IRMAA Planning Checklist

Use this before a large income decision so Medicare premium surprises are part of the conversation, not an afterthought.

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Before a Roth conversion

Estimate total Medicare MAGI after the conversion.
Check whether the conversion crosses the next 2026 IRMAA bracket.
Compare one large conversion with spreading conversions across years.

Before an RMD

Model RMD income with pensions, work income, and taxable investment income.
Review whether a QCD fits your charitable giving plan before taking the distribution.
Check whether extra IRA withdrawals in the same year create an avoidable surcharge.

Before a capital gain

Estimate taxable gain, not total sale proceeds.
Review whether a taxable account rebalance can be split across years.
Include mutual fund capital gain distributions if they are expected.

Before selling a home

Estimate the taxable gain after any available home-sale exclusion.
Include other same-year income events that can stack on top of the sale.
Do not assume a home sale automatically qualifies for IRMAA appeal relief.

Before relying on SSA-44

Confirm whether the event is one of the Social Security life-changing events.
Separate work stoppage or work reduction from planned one-time income spikes.
Review the appeal guide before assuming Roth conversions, capital gains, or home sales can be appealed away.

Next step: run the calculator, then use the avoid IRMAA surprises guide to frame the planning conversation.