RMD & IRMAA Guide (2026): Medicare Surcharges and the 2-Year Lookback

RMDs and IRMAA are tightly coupled: a required minimum distribution at age 73+ pushes your MAGI, which two years later sets your Medicare Part B and Part D surcharges. Plan the conversion years before RMDs start and you can avoid the surcharge entirely.

This is the smallest hub but the most consequential per-dollar: an IRMAA tier-jump costs $1,000-$8,000 per couple per year, and the planning window is narrow.

7 articles · last reviewed 2026-05-17 · part of the QuantCalc research library

RMD mechanics

IRMAA brackets and the 2-year lookback

QCDs and Medicare-friendly giving

Inherited IRA (SECURE 2.0)