Two Retirees With the Same $330,000 Income Year Get Opposite Medicare Bills and One Form Decides Which One You Are
Key takeaways
- Translation: the premium you pay this year was set by the tax return you filed almost two years ago.
- I ve been studying retirement tax planning for more than a decade, and IRMAA is one of the most consistently overlooked traps I see.
- The advice is accurate and the mechanic matters more than most retirees realize.
Two Retirees With the Same $330,000 Income Year Get Opposite Medicare Bills and One Form Decides Which One You Are YAKOBCHUK VIACHESLAV / Shutterstock.com Danielle Liverance Wed, June 10, 2026 at 8:05 PM GMT+7 4 min read On her January 2022 podcast episode 10 Changes That Are New in 2022, Suze Orman walked listeners through a Medicare quirk most retirees only discover after it has already cost them: "Your increase on your Medicare premiums, Part B depends on what your 2020 tax returns happen to be. Don t ask me why they do it that way."
Translation: the premium you pay this year was set by the tax return you filed almost two years ago. Social Security calls this the Income-Related Monthly Adjustment Amount, or IRMAA. Orman has mentioned on the podcast that she and her wife KT pay $526 a month each for Part B because their income crossed a threshold two years back.
I ve been studying retirement tax planning for more than a decade, and IRMAA is one of the most consistently overlooked traps I see. The stakes are concrete. If you do a big Roth conversion in 2026, sell a rental property, take an unusually large required minimum distribution, or simply have one fat income year for any reason, your Medicare premium will jump in 2028. Most people never see it coming because they are looking at this year s income, not the return they filed nearly two years ago.