Your First Required IRA Withdrawal At 73 Can Push You Past The IRMAA Cliff For A Full Year
Turning 73 comes with a deceptively simple retirement decision: take your first required minimum distribution (RMD) by December 31, or use the one-time option to delay it until April 1 of the following year.
That delay may appear harmless. But for retirees close to an IRMAA threshold, it can create an expensive surprise. Deferring the first RMD can result in two withdrawals being reported in the same tax year, increasing modified adjusted gross income (MAGI), potentially moving you into a higher Medicare premium bracket, and raising your Part B and Part D costs two years later.
Only a small percentage of Medicare beneficiaries pay an IRMAA surcharge. The risk is concentrated among retirees whose income is close to the Medicare thresholds. For 2026, those thresholds begin at $218,000 for married couples filing jointly and $109,000 for single filers. A single timing decision involving your RMD can add thousands of dollars to future Medicare premiums if it pushes your income into a higher bracket.
The Two-Year IRMAA Lookback Is Where the Surprise Happens
IRMAA—the Income-Related Monthly Adjustment Amount—generally uses your tax return from two years earlier to determine your Medicare premiums. That means your 2026 income typically determines your 2028 Medicare Part B and Part D premiums. An RMD taken in 2026, calculated using your IRA balance as of December 31, 2025, can affect what you pay for Medicare 24 months later.
The key income measurement is MAGI, which is your adjusted gross income (AGI on Form 1040, line 11) plus tax-exempt interest (line 2a). Many retirees overlook municipal bond income because it is tax-free, but it still counts toward IRMAA calculations.
What Higher IRMAA Brackets Can Cost In 2026
The following 2026 IRMAA amounts show the potential impact of crossing into higher income tiers. Figures are monthly and apply per person.
| Joint MAGI | Single MAGI | Part B Total Monthly Premium | Part D IRMAA Monthly Add-On |
|---|---|---|---|
| $218,000 or less | $109,000 or less | $202.90 | $0.00 |
| $218,001–$274,000 | $109,001–$137,000 | $284.10 | $14.50 |
| $274,001–$342,000 | $137,001–$171,000 | $405.80 | $37.50 |
| $342,001–$410,000 | $171,001–$205,000 | $527.50 | $60.40 |
For a married couple, moving from the standard Medicare tier into the first IRMAA bracket means each spouse pays an additional $81.20 per month for Part B and $14.50 per month for Part D. That adds up to about $2,296.80 per year in additional Medicare costs for the household. Moving into the next tier increases the annual surcharge impact to approximately $5,769.60.
Why The First RMD Often Creates The Problem
The first RMD is a common trigger because retirees have a special option: they can delay their first withdrawal until April 1 of the year after they turn 73. The downside is that the next RMD is still due by December 31 of that same year. The result? Two RMDs can hit one tax return.
For example, a retiree with a $900,000 traditional IRA might generate roughly $70,000 or more in taxable income from two RMDs combined, depending on market performance and account balances. That additional income could push a household above an IRMAA threshold.
Taking the first RMD during the year you turn 73 spreads the taxable income across two calendar years instead. For retirees near an IRMAA cutoff, that timing difference can matter. Under current law, the RMD starting age is 73 for individuals born from 1951 through 1959 and 75 for those born in 1960 or later.
The Survivor Issue Many Couples Miss
A retirement plan that works for two people may create problems after one spouse dies. When a surviving spouse files as single, the IRMAA thresholds are much lower. A couple that comfortably stays below the joint threshold may find the survivor much closer to—or above—the single threshold with the same retirement assets and withdrawal strategy.
The death of a spouse is considered a qualifying life-changing event for an SSA-44 appeal, but the survivor still needs to plan around the lower single-filer thresholds going forward.
Why SSA-44 May Not Help With A Voluntary RMD Increase
Form SSA-44 allows Medicare beneficiaries to request an IRMAA adjustment after certain life-changing events, including:
- Marriage
- Divorce or annulment
- Death of a spouse
- Stopping work
- Reducing work hours
- Certain losses of income-producing property
- Loss of pension income
- Certain employer settlement payments
However, voluntarily increasing income through actions such as a large RMD, Roth conversion, or taxable home sale generally does not qualify on its own. If your income rises because of your own financial decision, the IRMAA surcharge typically remains in place.
Steps Retirees Can Consider
- Take the first RMD during the calendar year you turn 73 rather than automatically waiting until the April 1 deadline. Run the numbers first to see whether delaying truly helps.
- If you are at least 70½ and charitably inclined, consider a qualified charitable distribution (QCD). A QCD can satisfy part of an RMD while avoiding an increase to AGI, making it a valuable IRMAA planning strategy.
- If your projected MAGI is within roughly $20,000 of an IRMAA threshold, consider modeling withdrawal timing, capital gains, Roth conversions, charitable giving, and taxable income before year-end.
Your RMD Decision Can Affect Medicare Years Later
Your first RMD is not just a retirement account deadline. It is also a Medicare planning decision. The April 1 delay option can be useful in the right circumstances, but retirees near an IRMAA threshold should view it as a planning choice—not an automatic strategy. A well-timed withdrawal can help prevent an avoidable Medicare premium increase two years down the road.
Source: 24/7WallSt
