Updated

Updated · 24/7 Wall St. · Jul 5

Delaying First RMD Can Add $2,296 in Medicare Premiums at $218,000 IRMAA Threshold

Updated

Updated · 24/7 Wall St. · Jul 5

Delaying First RMD Can Add $2,296 in Medicare Premiums at $218,000 IRMAA Threshold

Q: Can a little-known government form erase thousands in Medicare surcharges after an income spike?

Yes — but only in limited cases. The form is **SSA-44**, which lets Medicare beneficiaries ask Social Security to recalculate IRMAA surcharges when income has fallen because of a qualifying life-changing event. That matters because Medicare uses a **two-year lookback**. A spike in 2026 income, for example, can raise Part B and Part D premiums in 2028. Crossing even the first IRMAA threshold can cost a married couple about **$2,296.80 more per year**, and higher tiers cost much more. The catch is that **SSA-44 does not usually fix a surcharge caused by a voluntary income spike alone**. If the higher income came from delaying a first RMD, taking a large IRA withdrawal, doing a Roth conversion, or realizing capital gains, that generally does **not** qualify for reconsideration. The same is true for most self-created MAGI increases tied to retirement-account planning. SSA-44 is mainly for cases where income later dropped because of events such as **retirement or work reduction, death of a spouse, divorce, loss of pension income, or loss of income-producing property**. If approved, Social Security can lower future premiums and may refund overpaid amounts. For retirees nearing IRMAA thresholds, the better strategy is prevention: take the **first RMD in the year you turn 73** instead of using the April 1 delay, which can bunch two RMDs into one tax year. Charitable retirees can also use **Qualified Charitable Distributions** to satisfy RMDs without increasing AGI.

3 articles · Updated · 24/7 Wall St. · Jul 5

Retirees turning 73 can trigger higher 2028 Medicare Part B and Part D premiums if they delay a first required minimum distribution until April 1 and end up stacking two RMDs into one 2026 tax year.
The risk is concentrated near 2026 IRMAA income thresholds of $218,000 for joint filers and $109,000 for singles, because Medicare generally uses MAGI from two years earlier and counts tax-exempt interest in that calculation.
A couple pushed from the standard tier into the first surcharge bracket would pay $81.20 more per person monthly for Part B and $14.50 for Part D, or $2,296.80 a year; the second tier raises the added household cost to $5,769.60.
A deferred first RMD from a $900,000 traditional IRA could add roughly $70,000 of taxable income in one year, while taking it in the year the retiree turns 73 spreads income across two calendar years and can keep MAGI lower.
SSA-44 generally will not erase an IRMAA hit caused by a voluntary RMD, making year-end planning, qualified charitable distributions up to $111,000 in 2026, and survivor filing-status changes key defenses.