How IRMAA Affects Medicare Premiums in Utah

If you’re approaching retirement in Utah, one of the most overlooked  (and often misunderstood) Medicare costs is IRMAA.

IRMAA stands for Income-Related Monthly Adjustment Amount.

In simple terms:

If your income is above certain thresholds, you will pay more for Medicare.

For higher-income retirees, this can add thousands of dollars per year to healthcare costs — often unexpectedly.

Let’s break down how it works and how to plan for it.

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What Is IRMAA?

IRMAA is a surcharge added to:

• Medicare Part B premiums

• Medicare Part D prescription drug premiums

It applies to individuals whose income exceeds federal thresholds.

Medicare uses your Modified Adjusted Gross Income (MAGI) from two years prior to determine whether you owe IRMAA.

For example:
Your 2026 Medicare premiums are based on your 2024 tax return.

This two-year look-back time period catches many retirees off guard.

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How Much Does IRMAA Increase Medicare Premiums?

Medicare Part B has a standard monthly premium (in 2026 it’s $202.90)

If your income exceeds the threshold, that premium increases in tiers.

The higher your income, the higher the surcharge.

The same applies to Part D. You pay an additional monthly amount on top of your plan premium.

For married couples filing jointly, the income thresholds are higher than for single filers — but the surcharge can apply more quickly if filing single.

For higher-net-worth retirees in Utah, it’s not uncommon to see:

• Several hundred dollars more per month in Part B premiums

• Combined annual IRMAA costs of several thousand dollars

And many retirees don’t realize they’ve crossed a threshold until the premium notice arrives.

Here are the 2026 IRMMA brackets:

🧾 Part B & Part D IRMAA Brackets 2026 (Single / Married Filing Jointly)

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What Income Counts Toward IRMAA?

Medicare calculates IRMAA based on Modified Adjusted Gross Income (MAGI).

This includes:

• Wages

• IRA withdrawals

• 401(k) withdrawals

• Required Minimum Distributions (RMDs)

• Capital gains

• Rental income

• Interest and dividends

• Roth conversion amounts

• Business income

• Social Security (partially taxable portion)

It does not matter whether the income is recurring or one-time.

A single large event — like selling property or converting a large IRA balance — can trigger IRMAA for a full year.

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Common IRMAA Triggers in Utah

Here are situations I frequently see among Utah retirees:

1. Large IRA Withdrawals Before or After 65

Many retirees take significant withdrawals to:

• Pay off a mortgage

• Fund a second home

• Help children

• Make charitable gifts

These withdrawals can push income above IRMAA thresholds.

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2. Roth Conversions

Roth conversions are often smart from a long-term tax perspective.

However, the converted amount counts toward MAGI in that year.

Without coordination, a Roth conversion can temporarily increase Medicare premiums two years later.

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3. Selling Property

Utah real estate appreciation has been strong.

Selling property can create large capital gains — and unexpected IRMAA exposure.

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4. Required Minimum Distributions (RMDs)

Once RMDs begin, income may rise automatically each year.

This can gradually move retirees into higher IRMAA brackets.

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Can You Reduce or Avoid IRMAA?

Yes — but it requires planning.

IRMAA is not random. It’s income-driven.

Strategies may include:

• Spreading Roth conversions across multiple years

• Coordinating large withdrawals before age 63 (before the IRMAA lookback window)

• Timing property sales strategically

• Using Qualified Charitable Distributions (QCDs)

• Managing capital gains exposure

• Structuring retirement income efficiently

The key is coordination.

Medicare decisions cannot be separated from tax strategy.

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What If Your Income Has Dropped?

If you experienced a major life event such as:

• Retirement

• Divorce

• Death of a spouse

• Loss of income-producing property

You can file an appeal with Social Security using Form SSA-44.

Many retirees are unaware they can request an IRMAA adjustment based on reduced income.

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Why IRMAA Matters for Retirement Planning

 IRMAA becomes a long-term cost planning issue.

Over 10–20 years in retirement, small annual surcharges can compound into tens of thousands of dollars.

This is why Medicare planning should not happen in isolation.

It should be integrated into:

• Retirement income strategy

• Tax planning

• Social Security timing

• Estate planning

• Investment withdrawal sequencing

When coordinated properly, many IRMAA surprises can be avoided.

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Final Thoughts

IRMAA isn’t a penalty — it’s an income-based adjustment.

But without proactive planning, it can feel like one.

If you’re approaching age 65 in Utah and want clarity on how your income may impact Medicare premiums, it’s wise to review:

• Your projected retirement income

• Planned Roth conversions

• Potential property sales

• Social Security start dates

Medicare costs are manageable when addressed early.  If you’d like a deeper dive into how IRMAA could affect your retirement situation, get in touch with us and we can walk you through it.