RMD Tax Trap: How $122,000 in 401(k) Withdrawals Can Cost You $42,000 in IRMAA Surcharges Alone

1 hour ago 1

Marc Guberti

Mon, June 29, 2026 astatine 8:22 AM CDT 5 min read

Quick Read

A $122,000 RMD pushed Margaret and her hubby into the apical IRMAA tier, adding $13,872 per twelvemonth successful Medicare surcharges connected apical of mean premiums.
Medicare's 2-year income lookback means 3 consecutive RMDs fastener successful 3 abstracted years of top-tier surcharges, totaling astir $42,000 for the couple.
A qualified charitable organisation of up to $111,000 per idiosyncratic successful 2026 tin trim MAGI capable to driblet beneath the apical IRMAA cliff and retrieve the surcharge.
Are you ahead, oregon down connected retirement? SmartAsset's escaped instrumentality tin lucifer you with a fiscal advisor successful minutes to assistance you reply that today. Each advisor has been cautiously vetted, and indispensable enactment successful your champion interests. Don't discarded different minute; learn much here.

Margaret turned 75 successful March and took her archetypal required minimum organisation from a $3 cardinal accepted 401(k). Using the IRS Uniform Lifetime Table divisor of 24.6 for property 75, that archetypal RMD ran astir $122,000. She had budgeted for the national income tax. She had not budgeted for the Medicare premium surcharges the aforesaid withdrawal volition trigger 2 years later, oregon the ones already locked successful for the 2 RMDs that follow.

A elder pistillate with white, curly hairsbreadth and a airy bluish garment sits astatine a woody table, concentrating intently connected papers she holds successful her hands, portion besides holding a bluish pen. A metallic laptop, a achromatic teacup, and a smartphone are connected the array beside her. The inheritance shows a bright, modern room with achromatic cabinets, woody countertops, and a sunlit model with a greenish potted plant.

The cliff her CPA ne'er mentioned

Margaret's hubby is besides Medicare-eligible. Between his pension, some Social Security checks, dividends connected a sizable taxable brokerage account, and her caller RMD stacked connected top, their projected modified adjusted gross income clears the apical associated IRMAA tier. For 2026, that tier kicks successful for couples astatine modified adjusted gross income astatine oregon supra $750,000, and the consequences are absolute.

In that bracket, each spouse pays an other $487 per period successful Part B IRMAA, bringing the full Part B premium to $689.90. Layer connected the Part D income-related accommodation of $91 per period astatine that aforesaid tier, and each spouse is paying $578 per period successful surcharges. For the household, that is $1,156 per month, oregon $13,872 a year, connected apical of the modular premium everyone already pays.

Are you ahead, oregon down connected retirement? SmartAsset's escaped instrumentality tin lucifer you with a fiscal advisor successful minutes to assistance you reply that today. Each advisor has been cautiously vetted, and indispensable enactment successful your champion interests. Don't discarded different minute; larn much here.

Why 3 RMDs adjacent 3 IRMAA years

The 2-year lookback is what makes this an ambush. The $122,000 RMD Margaret took this twelvemonth sets her 2028 Medicare premiums. The property 76 RMD adjacent year, utilizing divisor 23.7 connected a portfolio that grew, drives 2029 premiums. The property 77 RMD, divisor 22.9, drives 2030 premiums. Three withdrawals, 3 afloat years astatine the apical household IRMAA, and the surcharge tab lands astatine astir $42,000 earlier a azygous national income taxation dollar is counted.

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