One High-Income Year Could Raise Your Medicare Premiums Later

A high-income year can raise Medicare Part B and Part D costs later through IRMAA. In 2026, surcharges begin above $109,000 for individuals and $218,000 for joint filers. Ground Picture/Shutterstock

A particularly profitable year in retirement can come with a delayed expense that catches some Medicare beneficiaries by surprise. Selling investments, realizing a large capital gain, taking substantial retirement-account withdrawals, or receiving other taxable income can push household income high enough to trigger Medicare premium surcharges later. The extra charge is formally called the Income-Related Monthly Adjustment Amount, or IRMAA, and it can increase both Medicare Part B and Part D costs. What makes IRMAA confusing is that the bill generally does not arrive during the same year that produced the higher income. Understanding that delay can help retirees plan major financial moves without being blindsided by higher healthcare premiums afterward.

Medicare Looks Back at Earlier Income