Social Security uses a two-year lookback, meaning your 2025 tax return determines your 2027 Medicare IRMAA surcharges announced each November. IRMAA MAGI adds tax-exempt municipal bond interest (Line 2a) to AGI (Line 11), and Roth conversions flow directly into that total. A spouse's death cuts the joint IRMAA threshold from $218,000 to $109,000, potentially triggering large surcharges even if income barely changed.
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Advisor.com's free matching tool pairs you with vetted fiduciaries from major national firms, all in under three minutes. See who you match with today. A retired couple in Naples converted $95,000 from a traditional individual retirement account to a Roth IRA in October 2025.
They wanted to shrink future required minimum distributions (RMDs) and liked the idea of paying tax while they could control the timing. Their usual modified adjusted gross income was approximately $190,000. The conversion pushed it near $285,000.
When the couple filed their return in April 2026, that income number became permanent. What it will cost them in Medicare premiums remains unfinished. The Centers for Medicare and Medicaid Services typically publishes the following year's premiums and income brackets in November.
Social Security then uses the couple's 2025 tax information to calculate their 2027 income-related monthly adjustment amount (IRMAA). Half the letter is already written. November supplies the price.
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