Home sales gains above $500,000 exclusion trigger IRMAA surcharges two years later, doubling premiums for some couples.
Retirees selling homes face a $649 monthly Medicare Part B premium increase per spouse in 2026 if 2024 gains exceed the $500,000 married-couple exclusion. The two-year lookback rule applies capital gains to future premiums, catching many off guard.
The $500,000 exclusion leaves taxable gains above that amount exposed to income-related monthly adjustment amounts (IRMAA). A surviving spouse’s threshold drops from $218,000 to $109,000, potentially pushing gains into higher brackets without income changes. CMS data shows 8% of Medicare Part B enrollees pay IRMAA surcharges.
A couple selling a $1.2 million home after buying it for $300,000 faced the surcharge despite the exclusion. Delaying the sale to January shifts the lookback year, offering a potential workaround.