She’s in Control of Her Medicare Costs Now

Tax day just passed. If you filed your return this week and immediately wondered, “What does this mean for my Medicare?”—you’re in good company.

Most retirees discover IRMAA too late. IRMAA—the Income-Related Monthly Adjustment Amount—is a surcharge added to Medicare premiums for people above certain income thresholds. It uses a two-year look-back, meaning your income this year can quietly raise your Medicare costs in 2027.

That’s the math one of our clients ran straight into.

Retired, Ready, and Rattled by IRMAA

Patricia was 62 and freshly retired. Pension coming in every month. She wanted to do Roth conversions now—a smart move, given her lower-income years before Social Security kicked in.

But every conversation about IRMAA made her uneasy. She had three years before Medicare even began. Yet the decisions she made this year—and the next—were already shaping her premiums.

Why IRMAA Makes Smart People Freeze

The natural response to a fee you don’t fully understand is to either ignore it or stop moving entirely.

Patricia was trying to avoid both. But without a clear picture of the actual numbers, she couldn’t tell the difference between a threat worth planning around and one that wasn’t. It’s like getting a warning light on your dashboard. Without knowing what it means, you either ignore it or pull over on the side of the highway. Neither is the right move.

One Chart Changed the Conversation

We built Patricia a waterfall chart—a clean breakdown of every income source, every deduction, and exactly how each one flows into the formula that determines her IRMAA surcharge.

She could see exactly where the threshold lines were. How much Roth conversion she could do before crossing one. What it would actually cost her if she did. No guesswork—just her specific numbers, mapped clearly.

What Patricia’s Life Looks Like Now

The background anxiety? Gone.

Patricia knows what her Medicare premiums will be and why. She reviews the picture with us twice a year. And she discovered something she didn’t expect: she has real flexibility.

Some years, she’ll do a larger Roth conversion and accept a slightly higher Medicare premium. Other years, she’ll stay below a tier. Either way, it’s a deliberate choice—not a surprise that shows up in her mailbox.

That shift—from dread to control—is what good planning actually feels like.

The Window Is Open Right Now

If you just wrapped up your tax return, you’re holding a full year of real data. That makes right now the ideal time to look at what your income means for future Medicare costs.

IRMAA isn’t something to fear. It’s something to plan around. And once you do, it stops being a threat—and starts being just another line in a system you actually understand.

Thank you for reading!

Last thing – I read every single reply to these emails.

I use these responses to guide my content, so your question might become next week’s deep dive.

Happy retiring,

Josh Rendler, CFP® Founder, Motion Retirement Partner, Award-Winning Retirement Firm