Medicare MAGI: What Income Counts for IRMAA?

Medicare MAGI is the income number used to decide whether you owe an IRMAA surcharge.

Estimate your surcharge

For IRMAA, Medicare generally uses modified adjusted gross income from your tax return. A practical way to think about it is adjusted gross income plus tax-exempt interest.

Income that can count

  • Wages, pension income, interest, dividends, and taxable Social Security benefits.
  • Traditional IRA and 401(k) withdrawals, including RMDs.
  • Roth conversions, taxable capital gains, and taxable home sale gains.
  • Tax-exempt interest, including municipal bond interest.

Common planning questions

Qualified Roth IRA withdrawals usually do not raise MAGI, while Roth conversions usually do. A properly handled QCD may reduce taxable IRA income, but the details matter.

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