IRMAA is based on modified adjusted gross income from an earlier tax year. If a Roth conversion adds taxable income, that income can push you into a higher Medicare premium bracket two years later.
Planning point: The conversion amount matters. A smaller conversion may stay below the next IRMAA threshold, while a larger conversion may create a monthly surcharge.
Why Roth conversions can trigger IRMAA
A Roth conversion moves money from a pre-tax retirement account into a Roth account. The converted amount is usually taxable in the conversion year. That taxable amount can increase AGI, which can increase Medicare MAGI.
For 2026 premiums, Medicare generally uses 2024 MAGI. That two-year lookback is why a conversion can feel disconnected from the premium bill that arrives later.
Use the Roth conversion IRMAA calculator
Education sponsor placement for Roth conversion planning, Medicare premium education, or advisor-client planning resources.
How much can you convert before IRMAA?
The answer depends on filing status, current MAGI, the conversion amount, and the current IRMAA brackets. The important number is not just the conversion. It is total Medicare MAGI after the conversion.
For example, if you are near the first IRMAA threshold, even a modest conversion can move you into the first surcharge bracket. If you have more room before the next threshold, the same conversion may not create a surcharge.
Can you appeal IRMAA after a Roth conversion?
A Roth conversion by itself generally is not a qualifying SSA-44 life-changing event. If your IRMAA surcharge is caused by a planned conversion, the better strategy is usually to estimate the premium impact before converting.
Review the SSA-44 appeal guide before assuming an appeal applies.
Roth conversion IRMAA FAQ
- Does a Roth conversion count as income for IRMAA?
- A taxable Roth conversion generally increases AGI and can increase Medicare MAGI for IRMAA.
- Can a Roth conversion affect Medicare Part D too?
- Yes. IRMAA can add surcharges to both Medicare Part B and Medicare Part D premiums.
- Is a qualified Roth IRA withdrawal treated the same way?
- No. Qualified Roth IRA withdrawals usually are not taxable income, while Roth conversions usually are taxable.
- What should I check before converting?
- Check your estimated MAGI, filing status, current IRMAA brackets, and room before the next bracket.
Next step: estimate the Roth conversion amount, then compare the result with the 2026 IRMAA brackets and the Medicare MAGI guide.