How One Financial Decision Could Increase Your Medicare Costs

When a large capital gain or ordinary income amount is incoming, I like to run a tax analysis to check on the possible tax impact.

I've found it's easy to miss the many ways income events can affect a tax return. Because our tax system can stack taxes on top of each other.

An Often-Overlooked Cost: IRMAA

One item that can get overlooked is IRMAA, which raises Medicare premiums if income exceeds certain thresholds.

For 2026, IRMAA begins when modified adjusted gross income MAGI is:

• $109,000 for single filers

• $218,000 for married filing jointly

How Expensive Can IRMAA Be?

So IRMAA begins at income levels that aren't as high as we may think, and it can be expensive.

For example, a married couple just over the threshold could pay approximately $2,300 more annually in Medicare premiums if both spouses are enrolled in Medicare Parts B and D.

At higher levels, the additional premiums could exceed $13,000 annually for a couple.

The Bigger Picture

Good to double check, because one income event can trigger a cascade of additional taxes that aren't always clear just from the tax bracket.