If I Convert $235k to a Roth IRA, Will It Affect My Medicare Premiums?

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Because Medicare premiums are tied to income, converting a $235,000 retirement account to a Roth IRA has the potential to cause Medicare Part B premiums to increase. For many taxpayers, in fact, a single-year conversion of that magnitude could more than triple the amount of the monthly premium most Medicare enrollees pay for Part B coverage. However, that’s not certain. Much depends on the enrollee’s income level before the conversion and other details. And it’s possible to use some strategies that could reduce or even eliminate the premium increase while still taking advantage of the benefits of a Roth conversion.

If you’re contemplating converting retirement funds to a Roth account, consider talking over the implications with a financial advisor.

Most people pay the same monthly premium to Medicare for Part B coverage. For 2024, this premium is $174.70 per month. It adjusts annually to reflect inflation and usage patterns that affect Medicare’s cost of doing business. Beginning in 2025, the standard premium is $185, an increase of $10.30, or $123.60 annually.

For higher-income enrollees, Medicare applies a surcharge to Part B and Part D premiums. This is called the Income-Related Monthly Adjustment Amount (IRMAA). The size of the surcharge varies according to income, using a specific income measure called Modified Adjusted Gross Income (MAGI), so that higher earners pay more. The surcharge also varies by filing status.

Brackets set up by filing status and income are used to determine IRMAA premiums. These brackets change annually, as does the Part B premium amount. For 2025, the Part B premium is $185. Here is a table showing IRMAA brackets for 2025:

At the higher income levels, clearly, IRMAA packs a sizable financial punch. A single filer earning more than $500,000 will pay $628.90 per month or $7,546.80 per year, compared to the $185 monthly or $2,220 per year paid by someone earning $106,000.

An important wrinkle to the IRMAA regulations is that the adjustment is applied to the current year’s premiums using the enrollee’s MAGI from two years earlier. So an increase in income this year won’t result in higher Medicare premiums this year.

Also note that IRMAA also applies to Part D premiums. However, since these premiums are much smaller than Medicare Part B premiums, the financial impact of an IRMAA-hiked Part D premium is relatively minor.

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