Tax Planning Ideas and Tax Updates

Medicare IRMAA in 2023

by Alli Thomas

Feb 17, 2023

Medicare Part B saw a slight cost decrease in 2023 following a large increase for 2022. The standard monthly premium for Medicare Part B decreased by $5.20 to $164.90 for 2023, while the annual deductible for all Medicare Part B beneficiaries declined by $7 to $226.

What about IRMAA? 

Thanks to the decrease in the standard premium, the income-related monthly adjustment amount (IRMAA) is slightly lower as well. At the same time, the income levels at which IRMAA begins being added have increased, so some Medicare beneficiaries will see additional savings.

IRMAA Surcharge Income Levels

In 2023, whether or not you have to pay IRMAA is determined by your reported annual income for 2021.

Whether or not you have to pay IRMAA is partially determined by your tax filing status. A modified adjusted gross income in 2020 of $97,000 or higher (for single filers) or $194,000 or higher (for married filers) will result in a Part B surcharge between $65.90 to $395.60 per month in addition to the regular Part B premium (see below chart).

2021 Single Filer 


2021 Married Filing Jointly


2023 Part B Premium + IRMAA


$97,000 and less


$194,000 and less




$97,001 – $123,000


$194,001 – $246,000




$123,001 – $153,000


$246,001 – $306,000




$153,001 – $183,000


$306,001 – $366,000




$183,001 – $500,000


$366,001 – $750,000




$500,001 +


$750,001 +




Part D (prescription drug coverage) also penalizes high-income beneficiaries. The IRMAA monthly premium surcharge on Part D can range from $12.20 to $76.40 in addition to the standard Part D premium.

Sources of Temporary Income Increases That Could Subject You to IRMAA

While avoiding having to pay IRMAA is not always possible for higher-income retirees, there are some common one-off situations that can bump up your income for a year to be aware of and consider in advance. These include:

Selling a home

Selling your home could lead to higher Medicare Part b premiums if your taxable income sees a boost. Although your Medicare benefits shouldn’t change when you sell your home, your monthly premiums may. It depends on whether the sale of your home affects your income.

Taking a required minimum distribution (RMD)

A bump up in your income can negatively affect the availability of deductions and can impact the taxation of Social Security. One significant negative impact of an RMD may be increased Medicare costs. This is often not paid the attention it deserves by many IRA owners until it is too late. (IRA Help)

Converting traditional IRA assets to a Roth IRA

A Roth conversion occurs when you move assets from a Traditional, SEP or SIMPLE IRA (collectively referred to as a Traditional IRA in this article) or qualified employer sponsored retirement plan (QRP) — such as a 401(k), 403(b), or governmental 457(b) — and reposition them to a Roth IRA. (Wells Fargo)

Realizing a large investment or capital gain

When you sell investments at a higher price than what you paid for them, the capital gains are “realized” and you’ll owe taxes on the amount of the profit. (Vanguard)

Winning the lottery (yes, it’s true!)

Playing lottery is something you’re more likely to do when you’re young. Approximately 70% of 20-30-year-olds buy at least one lottery ticket a year. Compared to 45% of seniors age 70 or older. (CreditDonkey)

Strategies to Avoid Medicare IRMAA

health insurance medicare part d medicare premiums medicare part b

  • When planning on doing a Roth IRA conversion, plan it carefully, as it will increase your taxable income. 
  • If you invest in municipal bonds (which can be a great source of tax-exempt income), be aware that that interest can affect your Medicare premiums 
  • If a higher-income retiree is the category you fall into and have had a life-changing event, make sure to notify Social Security by filing an IRMAA appeal. 
  • Planning to sell any appreciated assets (including real estate)? Know what your options are to minimize your taxable income. 
  • Consider opening a Medicare Savings Account (MSA) if you meet eligibility requirements.
  • Understand how taking annual required minimum distributions (RMDs) from your retirement accounts might affect your taxable income.
  • Consider making a qualified charitable donation (QCD) to reduce your tax liability.  

Read more: Three Ways to Reduce Your Income-Related Monthly Adjustment Amount (IRMAA) for Medicare Part B

The good news is that if your income decreases, so will your Medicare IRMAA, albeit with a two-year delay. 

Looking for more ideas to avoid paying IRMAA? Click here to schedule a free, no-obligation consultation and review of your financial plan using our Results In Advance Planning method with one of our advisors.

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Alli Thomas

Alli Thomas has worked in the financial services industry for nearly 20 years, with a focus on retirement-related investing. She began her career as a FINRA-licensed participant-services call-center associate at Vanguard, and then moved to Principal Financial Group, where she worked closely with employers, assisting with retirement plan set-up and design, selecting appropriate plan investment offerings, and maximizing employee participation through targeted education campaigns and enrollment meetings. Alli has also worked as a qualified 401(k) administrator and registered investment advisor for several small investment firms. She now writes about all things investment- and finance-related, leveraging her extensive experience and passion for retirement planning to help investors make well-informed financial decisions.

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