Medicare IRMAA Explained 2026: The Two-Year Lookback, Roth Conversions and Form SSA-44

You turn 65, you enroll in Medicare, and your Part B premium is higher than the standard one. Maybe a lot higher. The reason is IRMAA — the Income-Related Monthly Adjustment Amount — and what makes it catch people is the timing: Medicare generally looks back two years at your income. A Roth conversion, a capital gain, a business sale or a large retirement distribution at 63 can change what you pay at 65. David Heitner walks through how IRMAA works in 2026, what one bracket actually costs, and what you can do when your income has dropped. In this video: 0:00 - Why your income can raise your Medicare premium 1:37 - What IRMAA is 2:29 - Medicare looks back two years 3:36 - What income Medicare looks at 4:24 - IRMAA works in brackets, not percentages 5:39 - A married couple, and one bracket 6:58 - How expensive the top bracket gets 7:37 - Does this mean don't do a Roth conversion? 8:20 - What if you retire and your income drops? 9:02 - The eight life-changing events 9:49 - Form SSA-44 10:24 - Why a Roth conversion can't be appealed away 11:21 - IRMAA is determined every year 11:57 - Start thinking about Medicare before 65 12:42 - Bring your CPA and advisor into it 13:30 - What's next: the biggest Medicare mistakes This is Episode 9 of an ongoing series covering the foundation, Part A, Part B, Medicare Supplement insurance, Medicare Advantage, choosing between the two paths, Part D and enrollment timing. Episode 10 covers the biggest Medicare mistakes people make. The 2026 IRMAA figures used in this video: Standard Part B premium: $202.90 a month First IRMAA thresholds: modified adjusted gross income above $109,000 single, or $218,000 married filing jointly Part B premium in the first IRMAA bracket: $284.10 a month, which is $81.20 above standard Part D IRMAA in the first bracket: $14.50 a month, on top of your drug plan's own premium Highest Part B premium under IRMAA: $689.90 a month Highest Part D IRMAA: $91 a month IRMAA reaches roughly 8% of people with Part B All figures are 2026 amounts and are indexed annually. For a married couple where both spouses are subject to IRMAA, crossing into that first bracket works out to about $1,948.80 a year in additional Part B premiums plus $348 a year of Part D IRMAA — roughly $2,296.80 for the year. Worth knowing: Social Security recognizes eight life-changing events that can support a request to use more recent income — marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss or reduction of certain pension income, and certain employer settlement payments. Retirement usually involves a work stoppage or work reduction. Form SSA-44 is how you ask. Also worth knowing: a voluntary Roth conversion is not one of those eight events. "My income is lower now, so please ignore that conversion" is not an argument that works. That is exactly why the Medicare conversation belongs before the transaction rather than after it. FREE GUIDE - Medicare Insurance Basics (PDF): https://drive.google.com/file/d/1GHbM... More Medicare resources: https://heitsbenefits.com/medicare/?u... Questions about your own situation: Call or text (201) 647-2095. Heits Benefits Group does not offer every plan available in your area. Any information provided is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. Government or the federal Medicare program. David Heitner, National Producer Number 2098121 #Medicare #IRMAA #SSA44 #RothConversion #Medicare2026 #RetirementPlanning #TurningSixtyFive #MedicareExplained #HeitsBenefits Securities and advisory services offered through Independent Financial Group, LLC (IFG), a Registered Investment Adviser. Member FINRA/SIPC. Heits Benefits Group and IFG are unaffiliated entities. OSJ Branch: 12671 High Bluff Dr. Suite 200. San Diego, CA 92130 IFG Registered Representatives associated with this website may discuss and/or transact business only with residents of the states in which they are properly registered or licensed. Some insurance products are offered outside of the existing Broker Dealer relationship. The information provided is from sources believed to be reliable however, we cannot guarantee or represent that it is accurate or complete. Because situations vary, any information provided on this site is not intended to indicate suitability for any investor. Hyperlinks are provided as a courtesy and should not be deemed as an endorsement. When you link to a third-party website you are leaving our site and assume total responsibility for your use or activity on the third-party sites.