Yes, all three can trigger or increase IRMAA, the income-related surcharge added to Medicare Part B and Part D premiums. IRMAA is based on your income from two years prior, so a large transaction today can raise your premiums in the future.
IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra charge added to your Medicare Part B and Part D premiums if your income exceeds certain thresholds. The income Medicare uses is your modified adjusted gross income, or MAGI, from two years back. So your 2025 premiums are based on your 2023 tax return. Selling a house can create a large capital gain in a single year, which could push your income well above the IRMAA thresholds. A Roth conversion, where you move money from a traditional IRA into a Roth IRA, counts as taxable income in the year it happens, and a large conversion can do the same thing. Required Minimum Distributions, called RMDs, are the mandatory annual withdrawals from traditional retirement accounts that start at a certain age. Those distributions count as income too, and if they're substantial, they can push you into a higher IRMAA bracket. The surcharges are applied in tiers, so even crossing a threshold by a small amount can mean a meaningfully higher premium. The good news is that if you had a one-time income spike, you can appeal IRMAA using a form called SSA-44 if you've since had a qualifying life event, such as retirement, that reduced your income. Plan details and thresholds change annually, so check current figures at ssa.gov or speak with a financial advisor.
For you, this means big financial moves like selling property or converting retirement accounts can ripple forward and raise your Medicare costs two years later, so it's worth planning those transactions with a tax advisor if you're near an IRMAA threshold.
Our Commitment to Reliable Medicare Information
At Resting Sycamore Advisors, we work to provide accurate, current, and trustworthy information about Medicare Advantage, Medicare Part D, and Special Needs Plans.
To do that, we use data published by the Centers for Medicare & Medicaid Services (CMS), which is the official source for Medicare plan and enrollment information.
Our Medicare plan pages and comparison tools are powered by CMS datasets, including:
When possible, we link to the original CMS resources so you can review the source material directly.
We follow the CMS release schedule and update our website as new data becomes available.
We load new plan year Landscape and PBP files before the Medicare Annual Enrollment Period (October 15 through December 7). We also monitor CMS.gov for updates or revisions and refresh our content when needed.
We update enrollment and performance data as CMS publishes revised files, which are typically released monthly or quarterly.
We routinely monitor CMS announcements for corrections, reissued files, or other changes and update our pages accordingly.
Each plan page includes a Last Accessed date so visitors can see when the source information was most recently reviewed.
CMS data can be difficult to read in raw form. To make it easier to use, we format and organize the data for clarity.
This includes:
All data values come from CMS. We do not change the underlying values beyond formatting, organization, and presentation.
We keep internal records of the CMS dataset versions used on our site.
If CMS issues corrected or revised files, we update our website to reflect the latest available version.
Please keep the following in mind:
For personalized Medicare assistance, please use these official resources: