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

A $122,000 RMD pushed Margaret and her husband into the top IRMAA tier, adding $13,872 per year in Medicare surcharges on top of normal premiums.

Medicare's 2-year income lookback means three consecutive RMDs lock in three separate years of top-tier surcharges, totaling roughly $42,000 for the couple.

A qualified charitable distribution of up to $111,000 per person in 2026 can reduce MAGI enough to drop below the top IRMAA cliff and recover the surcharge.

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Margaret turned 75 in March and took her first required minimum distribution from a $3 million traditional 401(k). Using the IRS Uniform Lifetime Table divisor of 24.6 for age 75, that first RMD ran roughly $122,000. She had budgeted for the federal income tax. She had not budgeted for the Medicare premium surcharges the same withdrawal will trigger two years later, or the ones already locked in for the two RMDs that follow.

Margaret's husband is also Medicare-elig

Fuente original: Yahoo Finance (https://finance.yahoo.com/markets/options/articles/rmd-tax-trap-122-000-132230061.html)