth pre-retirees right at a tier line, sometimes a taxable bond inside an IRA beats a tax-free muni in taxable.

Does IRMAA apply forever once I cross a tier?

No — IRMAA recalculates every year based on the most recent 2-year-lookback. If your 2024 MAGI was high (one-time event), 2026 IRMAA hits hard, but 2027 IRMAA (based on 2025) drops back if 2025 income normalized. The cliff applies for one premium year only.

What's the absolute maximum IRMAA can cost?

2026 estimated Tier 5 (highest): Part B surcharge ~$443/mo + Part D surcharge ~$81/mo = $524/mo per beneficiary. That's $6,288/yr per beneficiary — or $12,576/yr for MFJ couple both on Medicare. The Tier 5 threshold (MAGI $500K+ Single / $750K+ MFJ) is meant for high-net-worth retirees but catches business sellers and large Roth converters too.

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About Good Deals

Good Deals is the planning workbook + advisory practice of Andrew Escher, CFA Charterholder + Investment Adviser Representative based in Austin, TX. Independent stack: Altruist for investment custody, BackNine for insurance placement, Good Deals for the planning layer that ties them together. We work with pre-retirees, HNW executives, and business owners who want structural tax + retirement planning — without the typical AUM-fee pitch.