Respect the lookback
Project modified adjusted gross income two years ahead of Medicare premiums.
MEDICARE IRMAA
Income can raise premiums.
Medicare income-related surcharges use modified adjusted gross income from an earlier year.
Watch bracket thresholds
Map Roth conversions, gains, RMDs and one-time income against IRMAA thresholds.
Know qualifying appeal events
Do not avoid profitable income blindly; compare the added premium with the tax or investment benefit.
FLIGHT CHECK
Questions before acting.
Enrollment dates
Lookback tax year
Conversions
Realized gains
Both spouses’ premiums
PRIMARY REFERENCE
Social Security Medicare premiums↗THE ACTUAL SOLUTION
Leave with a decision—not another article.
Project modified adjusted gross income two years ahead of Medicare premiums.
Map Roth conversions, gains, RMDs and one-time income against IRMAA thresholds.
Do not avoid profitable income blindly; compare the added premium with the tax or investment benefit.
Model marginal rates, phaseouts, state tax, Medicare effects, and timing before acting on the headline tax rate.
Model the Roth window
OPEN →YOU ARE DONE WHENLarge income events are scheduled with both tax and Medicare effects visible.
OPTIONAL DEEP DIVES