If you are approaching Medicare eligibility or are already enrolled, you may have heard the term IRMAA (Income-Related Monthly Adjustment Amount). For many, IRMAA can significantly increase their Medicare premiums, which can be frustrating for those trying to manage healthcare costs in retirement. In this guide, we’ll break down what IRMAA is, how it is determined, and, most importantly, how to avoid it.

Key Takeaways

• IRMAA is based on your MAGI, meaning higher income can result in significantly higher Medicare premiums.
• Strategic financial planning, including tax-deductible contributions and Roth conversions, can help lower your MAGI and avoid IRMAA surcharges.
• Appealing IRMAA may be possible if your income was unusually high due to life-changing events, like retirement or a one-time financial windfall.

What is IRMAA?

IRMAA, or the Income-Related Monthly Adjustment Amount, is an additional surcharge added to your standard Medicare premiums based on your income. It applies to individuals who earn above a certain threshold, meaning the wealthier you are, the higher your Medicare premiums will be. IRMAA applies to both Part B (medical insurance) and Part D (prescription drug coverage).

This surcharge is determined by your Modified Adjusted Gross Income (MAGI), which includes your taxable income plus any tax-exempt interest (like municipal bond income). The IRMAA surcharge was introduced to help ensure that Medicare is adequately funded as healthcare costs rise, with those who can afford to pay a bit more contributing a larger share.

The Role of MAGI in Determining Medicare Premiums

Your MAGI plays a crucial role in determining whether you will incur an IRMAA surcharge and how much it will be. MAGI is your Adjusted Gross Income (AGI) plus any tax-exempt interest. For example, if you have an AGI of $100,000 and $5,000 in tax-exempt interest income, your MAGI would be $105,000.

The Social Security Administration (SSA) uses your MAGI from two years prior to determine your IRMAA surcharge for the current year. For instance, the income you earned in 2021 will affect your 2023 Medicare premiums.

If your MAGI exceeds a certain threshold, you will be subject to the IRMAA surcharge. These thresholds vary depending on whether you file taxes as an individual or jointly. For example, in 2023, individuals with a MAGI above $97,000 or couples earning more than $194,000 may face higher premiums.

How to Avoid IRMAA

The good news is that there are several ways to avoid IRMAA or minimize the surcharge, particularly if you have flexibility in your income or financial planning. Below are key strategies to help you reduce or avoid IRMAA altogether.

1. Charitable Giving

One way to lower your MAGI is through charitable donations. Charitable contributions can be deducted from your taxable income, lowering your AGI and MAGI. By donating to a qualified charity, you can reduce your reported income, which may help you avoid the IRMAA surcharge.

If you’re over 70½ and want to donate directly from your IRA to a charity, consider strategies like donor-advised funds (DAFs) or qualified charitable distributions (QCDs).

2. Tax-Deductible Retirement Account Contributions

Contributing to retirement accounts like a Traditional IRA or 401(k) can also reduce your taxable income. These contributions are typically made pre-tax, which lowers your AGI and consequently your MAGI. This is especially helpful if you are still working or have a high income in your pre-retirement years.

By contributing the maximum allowable amount to tax-deferred accounts, you can lower your taxable income enough to avoid the IRMAA surcharge.

3. Tax-Free Retirement Income

Consider focusing on tax-free income sources, such as Roth IRAs or municipal bonds. Since the income from Roth IRAs and municipal bonds is not included in your MAGI calculation, it won’t trigger an IRMAA surcharge.

If you’re in a higher tax bracket and want to minimize IRMAA, converting some traditional retirement savings into a Roth IRA could be a strategic move (though it could trigger taxes on the conversion itself, so it’s important to plan carefully).

4. Tax-Efficient Investments

Tax-efficient investments are designed to minimize your tax liability. These include investments like tax-managed mutual funds, index funds, and ETFs that generate less taxable income. The less taxable income you generate from your investments, the less likely you are to exceed the income thresholds for IRMAA.

It’s important to consult with a financial advisor to design an investment portfolio that minimizes taxable income and maximizes tax benefits.

5. Tax-Efficient Withdrawal Strategies

When it’s time to begin withdrawing funds from your retirement accounts, doing so in a tax-efficient manner can help you avoid IRMAA. For example, you might want to prioritize withdrawing funds from taxable accounts or Roth IRAs rather than traditional retirement accounts, as these withdrawals don’t count toward your MAGI.

By structuring your withdrawals carefully, you can keep your taxable income (and MAGI) below the IRMAA thresholds.

Medicare Savings Accounts (MSAs)

For those who are self-employed or have a high-deductible health plan, Medicare Savings Accounts (MSAs) can be a useful tool for reducing income. Contributions to MSAs are tax-deductible, and the growth of these funds is tax-deferred. By lowering your taxable income, you can reduce your MAGI and avoid the IRMAA surcharge.

Roth Conversions

Roth conversions involve converting funds from a traditional IRA or 401(k) into a Roth IRA. While Roth conversions are taxable events, they can be a powerful strategy if managed carefully. By converting funds in years when your income is low enough to avoid IRMAA, you can create tax-free growth for the future.

It’s important to time these conversions wisely to minimize their impact on your MAGI for IRMAA purposes.

Appealing IRMAA

Suppose your income in the year the SSA uses to determine your premiums was unusually high due to a one-time event (like selling a business or receiving a large inheritance). In that case, you may be able to appeal IRMAA. The SSA allows beneficiaries to request a reconsideration of their IRMAA surcharge in cases of life-changing events. If your income has dropped due to circumstances like retirement or divorce, this could be an effective strategy to reduce your premiums.

Utilizing Financial Planning to Avoid IRMAA

The most effective way to avoid IRMAA is by using proactive financial planning. By working with a certified financial planner or tax professional, you can create a strategy that minimizes your income in retirement and helps you stay below the IRMAA thresholds.

A financial planner can help you balance withdrawals, investments, and retirement contributions to ensure that an IRMAA surcharge does not blindside you.

Bottom Line

IRMAA can significantly increase your Medicare premiums, but with careful planning and knowledge of how MAGI impacts your premiums, you can reduce or avoid it altogether. By implementing strategies like charitable giving, tax-deductible retirement contributions, and tax-efficient investment planning, you can protect your retirement income and avoid unnecessary Medicare surcharges.

Remember, it’s always a good idea to work with a financial advisor to navigate these complexities and ensure that your retirement is as financially comfortable as possible. Understanding how to avoid IRMAA can save you hundreds or even thousands of dollars in extra premiums over the years.