Do IRA or 401(k) withdrawals increase Medicare costs?

Question

Mary Brown · Accepted Answer

Yes. Withdrawals from traditional IRA or 401(k) accounts count as taxable income, which can increase your Medicare premiums through IRMAA.

Medicare looks at your income from 2 years prior, so even a large one-time withdrawal can raise your Part B and Part D costs for a year.

Note: Roth IRA withdrawals (if qualified) typically don’t count toward Medicare income.

Ann Sanfelippo · Answer

Yes, withdrawals from an IRA or 401(k) can increase Medicare costs because they count as taxable income. Higher income can trigger IRMAA, which is an extra charge added to your Part B and Part D premiums. Medicare looks at your income from two years ago to determine these costs. A large one-time withdrawal can push you into a higher bracket, even if your income later goes back down.

Answered by Ann Sanfelippo on January 7, 2026

Broker Licensed in FL, AL, AZ & 14 other states

Answered by Ann Sanfelippo Medicare Insurance Agent

Anthony Mendez · Answer

Yes, a withdrawal from a 401k or IRA is considered taxable income in the year it is received and may increase the Medicare part B and part D premiums. However, premiums for Medicare coverages such as Medicare Supplements and Medicare Advantage plans will not increase as a result of the withdrawal.

Answered by Anthony Mendez on June 22, 2026

Broker Licensed in AZ, CA, FL & IA, NE, NV & TX

Answered by Anthony Mendez Medicare Insurance Agent

Rowena Ndagha · Answer

Yes it may increase Medicare cost. 
Medicare use modified adjusted gross income (MAGI) from two years prior to determine if a senior will pay a higher premium. Higher premiums are called IRMAA ( income related monthly adjustment amount) if it goes over a certain threshold seniors may pay more for Medicare part B  and part D.

Alicia Tyring · Answer

In short, yes, IRA or 401K withdrawals can increase Medicare costs. You will see or notice the impact 2 years later. For instance, your 2026 Medicare premiums are evaluated based off your 2024 income, resulting in an IRMAA charge. Appealing IRMAA if income rose due to a one-time life event (retirement, divorce, death of spouse, etc.)

Answered by Alicia Tyring on January 7, 2026

Broker Licensed in IN, AL, AR & 42 other states

Answered by Alicia Tyring Medicare Insurance Agent

Roberto Alonso · Answer

Yes they can, by increasing the Modified Adjusted Gross Income( MAGI) on which Medicare is based to compute( two years in arrears) surcharges( Income Related Monthly Adjustment Amount -IRMAA) based on income for Medicare Part B and Part D premiums.

Some time planning is suggested to mitigate the impact, which could be substantial.

Dustin Haffner · Answer

Yes—IRA and 401(k) withdrawals can increase your Medicare costs.

If your income crosses certain thresholds, Medicare adds IRMAA (Income-Related Monthly Adjustment Amount) to:
Part B premiums
Part D premiums

So be sure to speak with a specialist.

Andrew Zurbuch, MBA · Answer

It could. They could increase your IRMAA. If you have MAGI to have a IRMAA, then it is added to your Original Medicare Part B premium. It varies on what your MAGI is per year. Thank you.

Mark Maliwauki · Answer

There is a calculation based on your income called IRMAA. If you make a significant income in your retirement or use your earned income from an IRA or 401k can increase your monthly Part B premium amount.

Answered by Mark Maliwauki on February 9, 2026

Broker Licensed in ID, AZ, CA & 13 other states

Answered by Mark Maliwauki Medicare Insurance Agent

Rachida Silva · Answer

Yes, they can. Traditional IRA and 401(k) withdrawals are counted as taxable income, which increases your Modified Adjusted Gross Income (MAGI).

Joshua Wood · Answer

They definitely can. The real answer is going to depend on the tax qualification of the investment account you're are taking distributions/withdrawals from. It is important to work with a knowledgeable team for all your retirement needs like our clients at our firm do. From tax advisors, investment advisors, insurance advisors, and Elder Law we can help you toe the line between protection, quality of life, and asset protection. 

Short answer- too much of the right type of income can dramatically increase your medicare costs for years.

Stephanie Salazar · Answer

How much and when you take an IRA or 401(k) withdrawal, your Medicare premium may increase. Your health insurance agent may provide basic guidelines. Depending on your income, a conversation with a tax professional may be in order.

Answered by Stephanie Salazar on March 9, 2026

Agent Licensed in SD

Answered by Stephanie Salazar Medicare Insurance Agent

Mueser (Sara) Kocareli · Answer

Depends on the amount withdrawn and what income bracket that puts you because these types of withdrawals count as taxable income.

William Lawler · Answer

No. IRA or 401(K) withdrawals do not affect Medicare costs. However, if the withdrawals place you in a higher tax bracket, your Part B premium may increase.

Carol Conner · Answer

What affects the cost of Medicare is if you are making more than the required amount as a single or joint spouse, it puts you in a different bracket if you’re retired and earning a large income per month

Answered by Carol Conner on March 30, 2026

Broker Licensed in TX

Answered by Carol Conner Medicare Insurance Agent

Todd Bostic · Answer

IRA and 401 do not increase your 401 because they are taxed differently and Medicare is based off of your income for the last 10 years you worked.

Do IRA or 401(k) withdrawals increase Medicare costs?

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Do IRA or 401(k) withdrawals increase Medicare costs?

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