Top 5 Medicare Tax Mistakes in Utah (And How to Avoid Them in 2026)

When most people think about Medicare, they focus on coverage and premiums—but what many don’t realize is that taxes play a huge role in how much Medicare actually costs.

Every year, I talk to people across Utah who unknowingly make tax-related Medicare mistakes that end up costing them thousands.

Here are the Top 5 Medicare Tax Mistakes in Utah (And How to Avoid Them in 2026).

1. Triggering Higher Medicare Premiums (IRMAA) Without Realizing It

Medicare premiums aren’t the same for everyone.  We all know we have an “Uncle Sam” that likes to dip into our pockets, but once we are on Medicare, we also have an Aunt “IRMAA” that likes to dip into our pockets.

If your income is above certain thresholds, you’ll pay more for:

• Medicare Part B
• Medicare Part D

This is called IRMAA (Income-Related Monthly Adjustment Amount).  Although IRMAA is not technically a tax, (technically it’s a surcharge) it is still an extra cost just like taxes.

See IRMAA income brackets here.

In 2026, your premiums are based on your income from two years prior.

👉 Example: A large IRA withdrawal or stock sale today could increase your Medicare premiums later.

Utah Tip: Many retirees here have IRAs, pensions, or real estate sales—these can easily push you into a higher bracket without planning ahead.

2. Going Just $1 Over an IRMAA Threshold

This is one of the most frustrating Medicare rules.

If your income goes even slightly over a threshold, even just $1, your premiums jump to the next level.

👉 That means a small increase in income can lead to hundreds or even thousands in extra Medicare costs.

How to avoid it:

• Monitor your income carefully
• Coordinate withdrawals from IRAs and other accounts
• Work with someone who understands Medicare + tax planning

3. Not Planning for Required Minimum Distributions (RMDs)

At age 73, the IRS requires you to start taking withdrawals from most retirement accounts.

These RMDs increase your taxable income, which can:

• Push you into a higher tax bracket
• Trigger IRMAA
• Increase your Medicare premiums

Utah Insight: This is especially common for people who have done a good job saving—ironically, success can create a tax problem later.

4. Contributing to an HSA After Enrolling in Medicare

This is a costly and very common mistake.

Once you enroll in Medicare, even just part A:
❌ You are no longer allowed to contribute to an HSA

If you do:

• You may face tax penalties
• You’ll need to correct contributions

Important: Even if you delay Medicare while working, timing matters—especially around your 65th birthday.  There are some very complicated rules when it comes to HSA contributions and Medicare, we deal with this alot!

5. Not Appealing Medicare Premium Increases When Income Drops

Many people don’t realize this…

If your income goes down due to:

• Work stoppage
• Death of spouse
• Marriage or Divorce
• Loss of income
• Or other specific situations

👉 You can file an IRMAA appeal and potentially lower your Medicare premiums.  The form is called SSA-44

But most people:

• Don’t know this exists
• Or don’t know how to do it

You should be able to file this form right on your social security or account.

Final Thoughts

Medicare isn’t just about choosing a plan—it’s about making smart financial decisions that can impact your costs for years to come.

Avoiding these tax mistakes can save you thousands over time and help you get the most out of your coverage.

If you’re in Utah and want help navigating Medicare without costly surprises:

📱 Text or call 801-369-3090
for personalized guidance

Tyler Haskell, CFP®