Overview
- Monday's reporting and CMS's 2026 premium schedule show IRMAA can push standard Part B from $202.90 to as high as about $690 per person when prior-year MAGI crosses surcharge thresholds.
- IRMAA uses modified adjusted gross income, which counts capital gains, depreciation recapture, IRA distributions, and tax-exempt interest, and the rule looks at tax returns from two years earlier to set current premiums.
- The surcharge structure is a cliff, so crossing a threshold by one dollar triggers the full higher tier rather than a partial increase, which can turn a single sale or withdrawal into a large ongoing monthly bill two years after the event.
- Formal relief is narrow: Form SSA-44 may lower IRMAA after a documented work-related income drop but does not cover voluntary events like home sales or planned Roth conversions, so advisers now recommend modeling MAGI and using timing or structuring tools such as installment sales, paced Roth conversions, and qualified charitable distributions.
- The issue matters for lifetime income planning because IRMAA interacts with required minimum distributions and Social Security taxation, so when retirees sell assets or take big distributions before RMD age they can permanently reduce net retirement income and should run MAGI projections first.