BEFORE YOU OPEN THE PLANNER
Most people have never heard of IRMAA; it affects roughly eight percent of people on Medicare. Those who have heard of it usually recognize it from a premium notice. Watch the 4-minute, 40-second overview or read the explanation below. Then open the planner whenever you are ready.
WATCH THE OVERVIEW
Learn what IRMAA is, why it is a separate Medicare planning consideration, and how this optional educational planner can help you explore your questions.
Ready to explore your numbers?
Have your tax return or estimated MAGI handy.
Could the income you receive today affect what you pay for Medicare later? If you are already on Medicare, approaching enrollment, or planning with a spouse who is, that question may deserve a closer look. Welcome to the SIS Resource Center's IRMAA Planner.
IRMAA stands for Income-Related Monthly Adjustment Amount. People sometimes call it a Medicare tax or surcharge. More precisely, it is an extra monthly premium charge for people with higher incomes who have Medicare Part B, Part D, or both. Part B covers medical services. Part D provides prescription drug coverage. The adjustment is added to the premiums that otherwise apply.
The income figure used for IRMAA is called modified adjusted gross income. For this purpose, it is your adjusted gross income plus tax-exempt interest. Taxable gains, taxable retirement distributions, and taxable Roth conversions can increase that amount. A sale's gross proceeds are not the same as the income counted for IRMAA. What matters is the income included in this specific calculation.
Timing matters, too. Social Security generally uses your income from two tax years earlier. For example, income for twenty twenty-four generally affects Medicare premiums for twenty twenty-six. That is why income earned before you enroll in Medicare can matter later. If the usual return is unavailable, Social Security may use an earlier return.
IRMAA works through income tiers. Crossing a threshold can move you into a higher monthly charge. It is not simply a percentage applied to the dollars above that threshold. Each enrolled person has their own adjustment. For a married couple filing jointly, the same combined income can affect both spouses, depending on each person's Medicare coverage.
IRMAA is not a Structured Installment Sale variable. It does not determine how a structured installment sale works. A structured installment sale does not change Medicare's rules. IRMAA is a separate future planning consideration, connected through the amount and timing of income.
Different income patterns can produce different Medicare costs. Spreading income across years could reduce a surcharge in one year, but could also create surcharges in other years. An SIS does not automatically reduce or eliminate IRMAA. The useful question is how your overall income, Medicare enrollment, and timing fit together.
We provide the IRMAA Planner solely as an information and education resource. It is optional, and you can use it whether you are considering a Structured Installment Sale or simply have questions about Medicare costs.
Start by selecting the income year you want to explore. Then enter your tax filing status, your estimated MAGI, and the Medicare coverage to include. For a joint return, use combined income. The planner can show an estimate for one enrolled person or two.
The results show estimated extra monthly and annual costs, along with a premium breakdown. You can see how close your income is to the next threshold, compare another income amount, and download a report for a conversation with your advisor. Future-year estimates use a clearly labeled rate benchmark. They are not predictions of future thresholds or premiums.
Social Security makes the actual determination. Certain life-changing events, such as retirement that reduces income, may support a request for a lower adjustment. A voluntary sale or Roth conversion alone generally does not qualify. Your advisor can help you consider the relevant income and timing.
Ready to explore? Have your tax return or estimated modified adjusted gross income available, and open the IRMAA Planner. Understand the connection, explore your questions, and bring greater clarity to your planning conversation.
01 / THE TERM
IRMAA stands for Income-Related Monthly Adjustment Amount. People sometimes call it a “Medicare tax” or a “Medicare surcharge,” but it is not a tax and nothing is paid to the IRS. It is an additional amount added to the monthly premium for Medicare Part B (medical coverage) and Part D (prescription drug coverage) when a person’s income is above thresholds set by federal law.
Social Security determines it each year using income information it receives from the IRS, and it is paid along with the regular premium, usually as a deduction from a Social Security benefit. Each person enrolled in Medicare has their own IRMAA, even when a couple files one joint return.
Your 2026 premiums are based on the income on your 2024 federal return. In general, the income you report in one year sets your Medicare premium two years later. If that return is not yet available, Social Security may use the year before it.
For IRMAA, “modified adjusted gross income” (MAGI) is your adjusted gross income plus tax-exempt interest. Taxable gain from a sale, interest, and taxable Roth conversions all count. The gross selling price of what you sold does not; what counts is the taxable income it produces.
The thresholds are tiers. One dollar over a threshold moves a person to the next tier for every month of that premium year. For 2026, IRMAA begins when 2024 MAGI exceeds $109,000 (single) or $218,000 (married filing jointly), and ranges from $81.20 to $487.00 a month for Part B and $14.50 to $91.00 for Part D, per person, on top of the standard $202.90 Part B premium.
02 / THE CONNECTION
A Structured Installment Sale does not change IRMAA’s rules, and IRMAA is not an input to the SIS Calculator or the SIS Analyzer. The connection is simpler than that: a sale changes how much gross income you report, and in which years.
Taking the full price at closing puts the entire taxable gain into one year’s income, and two years later into one year’s Medicare premium. Receiving the price in installments puts a smaller amount into each year’s income instead, year after year.
Whether that helps depends on the numbers. Smaller annual amounts may stay under a threshold each year, or land in a lower tier for several years rather than a high tier for one. They may also create a surcharge in years that would otherwise have had none. Neither direction is automatically better, which is why the question is worth checking rather than assuming.
03 / THE TOOL
The IRMAA Planner is an information and education resource for people with IRMAA-related questions. It is provided as a courtesy and sits apart from the SIS tools.
READY WHEN YOU ARE
Have your most recent federal return handy, or an estimate of the income year you want to check, along with the Medicare coverage of each person in your household. The planner opens with an example you can replace with your own figures.
2026 amounts apply to 2024 income and are the figures used in the planner. Educational reference only; not tax, legal, insurance, or investment advice. Social Security makes the actual determination.
