2026 edition · every figure cited to the Federal Register and SSA program manual · part of Clear Money Guide’s Roth conversion series: what a conversion costs · state taxes on conversions · is it worth it?
Updated July 25, 2026. Quick answer: Yes — if a conversion pushes your MAGI over $109,000 (single) or $218,000 (joint), your Medicare premiums jump two years later: 2026 conversion income sets 2028 premiums (20 C.F.R. §418.1135). These are cliffs, not phase-outs — crossing a threshold by $1 triggers the full tier surcharge, from +$95.70 to +$578.00 per month per enrollee once Part D is counted. And no, you cannot appeal it: SSA’s own manual explicitly lists “conversion of an IRA” as a non-qualifying event for premium relief.
Two corrections before the numbers (both verified on-page July 25, 2026)
Ranking coverage of this exact question is serving stale figures. A widely syndicated December 2025 piece tells readers the “standard premium is $174.70 for Part B” — that was 2024’s premium; the 2026 standard is $202.90 (90 FR 52063, Nov. 2025). A ranking advisor-firm article quotes $106,000 as the single-filer IRMAA threshold — that was 2025’s; the 2026 first tier starts at $109,000 single / $218,000 joint. If an article’s IRMAA numbers don’t match the tables below, it’s describing a different year.
The 2026 IRMAA tiers (per enrollee, per month)
Single, head of household, or qualifying surviving spouse
| 2026 MAGI | Part B premium /mo | Part D add-on /mo |
|---|---|---|
| Up to $109,000 | $202.90 | — |
| $109,000 – $137,000 | $284.10 | $14.50 |
| $137,000 – $171,000 | $405.80 | $37.50 |
| $171,000 – $205,000 | $527.50 | $60.40 |
| $205,000 – $500,000 | $649.20 | $83.30 |
| Above $500,000 | $689.90 | $91.00 |
Married filing jointly
| 2026 MAGI | Part B premium /mo | Part D add-on /mo |
|---|---|---|
| Up to $218,000 | $202.90 | — |
| $218,000 – $274,000 | $284.10 | $14.50 |
| $274,000 – $342,000 | $405.80 | $37.50 |
| $342,000 – $410,000 | $527.50 | $60.40 |
| $410,000 – $750,000 | $649.20 | $83.30 |
| Above $750,000 | $689.90 | $91.00 |
The married-filing-separately trap: MFS filers who lived with their spouse at any point in the year skip the middle tiers entirely — MAGI over $109,000 jumps straight to $649.20/mo Part B (plus $83.30 Part D), and over $391,000 to the top tier. For a couple weighing MFS to isolate one spouse’s conversion, this quirk usually destroys the math. (Source for all tiers: 90 FR 52063–52074; SSA POMS HI 01101.020.)
The two-year lag — and why the IRMAA clock starts at 63
Premiums for any year are set from your tax return of two years prior (20 C.F.R. §418.1135; Social Security Act §1839(i)(4)): your 2026 premiums come from your 2024 return, and a 2026 conversion shows up in your 2028 premiums. The planning consequence almost nobody states: if you enroll in Medicare at 65, the first return that can hurt you is the one you file for the year you turn 63. Conversions completed in the year you turn 62 or earlier can never touch your premiums — which is why the conversion window between retirement and age 63 is the cheapest real estate in the entire strategy.
Check your cliff before you convert
2026 IRMAA cliff checker
Price the conversion before you make it
A conversion cannot be undone once it is done, so it is worth having someone model the bracket it fills, the knock-on effects on your other income and how long the money has to compound before you settle on an amount.
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The new $6,000 senior deduction will not protect you
A tempting 2026 error: assuming OBBBA’s $6,000-per-person senior deduction (2025–2028) offsets conversion income for IRMAA purposes. It cannot. The deduction lives in IRC §151(d)(5)(C), which is below the line — §62(a)’s definition of AGI does not include it, so it reduces taxable income but never AGI. IRMAA MAGI is AGI plus tax-exempt interest (POMS HI 01101.010), so the deduction is invisible to Medicare. It also phases out at 6% of MAGI above $75,000 single / $150,000 joint — which a conversion accelerates — a double effect our income-tax coverage of conversions prices in.
No, you can’t appeal a conversion-driven IRMAA
Form SSA-44 relief exists only for eight life-changing events — marriage, divorce, a spouse’s death, work stoppage or reduction, loss of income-producing property, loss of pension income, or an employer settlement. An income spike is not on the list, and SSA’s manual (POMS HI 01120.005) names “conversion of an IRA” explicitly among non-qualifying events, alongside capital gains and lottery winnings. The surcharge lasts one premium year and disappears when the high-MAGI year rolls out of the lookback — a 2026 conversion means higher premiums in 2028 and normal ones in 2029, assuming 2027 income returns to baseline.
What this means for conversion strategy
Three rules fall out of the arithmetic: (1) Convert to the cliff, not through it — the checker above shows your headroom; leaving $1,000 of headroom costs nothing, while overshooting by $1,000 can cost $1,148–$2,882 per person in 2028 premiums. (2) Front-load before 63 where possible — pre-63 conversions are invisible to Medicare forever. (3) Price the surcharge as a one-year tax, not a catastrophe — a single-tier breach costs a couple about $2,300 (both enrolled, first tier); sometimes paying it deliberately in one big conversion year beats grazing a cliff for five consecutive years. Sequencing multiple years of conversions around cliffs, brackets, and state tax simultaneously is exactly the problem worth an hour with a professional:
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Suggested citation: Clear Money Guide, “Will a Roth Conversion Raise Your Medicare Premiums? (2026 edition),” clearmoneyguide.com/roth-conversion-irmaa/. Free to cite with attribution and a link. Figures verified July 25, 2026 against the Federal Register and SSA POMS.
Primary sources
Run your own numbers. Roth conversion guardrail estimator — find the bracket ceiling for this year.