My income fluctuates significantly year to year from investment distributions. How can I avoid IRMAA surcharges when I have an unusually high-income year?

Question

David Bell · Accepted Answer

They use taxes from two years ago (so 2023's taxes for 2025), so you have time to prepare. The brackets change every year and they are tiered so if you just go over a little the penalty is is about $1,200 for the year. Work with your tax advisor if you will be near the current year's levels to reduce you income through things like charitable giving and other tax deductions. Balance the deduction spending against the expected penalty. To be honest, it's a great problem to have. Good work on the savings.

Answered by David Bell on April 17, 2025

Agent Licensed in ID, AZ, CA & 8 other states

Answered by David Bell Medicare Insurance Agent

Diane Andree · Answer

IRMAA charges are calculated each year based on your tax return of two years ago. In any one year, you have a fluctuation, you can appeal an IRMAA by filling out an SSA-44 form. this can be found on and downloaded from the SSA.gov website.

Answered by Diane Andree on April 11, 2025

Agent Licensed in NY

Answered by Diane Andree Medicare Insurance Agent

Don Golding · Answer

To minimize IRMAA (Income-Related Monthly Adjustment Amount) surcharges on your Medicare Part B and Part D premiums when income changes, focus on strategies to reduce your Modified Adjusted Gross Income during years of high income. This includes making tax-deductible contributions to retirement accounts, donating appreciated assets to charity, and potentially delaying or timing Roth conversions to avoid unexpected income spikes.

Answered by Don Golding on April 14, 2025

Broker Licensed in TX, AL, AR & 5 other states

Answered by Don Golding Medicare Insurance Agent

Vachik Chakhbazian · Answer

focus on strategies to lower your Modified Adjusted Gross Income (MAGI), which is used to calculate IRMAA. This can include shifting from traditional to Roth IRAs, maximizing tax-deductible retirement account contributions, and utilizing tax-efficient withdrawal strategies. You can also consider appealing the surcharge if you have a life-changing event that significantly impacts your income

Answered by Vachik Chakhbazian on April 11, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Kelly Linster · Answer

IRMAA looks back two years to determine your surtax. Consulting an account could help in smoothing out the IRMAA adjustments.

Robert Baez · Answer

If your income is above a certain limit 
(in 2025 $106,000 if you file individually or $212,000 if you’re married 
and file jointly), you’ll pay an extra amount in addition to your plan 
premium (sometimes called “Part D IRMAA”). You’ll also have to pay this 
extra amount if you’re in a Medicare Advantage Plan that includes drug 
coverage. This doesn’t affect everyone, so most people won’t pay an extra 
amount.

Ryan Ross · Answer

Great question! If your income jumps in a year due to investment distributions, you might face IRMAA (Income-Related Monthly Adjustment Amount) surcharges on your Medicare premiums. But here's how you might be able to avoid or reduce them:

1. File an appeal (Form SSA-44) – If the high income was a one-time event (like a large capital gain or distribution), you can explain it to Social Security and ask them to adjust your premiums based on your current income.

2. Strategic timing – Try to spread distributions over multiple years, or take them in years when your income is lower, if possible.

3. Work with a financial advisor – They can help you plan distributions to stay under IRMAA thresholds and explore tax-efficient strategies.

Want help with the IRMAA appeal process or figuring out how this impacts your Medicare? I’m here to help!

My income fluctuates significantly year to year from investment distributions. How can I avoid IRMAA surcharges when I have an unusually high-income year?

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My income fluctuates significantly year to year from investment distributions. How can I avoid IRMAA surcharges when I have an unusually high-income year?

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