A Big Pension Can Lock You Into Medicare’s Top IRMAA Bracket for Life

A 66-year-old retiree with a $410,000 pension can push MAGI into Medicare’s top IRMAA tier for 2026, permanently raising his Part B and Part D surcharges to about $578 per month ($6,936 per year). Because IRMAA uses a two-year lookback, pension income and future RMDs can keep him in that bracket for years, with survivor rules potentially shifting thresholds. Strategies to mitigate include partial Roth conversions before age 73, using Qualified Charitable Distributions to reduce MAGI, and filing SSA-44 after qualifying life events when income dips (though a pension alone doesn’t qualify). The key is to separate permanent from controllable income and plan ahead to avoid permanently higher IRMAA costs.