How do you avoid IRMAA surcharges on Medicare premiums?

Question

Ann Sanfelippo · Accepted Answer

You can’t always avoid IRMAA, but you can often reduce or minimize it through income planning. IRMAA is based on your Modified Adjusted Gross Income (MAGI) from two years ago, so large IRA withdrawals, Roth conversions, capital gains, and other taxable income can push you into a higher premium bracket.

Strategies may include spreading withdrawals over multiple years, using Roth assets strategically, and working with a tax professional to manage taxable income. If your income drops because of a life-changing event such as retirement, you can request an IRMAA reconsideration through the Social Security Administration using Form SSA-44.

Planning ahead is often the best way to keep Medicare premiums lower.

Kevin Chaikin · Answer

If you have a qualifying life event such as retirement, reduction of work, divorce, annulment, death of a spouse, etc. you should use Form SSA-44 to appeal the IRMAA decision. If that life event reduces your Modified Adjusted Gross Income to a lower level or completely removes you from IRMAA charges, it is well worth your time to submit that form. You may need documentation depending on the life changing event. Expect up to 8 weeks for the appeal to be processed.

Answered by Kevin Chaikin on June 15, 2026

Broker Licensed in VA, AL, AZ & 31 other states

Answered by Kevin Chaikin Medicare Insurance Agent

Edward Smith, ChFC, CRPS, AIF · Answer

As a financial advisor, I am used to this question. There are different strategies. One of the most common is to move taxable assets to tax deferred or tax-free assets. This will reduce your taxable income and possibly reduce or remove your IRMAA surcharge. Also, remember the IRS looks back 2 years to access IRMMA. If you simply had one year of higher-than-normal income due to a capital gain or something like that, you can always and should always appeal the IRMMA decision.

Answered by Edward Smith, ChFC, CRPS, AIF on June 1, 2026

Broker Licensed in OH, GA, IN, KY & TN

Answered by Edward Smith, ChFC, CRPS, AIF Medicare Insurance Agent

Tamela Clayton · Answer

IRMAA is an extra charge added to your Medicare Part B and Part D premiums if your income is over certain limits.  

You don’t really “dodge” it with tricks, you avoid it by keeping your reported income under the IRMAA brackets or by asking Social Security to re‑evaluate if your income has gone down because of a life‑changing event like retirement, divorce, or death of a spouse.

Françoise Mueller · Answer

You can avoid IRMAA by keeping your income below the IRS limits, which often just means being mindful of things like withdrawals, tax planning, or avoiding big one‑time income jumps. And if Social Security is using an old tax return and your income has gone down because of a life change, I help you file the appeal so they can remove that IRMAA surcharge.

Answered by Françoise Mueller on June 1, 2026

Broker Licensed in UT, AL, AZ & 33 other states

Answered by Françoise Mueller Medicare Insurance Agent

Jasmine McGehee · Answer

There's not a way to avoid IRMAA, but there are somethings you can do to try and mitigate it. Since IRMAA is based on a 2 year look back period you could try and plan in advance to not make more than the threshold or if your income has significantly changed in two years you can attempt to appeal it.

Answered by Jasmine McGehee on May 29, 2026

Broker Licensed in KY, IN & TN

Answered by Jasmine McGehee Medicare Insurance Agent

Marcy Bulliner · Answer

IRMAA can be avoided by working with your retirement planner to make sure your income stays below certain thresholds, whether it's from employment or investment withdrawals. If your income does exceed the standard Part b and Part d limits there are forms you can submit to get that increase reduced or waived.

Answered by Marcy Bulliner on June 1, 2026

Agent Licensed in MI, IN, MO, SC & TX

Answered by Marcy Bulliner Medicare Insurance Agent

Margaret Winter · Answer

Avoiding IRMAA is nearly impossible unless you can amend your tax return or provide substantial reasoning why your life circumstances have changed. If you are a high-income earner, proper planning will help alleviate the stress of the added surcharge. If you are planning on selling assets which will cause significant taxable income, it is best to reach out to your accountant or financial advisor to plan carefully and determine if avoiding IRMAA is even an option.

Answered by Margaret Winter on May 28, 2026

Broker Licensed in WI

Answered by Margaret Winter Medicare Insurance Agent

Dean Chiapetto · Answer

IRMMA is Income Related Monthly Adjustment Amount so if your income high you will have to pay the IRMAA. If there is a one time event like a sale of property you can request an exemption for that event.
Unfortunately, if you have a traditional 401k or IRA when you withdraw for your Required Minimum Distibution your income may go over the amount for IRMAA.
Contact a Local Broker.
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Priscilla Ramos · Answer

IRMAA is based on income, so lowering your reportable income or requesting a review after certain life events can help avoid the surcharge.

Keith Brown · Answer

FOR 2026 IRMAA IS BASED ON YOUR INCOME FROM 2 YEARS AGO (2024).  THERE IS NO WAY TO AVOID THE SURCHARGES.  AS YOUR INCOME CHANGES, IRMAA WILL BE ADJUSTED.

Tiera McQuater · Answer

One of the most important things to understand is that Medicare generally does not pay for ongoing long-term custodial care—such as needing help with bathing, dressing, eating, or other activities of daily living over an extended period.

Medicare may cover certain short-term skilled nursing facility care, home health services, or rehabilitation when specific medical and eligibility requirements are met, but that is very different from paying for long-term care indefinitely.

That’s why planning before you need care is so important. Consider where you would want to receive care, what support you may have from family, your financial resources, and whether options such as long-term care insurance or other financial planning strategies make sense for you. Medicaid may help with long-term care costs for people who meet their state’s financial and eligibility requirements, but those rules are very different from Medicare.

I also encourage people to look beyond today’s premium or extra benefits when evaluating Medicare coverage. Think about your overall healthcare needs and how your Medicare coverage fits into your larger retirement and aging plan.

You don’t have to wait until a health crisis to start asking these questions. A Medicare review can help you understand what Medicare does—and does not—cover so you can identify potential gaps and begin planning for them before you need care.