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How RMDs Affect IRMAA and What You Can Do Before They Start?

As you approach retirement age, it’s important to understand how Required Minimum Distributions (RMDs) can impact your Medicare costs through Income-Related Monthly Adjustment Amounts (IRMAA). This article will help you navigate these concepts so you can plan accordingly.

Last updated: August 17, 2026

Where this answer comes from, and what it can't tell you

Written from the published Medicare rules and the source material preserved for this question. It explains the topic in general terms. It is not a reading of your own coverage documents, not a prediction of how Medicare or a plan will decide a case, and not advice about a particular plan. Your current notice, policy, Evidence of Coverage, or formulary controls when it differs from a general explanation. Resting Sycamore is not Medicare.gov and is not endorsed by any government agency.

What Are RMDs?

Required Minimum Distributions (RMDs) are amounts that the government requires you to withdraw from certain retirement accounts, like 401(k)s and traditional IRAs. You must start taking RMDs by April 1 of the year following the year in which you turn age 72 or, if you're still working past 72 and have a workplace plan (like a 401(k)), you can delay RMDs from that account until you retire.

Here’s an example: If you turned 72 last April, you need to take your first RMD this year. The amount depends on the value of your retirement accounts at the end of the previous year and your life expectancy according to IRS tables.

What Is IRMAA When Required Minimum Distributions Begin?

Income-Related Monthly Adjustment Amount (IRMAA) is an extra charge that some people with higher incomes pay for their Medicare Part B and Part D premiums. If your income exceeds certain thresholds, you might have to pay more each month for these parts of Medicare.

The amount you pay in IRMAA depends on your modified adjusted gross income (MAGI), which includes various types of income such as wages, interest, dividends, and distributions from retirement accounts like RMDs. The higher your income, the higher your IRMAA could be. There are five income ranges with corresponding IRMAA rates.

How Do RMDs Impact Your Medicare Costs?

RMDs can increase your MAGI for a given year, which in turn may push you into a higher IRMAA bracket. For example, if you have a large retirement account and take significant RMDs, the extra income could bump you up to a higher tier for IRMAA.

Let’s say you’re currently paying standard Medicare Part B premiums but your income is just below the threshold that triggers IRMAA. If an RMD pushes your income over this threshold, you’ll start paying additional amounts each month for Parts B and D.

Which Factors Can Affect IRMAA Before Required Minimum Distributions Begin?

There are several steps you can take to mitigate potential increases in Medicare costs due to RMDs:

1. Plan Your Withdrawals: Consider how much you need from your retirement accounts before RMDs begin. If possible, try to withdraw smaller amounts now to reduce the size of future RMDs.

2. Diversify Retirement Accounts: Some types of retirement savings might not be subject to RMDs or have different rules for withdrawals. For instance, Roth IRAs do not require you to take RMDs during your lifetime. If possible, consider converting some traditional IRA funds into a Roth IRA before RMDs start.

3. Manage Other Income Sources: Try to limit other sources of income around the time when RMDs begin to avoid pushing yourself into higher tax brackets and IRMAA tiers.

4. Check the Controlling Tax and Benefit Rules: Review the applicable tax year's modified adjusted gross income, required minimum distribution timing, IRMAA brackets, and appeal rules against your tax records and Social Security notice. Tax consequences depend on individual circumstances, so do not treat a general example as a personal calculation.

5. Stay Informed About Changes: Medicare rules and thresholds change over time, so stay informed about any updates to RMDs, IRMAA rates, and other relevant regulations. This knowledge will help you make informed decisions as you approach retirement age.

Understanding how RMDs can affect your Medicare costs is crucial for planning a comfortable retirement. By taking proactive steps now, you can manage your finances more effectively and avoid unexpected increases in healthcare expenses.

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