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 lookback year is already filed and no life event applies, that year is generally set. Focus on the next year you can still influence.

How to Avoid IRMAA

Example: you are $2,500 under the next bracket.

A single filer with income of $134,500. The next bracket starts at $137,000. Crossing it adds about $1,737/yr to Part B and Part D.

$134,500

109k137k171k205k500k

Check your exact distance

The levers that lower your income

IRMAA is set by your modified adjusted gross income (MAGI): your AGI plus tax-exempt interest. These moves can reduce it in the year that counts. None fits everyone; a small move near a bracket can matter more than a large one far away.

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 move only works if it lands in the right year. Your 2026 IRMAA is based on your 2024 income, so a 2026 surcharge generally had to be changed back in 2024. Plan forward, not after the bill arrives.

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

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. How to appeal
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 lookback year is already filed and no life event applies, that year is generally set. Focus on the next year you can still influence.

Source: official 2026 Medicare amounts (CMS) and SSA publication 05-10536. Dollar examples use the 2026 brackets. This page is educational and not financial or tax advice. Last verified June 2026.