Risk Management & InsuranceHealth InsuranceStop Worrying About 2026 Medicare Premiums. The Game Is Already Underway

Stop Worrying About 2026 Medicare Premiums. The Game Is Already Underway

IRMAA Medicare Premium Planning: Your 2025-2027 Action Plan. How Your 2025 Tax Return Controls Your 2027 Medicare Costs

IRMAA Medicare Premium Planning
IRMAA Medicare Premium Planning

Youโ€™ve spent decades planning, saving, and investing diligently. Now, on the cusp of retirement, youโ€™re confronted with a penalty for your success: the Income-Related Monthly Adjustment Amount, or IRMAA. Itโ€™s a surcharge on your Medicare Part B and D premiums, and the anxiety it produces is palpable. Youโ€™re worried about this unknown future cost eating away at your hard-earned nest egg.

Let me be direct: Itโ€™s time to stop feeling anxious and start being strategic.

The widespread myth is that IRMAA is a problem you deal withย inย retirement. This is wrong.

IRMAA is a direct result of your tax return from two years prior. Your 2026 Medicare premium isn’t a future problem; it’s a number being written in pen on your 2024 tax return. This is the key to shifting from a position of fear to one of absolute control.

TL;DR Summary of IRMAA Medicare Premium Planning
  • The Problem: Most retirees don’t realize that Medicare premiums can jump by hundreds or thousands of dollars per year due to IRMAA surcharges triggered by income from two years priorโ€”a costly surprise that catches them off guard.
  • The Answer: Your 2026 Medicare premium is locked in by your 2024 Modified Adjusted Gross Income (MAGI), giving you a strategic 2-year planning window to manage withdrawals, conversions, and income sources before penalties hit.
  • The Insight: IRMAA isn’t a punishmentโ€”it’s a predictable math problem you can solve by proactively controlling your MAGI in the years before you claim Medicare, not scrambling after your first bill arrives.
  • The Opportunity: Master the Form 1040 lines that determine your IRMAA calculation and you’ll unlock strategies to permanently reduce your Medicare costs while optimizing your retirement income distribution.

The IRMAA Time Machine: Why Your 2024 Tax Return Controls Your 2026 Medicare Premiums

The Social Security Administration (SSA) doesn’t guess your retirement income. To determine your IRMAA, they use a simple but powerful mechanism: a 2-year lookback. They pull your tax return from two years ago, find your MAGI, and use that number to set your premiums today.

This isn’t a bureaucratic quirk; it’s a planning opportunity. Itโ€™s a time machine that lets you see the direct consequences of your current actions two years into the future.

This is why you must shift your mindset from reactive tax filing to Proactive MAGI Budgeting. Instead of just trying to get the lowest tax bill for 2024, the goal is to manage your income to land precisely where you want to be for your first, critical years of Medicare.

๐Ÿ’ก Michael Ryan Money Tip: Verify Your Source

The specific calculation methodology (Line 11 + Line 2a) is the official, verifiable formula directly sourced from the Social Security Administration’s Program Operations Manual System (POMS HI 01101.010).

The 2026 IRMAA Brackets: The Numbers You Need to Target

The government has not yet released the official 2026 IRMAA brackets. However, they are based on the 2024 tax year, so we can use the 2024 MAGI thresholds as a very close projection. Think of these not as future penalties, but as the boundaries on the field. Your job in 2024 is to land the ball exactly where you want it.

Projected 2026 IRMAA Brackets (Based on 2024 MAGI, Filed in 2025)

2024 MAGI (Individual) 2024 MAGI (Joint) Projected Part B Monthly Premium
โ‰ค $103,000 โ‰ค $206,000 ~$174.70 (Standard Premium)
> $103,000 and โ‰ค $129,000 > $206,000 and โ‰ค $258,000 ~$244.60
> $129,000 and โ‰ค $161,000 > $258,000 and โ‰ค $322,000 ~$349.40
> $161,000 and โ‰ค $193,000 > $322,000 and โ‰ค $386,000 ~$454.20
> $193,000 and < $500,000 > $386,000 and < $750,000 ~$559.00
โ‰ฅ $500,000 โ‰ฅ $750,000 ~$594.00

Source: Official 2024 thresholds from Medicare.gov. The 2026 brackets will likely be adjusted slightly for inflation, but these are the numbers that should guide your 2024 planning.

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Case Study: How a Proactive Engineer Saved $15,000 in Future Premiums

Let me tell you about a client, a sharp engineer named David. He was set to retire at 65 and knew his final two years of work would include a large bonus and the sale of significant company stock. A reactive approach would have sent his MAGI skyrocketing, triggering a massive IRMAA surcharge for his first few years on Medicare.

Instead, we built a proactive “income runway.” Hereโ€™s what his planning looked like:

Year (Age) Income Event Action Taken Resulting 2024 MAGI
2023 (63) Final Year Bonus Deferred a portion of his bonus payout to January 2024. Kept MAGI low.
2024 (64) Stock Option Sale & Bonus Sold half the stock, took the deferred bonus, and executed a strategic Roth conversion up to the $258,000 MAGI limit. $257,500
2025 (65) Retirement & Final Stock Sale Sold the remaining stock. His income was lower as he was now retired. Lower MAGI.

By strategically spreading his income events across 2024 and 2025, David’s 2024 MAGI landed him in the second IRMAA tier, not the fourth or fifth. This single act of proactive planning saved him over $4,000 on his 2026 premiums alone and is projected to save him over $15,000 during his first three years of retirement. He didn’t avoid IRMAA entirely; he controlled it.

Your 2025 IRMAA Action Plan: A Checklist for Pre-Retirees

Before December 31, 2025, sit down and review these controllable components of your financial life.

2025 IRMAA Action Plan

Your 2025 IRMAA Action Plan

A Checklist for Pre-Retirees

โฐ Complete Before December 31, 2025
0%
0 of 4 items completed
Time Your Capital Gains
If you have a large, appreciated asset to sell, could you sell half this year and half next? Don’t let a single transaction push you over a cliff for the next two years.
Reframe Roth Conversions as ‘Buying’ a Lower Premium
Think strategically: Every dollar you convert today is a dollar you won’t pay taxes on later. Yes, it increases your MAGI now. The strategic move isn’t to avoid this, but to control it with precision. The goal is to fill up your current tax bracket or the next IRMAA tier to the very last dollar.
Calculate precisely: Think of it as ‘buying’ a guaranteed lower Medicare premium for a future year. Instead of a vague conversion, calculate the exact amount that takes your MAGI to $257,999 (for joint filers). This isn’t just a tax move; it’s a direct investment in a lower-cost retirement, and a powerful way to mitigate the Sequence of Return Risk you’ll face later.
Manage Your Distributions
If you are over 73, you must take RMDs. But if you are not, you have control. Avoid taking large, unnecessary withdrawals from tax-deferred accounts in the critical two years before Medicare.
Leverage Charitable Giving
If you are over 70.5, a Qualified Charitable Distribution (QCD) is a powerful tool because the money goes directly from your IRA to charity and is excluded from your MAGI.

๐Ÿš€ Next Steps: Before Year-End

Need to model your risk? Use our [IRMAA MAGI Calculator] to test your 2024 income against the projected 2026 thresholds. Every dollar of MAGI you cut this year saves you a projected 15% to 50% in future Medicare premiums.

The Michael Ryan Money Bottom Line

Stop thinking of IRMAA as a future penalty. It is a direct, predictable consequence of the choices you are making with your incomeย today. By understanding the 2-year lookback and proactively managing your MAGI, you can take control of this cost, smooth your entry into retirement, and keep thousands of dollars where they belong.

In your pocket.


Frequent Readers’ Questions

What exactly is the 2-year lookback for IRMAA?

It is the mechanism the Social Security Administration uses to set your Medicare premiums. They use the Modified Adjusted Gross Income (MAGI) from your tax return filed two years ago to determine if you need to pay a higher premium this year. For example, your 2026 premiums are based on your 2024 MAGI.

How can I appeal an IRMAA determination?

You can appeal if you’ve had a “Life-Changing Event” (LCE) that has significantly lowered your income since the MAGI year on record. Common LCEs include retirement, death of a spouse, divorce, or loss of a pension. You must file Form SSA-44, “Application for Reconsideration,” with the Social Security Administration, providing proof of the event and your new, lower income.

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Note: The content provided in this article is for informational purposes only and should not be considered as financial or legal advice. Consult with a professional advisor or accountant for personalized guidance.

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Michael Ryan
Michael Ryanhttps://michaelryanmoney.com/
Michael Ryan, Retired Financial Planner | Founder, MichaelRyanMoney.com With nearly three decades navigating the financial world as a retired financial planner, former licensed advisor, and insurance agency owner, Michael Ryan brings unparalleled real-world experience to his role as a personal finance coach. Founder of MichaelRyanMoney.com, his insights are trusted by millions and regularly featured in global publications like The Wall Street Journal, Forbes, Business Insider, US News & World Report, and Yahoo Finance (See where he's featured). Michael is passionate about democratizing financial literacy, offering clear, actionable advice on everything from budgeting basics to complex retirement strategies. Explore the site to empower your financial future.