A one-time $25,000 scratch-ticket payout triggered $1,150 in Medicare premium surcharges two years later due to IRMAA rules.
A 70-year-old Ohio retiree faced an unexpected $1,150 increase in Medicare premiums after winning $25,000 on a scratch ticket. The windfall pushed his modified adjusted gross income (MAGI) over the $109,000 IRMAA threshold, triggering surcharges two years later.
Medicare’s two-year lookback rule means a 2026 income spike can raise 2028 premiums. The retiree’s Part B premium jumped from $203 to $284 monthly. IRMAA appeals are limited to life events like job loss or divorce, excluding lottery wins or capital gains.
Only 8% of Medicare Part B enrollees pay income-related surcharges, but those near the threshold risk higher costs from one-time income spikes.