A single required minimum distribution can push retirees into higher IRMAA brackets, doubling monthly Medicare Part B premiums.
A retiree’s first required minimum distribution (RMD) in December lifted their Medicare Part B premium from $203 to $406 per month, jumping two IRMAA brackets. The increase applies for the entire year, even if income crosses the threshold by just $1.
IRMAA brackets are based on modified adjusted gross income from two years prior. For 2026 premiums, 2024 tax returns determine the bracket. An individual filer with MAGI up to $109,000 pays $202.90 monthly, while crossing $137,001 raises the premium to $405.80.
Retirees use tools like qualified charitable distributions and Roth conversions to mitigate IRMAA exposure before RMDs begin.