Is IRMAA permanent?
No. It is reviewed each year. If your income falls below the limits in a later year, the extra premium can go away.
Taxes and required withdrawals
How Can RMDs Affect Medicare Premiums (IRMAA)?
Required minimum distributions count as taxable income. If your income rises above certain limits, Medicare charges higher Part B and Part D premiums, called the income-related monthly adjustment amount, or IRMAA. Medicare generally uses your tax return from two years earlier. So large RMDs or other big withdrawals can raise your Medicare costs two years later, in addition to your income tax.
Written and reviewed by Dan Hopwood, Retirement Income Specialist · Retirement Income Knowledge Center · Last reviewed
What IRMAA is
Most people pay a standard Medicare Part B premium. People with higher incomes pay an extra amount on top, and a similar extra amount applies to Part D prescription coverage. The Social Security Administration decides whether IRMAA applies based on your modified adjusted gross income.
The two-year lookback
IRMAA is generally based on the tax return from two years before. Income you report this year can affect the Medicare premiums you pay two years from now. That delay surprises many retirees.
Illustrative timeline
- Year 1
- RMD plus a large extra withdrawal raises income
- Year 3
- Medicare premiums may include IRMAA based on Year 1 income
Illustration only. Whether IRMAA applies depends on the income limits in effect and your filing status.
Why RMDs matter here
RMDs are not optional, and they tend to grow as a share of the account over time. A large tax-deferred balance can create steady taxable income later in life. Seeing that early gives you time to understand your options, which is where a tax professional can help.
If your income drops
If a life-changing event, such as retirement, the death of a spouse or loss of a pension, reduces your income, you can ask the Social Security Administration to use more recent income. It has a form for that request.
See how large your future RMDs could be
The calculator projects your required withdrawals and estimated tax, which helps you spot years when your income could rise.
Open the RMD Tax Exposure CalculatorFree • Results on-screen right away • No email required
Common questions
Do Roth IRA withdrawals count toward IRMAA?
Qualified Roth IRA withdrawals are generally not taxable income, so they generally do not raise the income used for IRMAA. A Roth conversion itself, however, does add income in the year you convert.
Where can I find the current IRMAA limits?
Medicare.gov and the Social Security Administration publish the current income limits and premium amounts each year.
Can RMDs push my Medicare premiums higher?
Yes. RMDs count as income, and higher income can trigger IRMAA surcharges on Medicare Part B and Part D premiums, usually based on your tax return from two years earlier. Planning withdrawals ahead of time may help you see this coming.
Can I appeal IRMAA if my income dropped?
Yes. If income fell because of a life-changing event such as retirement or a spouse's death, you can ask Social Security to reconsider using a form it provides. You will need proof of the event and the lower income.
When do I have to take my first RMD?
Under current law, the RMD age is 73 for many people, and 75 for people born in 1960 or later. You can delay your first RMD until April 1 of the following year, but then you take two in that year. This is general education, not tax advice.
What is a qualified charitable distribution?
A qualified charitable distribution lets IRA owners age 70½ or older send money directly from an IRA to a qualifying charity, up to an annual IRS limit. It can count toward an RMD without being added to taxable income. This is general education, not tax advice.
What happens if I miss an RMD?
The IRS may charge an excise tax on the amount you should have withdrawn, currently 25%, which can drop to 10% if corrected promptly. The IRS also explains how to request a waiver for reasonable errors. A tax professional can help.
Do RMDs raise the tax on my Social Security?
They can. RMDs add to the income used to figure how much of your Social Security is taxable. This is general education, not tax advice.
Authoritative sources
This page is educational and general in nature. RetirementLeverage™ and Retirement Planning Store, Inc. do not provide individualized investment, securities, tax, or legal advice; please consult a qualified tax professional or attorney about your own situation. Insurance products and services may not be available in every state, and any guarantees are subject to the financial strength and claims-paying ability of the issuing insurance company.