IRMAA Basics
Understanding IRMAA and Qualified Charitable Distributions Impact
Verified against SSA POMS as of August 31, 2026
The short answer
IRMAA refers to Income Related Monthly Adjustment Amount, a surcharge on Medicare premiums for higher-income individuals. A Qualified Charitable Distribution (QCD) is a type of IRA distribution that is not considered taxable income and is not included in adjusted gross income. MAGI for IRMAA purposes is the sum of adjusted gross income and tax exempt interest. QCD does not fall into either of those two categories so it does not impact MAGI for IRMAA purposes.
Understanding IRMAA
IRMAA, or Income Related Monthly Adjustment Amount, impacts Medicare Part B and Part D premiums for higher-income individuals. The adjustment is based on MAGI, which is your adjusted gross income plus tax-exempt interest from two years prior.
MCR:node/26306 View source ›What are Qualified Charitable Distributions?
A Qualified Charitable Distribution (QCD) is a direct transfer of funds from an individual's IRA to a qualified charity, as defined by the Pension Protection Act of 2006 P.L. 109-280. Individuals aged 70.5 years and older can exclude these distributions from their gross income if made directly to a qualified charity. For 2026, the maximum annual QCD is $111,000 for an individual. If filing jointly, each spouse can contribute up to $111,000. The QCD is particularly beneficial for those who use the standard deduction and for those who need to lower their MAGI to avoid IRMAA surcharges.
IRMAA Thresholds and Adjustments
IRMAA is applied when a beneficiary’s MAGI exceeds $109,000 for individuals and $218,000 for married couples filing jointly, per the 2026 guidelines.
MCR:node/26306 View source ›Impact of QCD’s on IRMAA
A QCD is a non taxable IRA distribution as promulgated by the Pension Protection Act of 2006. QCDs are also excluded from your adjusted gross income (AGI), even though a QCD is an IRA distribution. IRMAA uses a person’s MAGI to determine its income thresholds. MAGI is the sum of adjusted gross income and tax exempt interest. Since QCD’s are not part of AGI and are not tax exempt interest, they are not part of IRMAA’s MAGI calculation.
Strategies for Managing IRMAA
Consider tax planning strategies to reduce your Modified Adjusted Gross Income (MAGI), thus potentially lowering your IRMAA surcharges. For example, a client who files as single and is 77 years old may have a Required Minimum Distribution (RMD) of $90,000 and a taxable Social Security amount of $32,000 in 2026, totaling a MAGI of $122,000. This could impact his 2028 Medicare premiums due to a possible IRMAA surcharge. Working with his advisor, he estimates the single IRMAA initial threshold for 2028 to be $116,000. To avoid surcharges, he aims to keep his MAGI at $114,000 for 2026. Since he cannot reduce his Social Security income, he opts to make a Qualified Charitable Distribution (QCD) of $8,000 from his RMD to his favorite charity. This strategy reduces his MAGI to $114,000, potentially allowing him to avoid IRMAA surcharges in 2028 if his estimates are accurate. Consultation with a tax advisor is recommended.
MCR:node/26306 View source ›Frequently asked
How does IRMAA affect my Medicare premiums?
IRMAA is an additional amount added to your Medicare Part B and Part D premiums if your modified adjusted gross income exceeds certain thresholds.
What income is considered for the IRMAA calculation?
IRMAA calculations are based on your MAGI from two years prior, which includes adjusted gross income and tax-exempt interest.
Are there ways to lessen the impact of RMD’s on my MAGI for IRMAA purposes?
Yes. Those who are age required to take RMD’s can opt to make a qualified charitable distribution (QCD) as part of their RMD. The QCD is tax exempt and does not figure in the MAGI calculation for IRMAA. A person thinking about a QCD should consult with their tax and financial advisors.
Do all IRA distributions impact my modified adjusted gross income (MAGI) which is used to determine IRMAA?
Generally, IRA distributions are taxable and will count toward MAGI, which is then used to determine IRMAA. However, Qualified Charitable Distributions, which are considered a type of IRA distribution, are tax exempt and are NOT part of the MAGI calculation.