How can I lower my income to avoid IRMAA?
Because IRMAA uses your income from two years ago, planning ahead is the main way to avoid a higher tier.
Know the lines first
For 2026 premiums, the first line is $109,000 of income for a single filer and $218,000 for a married couple filing jointly. Check where you stand before you decide what to change.
Moves that lower income
- Spread Roth conversions across several years so no single year jumps over a line.
- Time capital gains. Selling a large position in one year can push you up a tier; consider spreading sales.
- Use qualified charitable distributions from an IRA once you are old enough, so the gift is not counted as taxable income.
- Contribute to pre-tax accounts while you are still working.
Watch the two-year delay
Income you report this year affects premiums two years from now. Be careful with one-time spikes: Social Security generally does not treat a capital gain from selling property, a lottery or casino win, or an IRA conversion as a reason to lower IRMAA, so plan those years ahead rather than relying on an appeal. A genuine life-changing event, such as retiring, is different and can be appealed with form SSA-44.
See how far you are from the next line → · How to appeal →
Sources: Medicare.gov: costs; SSA: premiums; SSA: request to lower IRMAA.