4. Medicare Premiums and IRMAA Thresholds Could Shift
Medicare Part B and Part D premiums are income-sensitive. Higher earners pay additional surcharges through the Income-Related Monthly Adjustment Amount (IRMAA).
While IRMAA brackets are adjusted annually for inflation, even modest income increases can push retirees into higher premium tiers.
In 2026, seniors should pay attention to:
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Two-year look-back income (2024 income affects 2026 premiums)
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RMD withdrawals
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Capital gains from investment sales
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Roth conversion strategies
Even a one-time spike in income—such as selling property—could temporarily increase Medicare premiums.
Strategic planning can help minimize these surprises.
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