A $60,000 401(k) distribution in 2026 could trigger $1,783 in annual Medicare premium surcharges by 2028 for married couples.
Retirees face unexpected Medicare premium hikes due to a two-year lookback rule on 401(k) withdrawals. A $60,000 distribution in 2026, combined with Social Security and pension income, can push modified adjusted gross income to $112,000, triggering surcharges in 2028.
The first IRMAA tier starts at $109,000 for individuals or $218,000 for joint filers, raising Part B premiums from $202.90 to $284.10 monthly. Part D adds another $14.50, totaling $1,148 annually. About 8% of Part B beneficiaries pay these surcharges, primarily 401(k) holders.
Retirees can mitigate costs by modeling income below thresholds, using qualified charitable distributions up to $111,000, or filing Form SSA-44 after life-changing events.