How much income can I add before the next IRMAA cliff?

Choose the relevant premium year and filing status, then compare your baseline MAGI with the additional MAGI you expect. The result shows the whole-dollar room remaining in your bracket. Room based on projected thresholds is an estimate, not a guaranteed limit.

Can I use this as a Roth conversion IRMAA calculator?

Yes, to compare the IRMAA effect of your estimated MAGI increase. It does not calculate conversion taxes or recommend how much to convert. Taxable basis, Social Security taxation, and other tax-return effects can make the MAGI change different from the gross conversion amount.

Do IRA withdrawals or capital gains affect Medicare IRMAA?

Taxable IRA withdrawals and realized capital gains can increase MAGI. Enter the estimated additional MAGI after the relevant tax rules, excluding anything already included in your baseline. Sale proceeds and gross withdrawal amounts are not necessarily the amounts that enter MAGI.

Which Medicare year does a 2026 income change affect?

Under the usual two-year lookback, 2026 income affects 2028 premiums. The worksheet labels 2028 figures as projected because official amounts have not been released. A historical comparison using 2026 premium figures instead concerns 2024 income.

Can I appeal instead of planning?

Sometimes. If a life event such as retirement or the death of a spouse lowered your income, you can ask Social Security to use newer figures with Form SSA-44.

Does tax-exempt muni interest count?

Yes. MAGI for IRMAA adds back tax-exempt interest, including municipal bond interest, so include it when you estimate your distance.

What if I am already over?

If the return for the lookback year is already filed and no qualifying life event applies, that premium year is generally set. You can still use the worksheet to see what a future income change would cost. If you received a determination, check the income year and amounts on the letter. Qualifying life events, newer returns, and corrected tax information each have their own review route through Social Security.

How to Avoid IRMAA: Compare Income Scenarios

Compare the IRMAA cost of an income decision

Start with your estimated annual IRMAA MAGI before the proposed action, then enter its estimated addition to MAGI. Keep the addition out of the baseline so it is counted once. The MAGI calculator helps identify the income that belongs in the estimate.

The comparison shows monthly and annualized IRMAA surcharges for the coverage you select, per person. Joint filing selects the joint thresholds; it does not automatically double the result. Standard Part B premiums, drug-plan premiums, and income taxes are outside these totals.

Remaining room measures the whole dollars you could add while staying in that bracket, assuming the table and all other income stay the same. Whether a transaction is worthwhile also depends on taxes and future income. Read about Roth conversions and IRMAA before treating a bracket threshold as a conversion target.

Options for managing income and timing

IRMAA depends on modified adjusted gross income. Some options lower current income; others shift income between years. Their value depends on your circumstances and the applicable tax rules. See what counts as MAGI for the definition and less common add-backs.

Qualified Charitable Distributions

If you are 70½ or older, give directly from an IRA to charity. The gift is excluded from your income and can count toward a required distribution.

Best if: you give to charity and are taking RMDs.

Roth conversion timing

Converting raises income now but shrinks the future required withdrawals that drive MAGI later. Convert during low-income years, often after retiring and before RMDs begin.

Best if: you have low-income years before RMDs start.

Manage capital gains

Gains land in MAGI the year you realize them. Harvesting losses or spreading a large sale across two tax years can keep a single year under a bracket.

Best if: you control when you sell assets.

Max your HSA

HSA contributions lower your income in the contribution year. You must stop once you enroll in Medicare, so plan the final year carefully.

Best if: you are not yet on Medicare.

Spread IRA withdrawals

A large one-time withdrawal can spike MAGI into a higher bracket for a year. Smaller amounts across several years can keep each year under the line.

Best if: you can choose how much to draw.

Withdrawal sequencing

Which accounts you draw from changes taxable income. Pulling from taxable or Roth in high years and traditional in low years smooths MAGI.

Best if: you hold taxable, traditional, and Roth accounts.

Timing matters: the two-year lookback

A 2026 income change ordinarily affects 2028 premiums. Choose 2028 / 2026 in the worksheet to estimate that effect using projected figures. Official thresholds can differ, so leave room for uncertainty when planning near a bracket. Read the two-year lookback explanation and the 2028 projection notes.

Did a life event lower your income?

You may be able to reduce your surcharge by appealing with Form SSA-44.

See if you can appeal

Common questions

How much income can I add before the next IRMAA cliff?: Choose the relevant premium year and filing status, then compare your baseline MAGI with the additional MAGI you expect. The result shows the whole-dollar room remaining in your bracket. Room based on projected thresholds is an estimate, not a guaranteed limit.
Can I use this as a Roth conversion IRMAA calculator?: Yes, to compare the IRMAA effect of your estimated MAGI increase. It does not calculate conversion taxes or recommend how much to convert. Taxable basis, Social Security taxation, and other tax-return effects can make the MAGI change different from the gross conversion amount.
Do IRA withdrawals or capital gains affect Medicare IRMAA?: Taxable IRA withdrawals and realized capital gains can increase MAGI. Enter the estimated additional MAGI after the relevant tax rules, excluding anything already included in your baseline. Sale proceeds and gross withdrawal amounts are not necessarily the amounts that enter MAGI.
Which Medicare year does a 2026 income change affect?: Under the usual two-year lookback, 2026 income affects 2028 premiums. The worksheet labels 2028 figures as projected because official amounts have not been released. A historical comparison using 2026 premium figures instead concerns 2024 income.
Can I appeal instead of planning?: Sometimes. If a life event such as retirement or the death of a spouse lowered your income, you can ask Social Security to use newer figures with Form SSA-44.
Does tax-exempt muni interest count?: Yes. MAGI for IRMAA adds back tax-exempt interest, including municipal bond interest, so include it when you estimate your distance.
What if I am already over?: If the return for the lookback year is already filed and no qualifying life event applies, that premium year is generally set. You can still use the worksheet to see what a future income change would cost. If you received a determination, check the income year and amounts on the letter. Qualifying life events, newer returns, and corrected tax information each have their own review route through Social Security.

Received a determination? Use the IRMAA Letter Checker. For a qualifying income-reducing life event, open the SSA-44 worksheet. Other review routes are explained in the IRMAA appeal guide. The general IRMAA calculator looks up one income amount.

Sources: SSA IRMAA tables, IRS IRA guidance, and the year data cited in each comparison result. Final 2025 and 2026 figures and projected 2027 and 2028 figures are identified separately. Informational and educational only, not financial or tax advice. Last verified September 2026.

Planning ahead for 2027?

IRMAA looks back two years, so your 2025 income sets your 2027 premium. See the projected 2027 IRMAA brackets →