Does a Roth conversion affect Medicare premiums?

Why does converting to a Roth raise Medicare premiums?

A conversion is a taxable distribution, reported inside adjusted gross income on Form 1040 line 11. The MAGI that sets IRMAA is that AGI plus tax-exempt interest from line 2a, so every converted dollar is a MAGI dollar in the conversion year. How to estimate your MAGI walks the two lines in full.

Two enrolled spouses means two surcharges computed from a single joint return, so a per-person figure understates a household's exposure by half. Every dollar amount below is labeled per person or per couple for that reason.

Which year's premiums does a conversion raise?

Premiums for a given year are set from the tax return of two years earlier, though never one more than three years old; Social Security's manual uses 2026 premiums from the 2024 return as its own example. That lag is why a conversion's dollar cost depends entirely on when it happened.

Known figures per the CMS 2025 and 2026 announcements; 2027 thresholds are computed here from the CPI formula the statute prescribes, detailed on the 2027 IRMAA projections page.

A page that attaches an exact dollar cost to a conversion made this year is quoting 2028 figures that do not exist. What can be said within the rules: tiers 1 through 4 index to CPI-U under 42 U.S.C. §1395r(i)(5), so a threshold falls only if the 12-month average of consumer prices falls, which makes today's thresholds a labeled floor estimate for later years.

How much can you convert before crossing the next IRMAA bracket?

Headroom is the gap between MAGI after the conversion and the next boundary. Boundaries read "greater than X and less than or equal to Y," so a MAGI sitting exactly on a line stays in the lower tier; the one bound that works the other way is the top tier, which starts at $500,000 single / $750,000 joint exactly.

Roth conversion IRMAA calculator

What did a 2024 conversion do to 2026 premiums?

The known pairing, at each bracket edge. Smallest case first: a single filer with 2024 MAGI of $95,000 converted $20,000, ending at $115,000. That is $6,000 above the $109,000 line, tier 1. The 2026 cost is ($81.20 + $14.50) x 12 = $1,148.40 for the year: 19.1 percent of the $6,000 that crossed, 5.7 percent of the whole $20,000.

Now the sharpest case. A conversion that left a couple $1 above $218,000 cost them $2,296.80 in 2026. Divide by the dollar that caused it and the rate is roughly 230,000 percent. Nothing about the math is unusual; the tiers are steps, and the first dollar onto a step carries the entire step.

Higher up the table the steps stay expensive. Joint filers at $340,000 converted $10,000, finishing at $350,000 and crossing the $342,000 boundary by $8,000. Each spouse's combined monthly surcharge rose from $240.40 to $385.00, up $144.60 per month. Couple cost: 2 x $144.60 x 12 = $3,470.40, which is 43.4 percent of the $8,000 that crossed and 34.7 percent of the $10,000 converted.

A large conversion can clear more than one boundary. A single filer starting at $100,000 converted $75,000, landing at $175,000: above $171,000, at or below $205,000, tier 3. The 2026 surcharge is ($324.60 + $60.40) x 12 = $4,620.00, versus zero without the conversion, or 6.2 percent of the full $75,000. The standard $202.90 premium is unchanged either way; only the surcharge moves. To place any 2024 MAGI in its tier, the IRMAA calculator does the boundary arithmetic in one pass.

Married filing separately is its own hazard. A separate filer who lived with their spouse at any point in the year and converted past $109,000 skips the middle tiers entirely: $446.30 + $83.30 = $529.60 per month, about $6,355.20 for the year. Living apart the entire year restores the single-filer table on request, a correction the IRMAA appeal guide explains.

Converted in 2025 instead, the same $20,000 would be measured against the projected 2027 tier 1 line of $112,000 single (CMS announces the final line in fall 2026) at surcharge rates still unannounced. Converted in 2026, it waits on 2028 thresholds and rates due in fall 2027. Neither case gets an exact dollar figure here, because none exists.

What does IRMAA cost as a percentage of the conversion?

Three rates describe the same event. On the dollars that crossed a boundary, the examples above run from 19.1 percent at the first cliff to 43.4 percent at the tier 2/3 edge. On the whole conversion, the same events cost 5.7, 7.7, 34.7, and 6.2 percent; a conversion landing mid-tier rather than just over a line tends toward the low single digits. On the single crossing dollar, the rate exceeds 100 percent by orders of magnitude.

The flip side of the cliff design is flatness inside each tier. Everyone in a tier pays the same dollar surcharge, so once a boundary is crossed, further converted dollars add nothing to the premium until the next boundary. A conversion's marginal IRMAA cost is zero almost everywhere and enormous at five specific lines.

Can you appeal IRMAA caused by a Roth conversion?

No. Relief requires one of eight qualifying life-changing events, and a conversion is not one of them; SSA's operations manual lists IRA and Roth conversions by name among the situations that never justify a new determination. The surcharge stands for its one premium year no matter how sharply income drops afterward.

What does move the needle is unrelated to the conversion itself: retirement, work reduction, and the other listed events, filed on Form SSA-44 with a current-year income estimate. The guide to appeals separates that path from the formal appeal track and its deadlines.

How does a conversion ladder interact with the IRMAA windows?

Converting across several years spreads MAGI across several returns, and each return feeds exactly one premium year. Someone enrolling at 65, the usual case, generally has the age-63 return as the first one Social Security reads; the calendar mechanics behind that are on the avoid-IRMAA page. Conversion years before that return never meet Medicare at all.

Conversion years from 63 onward each buy their own premium-year exposure, measured against thresholds that are final at most two years ahead. A ladder running 2024 through 2027 has one rung with known 2026 dollars, one measurable only against projections, and two priced by announcements that have not happened.

Does the higher premium last forever?

No. Every premium year gets a fresh determination from its own lookback return, so a single conversion year surcharges a single premium year. A 2024 conversion that raised 2026 premiums has no effect on 2027, which reads the 2025 return against the 2027 thresholds instead.

Do Roth withdrawals count toward IRMAA later?

No, and that is the payoff side of the arithmetic. Qualified withdrawals from a Roth IRA or Roth 401(k) are excluded from AGI, so they never reach the income figure a premium is built on, in any year, at any amount.

Dollars left in traditional accounts behave the opposite way: withdrawals and required minimum distributions land in AGI in full, every year they are taken. The MAGI for IRMAA page carries the complete tables of what lands in AGI and what stays out.

Was the conversion worth the surcharge?

This page can supply the IRMAA half of that ledger and no more. The $20,000 conversion in the first example cost $1,148.40, once. From then on, those dollars and their growth exit the MAGI system entirely, while the same $20,000 left in a traditional IRA re-enters MAGI whenever it comes out, including as required minimum distributions, each withdrawal year a fresh chance to cross a threshold.

Whether the trade favors converting depends on income tax rates in both periods, which are outside this page's scope. The IRMAA-only arithmetic is above; the tax side belongs to a preparer with the whole return in front of them.

Where do the numbers on this page come from?

All 2026 thresholds and surcharges trace to the CMS announcement of 2026 premiums, published November 14, 2025 and corroborated at 90 FR 52063 in the Federal Register. The 2025 figures come from that year's CMS announcement. The MAGI definition, the two-year lookback, and the lists of what does and does not qualify for relief are from SSA's Program Operations Manual System. The 2027 thresholds are projections and stay labeled that way until CMS announces; the method is documented on the 2027 projections page. Questions reach us through the contact page.