IRMAA and Medicare Premium Planning for St. Louis and St. Charles County

If your income is above certain levels, Medicare charges more for Part B and Part D coverage. The extra charge is called the Income-Related Monthly Adjustment Amount, or IRMAA. Many retirees first learn about it when a letter from Social Security arrives.

How IRMAA works in 2026

• The standard Part B premium for 2026 is $202.90 a month.
• IRMAA applies when modified adjusted gross income (MAGI) is above $109,000 for individual filers or $218,000 for joint filers.
• Social Security generally uses your tax return from two years earlier, so 2026 premiums are based on 2024 income.
• For IRMAA, MAGI is your adjusted gross income plus tax-exempt interest.
• The surcharges are tiered. Going even $1 over a tier threshold can move you into the next tier for the whole year.

When income drops

If you had a life-changing event that reduced your income, such as marriage, divorce, the death of a spouse, a loss of income or an employer settlement payment, you can ask Social Security to use more recent income. You do that with Form SSA-44. If you amended your tax return, you can call Social Security at 1-800-772-1213.

Planning that may help

Because IRMAA looks back two years, decisions you make now may affect your premiums later. Depending on your situation, it may help to look at:

• the size and timing of Roth conversions
• when you realize capital gains
• the order in which you withdraw from taxable, tax-deferred and Roth accounts
• qualified charitable distributions (QCDs) from IRAs, if you're 70½ or older

Each of these has trade-offs and may not fit your situation. Lowering one year's premiums isn't always the right goal. Renaud & Company, LLC does not provide tax or legal advice, so we coordinate with your tax professional, with your permission, before you act.

Talk with us

We work with retirees across O'Fallon, St. Charles County and the St. Louis area. Call (636) 240-5055 to review how your retirement income plan and Medicare premiums fit together.

Figures are for 2026, from CMS's "2026 Medicare Parts A & B Premiums and Deductibles" fact sheet (Nov. 14, 2025) and SSA's "Request to lower an IRMAA" page. Amounts change each year. Update this page when CMS releases the 2027 figures, usually in the fall.

Renaud & Company, LLC is an SEC-registered investment adviser. Renaud Tax & Accounting LLC is a separate tax and accounting firm. Advisory and tax services are offered under separate engagements and separate fees. Registration with the SEC does not imply a certain level of skill or training.