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401(k) Withdrawal Medicare Premium Calculator
Estimate whether a taxable 401(k) withdrawal could increase your Medicare premium surcharge through IRMAA.
Short answer: traditional 401(k) withdrawals can raise Medicare MAGI. Qualified Roth 401(k) withdrawals usually do not affect IRMAA the same way.
- Uses 2026 CMS Part B and Part D IRMAA surcharge amounts.
- Shows monthly and annual surcharge estimates in plain English.
- Built for planning conversations, not tax, legal, or Medicare enrollment advice.
Step-by-step estimate
Check your estimated IRMAA risk
Enter your expected Medicare MAGI and add any one-time income events.
2026 IRMAA brackets at a glance
For 2026 Medicare premiums, IRMAA uses 2024 modified adjusted gross income. The first surcharge begins above $109,000 for single filers and above $218,000 for married couples filing jointly.
| Filing status | First IRMAA threshold | First Part B surcharge | First Part D surcharge |
|---|---|---|---|
| Single | Over $109,000 | $81.20/month | $14.50/month |
| Married filing jointly | Over $218,000 | $81.20/month | $14.50/month |
| Married filing separately | Over $109,000 | $446.30/month | $83.30/month |
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Why 401(k) withdrawals can affect Medicare premiums
Traditional 401(k) withdrawals are usually taxable income. That means they can raise Medicare MAGI and potentially affect IRMAA. The Medicare question is not the account balance; it is how much taxable income lands on the tax return used for the premium year.
Use this page to test a planned withdrawal and see how close it may put you to the next bracket. 2026 IRMAA brackets, Medicare MAGI, and the main IRMAA calculator can help frame the estimate.
| Retirement account event | Typical IRMAA impact | Planning page |
|---|---|---|
| Traditional 401(k) withdrawal | Can raise AGI and Medicare MAGI | Use this calculator |
| Qualified Roth 401(k) withdrawal | Usually not taxable income | Roth and IRMAA guide |
| RMD | Usually taxable and can raise MAGI | RMD IRMAA calculator |
| Traditional IRA withdrawal | Usually taxable and can raise MAGI | IRA withdrawal calculator |
401(k) withdrawal FAQ
- Does this income count for IRMAA?
- Taxable retirement income generally counts in MAGI for IRMAA purposes.
- Should I enter the gross amount?
- Enter the amount you expect to count in taxable income or Medicare MAGI, not an account balance.
- Can a 401(k) contribution lower IRMAA?
- A current-year pre-tax contribution can reduce taxable wages for a worker, but it does not change a prior tax year already used for an IRMAA notice.
- Is this personal advice?
- No. This page provides educational estimates and should be checked against official guidance.
Official sources
SSA explains that IRMAA is based on MAGI, generally using tax information from two years earlier. The exact tax treatment of retirement distributions depends on account type and tax facts.