Your First Required IRA Withdrawal at 73 Can Push You Past the IRMAA Cliff for a Full Year

Deferring the first RMD to April 1 stacks two distributions into one tax year, potentially adding $70,000 onto existing retirement income for a $900,000 IRA holder.

IRMAA's two-year lookback locks 2028 Medicare premiums to 2026 income, and tax-exempt municipal bond interest counts toward MAGI with no correction after filing.

Crossing the first IRMAA tier costs a couple roughly $2,300 more per year; the second tier pushes the household Medicare bill to nearly $6,000.

Many financial professionals are salespeople paid on what they push, not whether you end up wealthier. A fiduciary is the opposite. The SEC legally requires them to put your interests first. Advisor.com's free matching tool pairs you with vetted fiduciaries from major national firms, all in under three minutes. See who you match with today.

A retiree who turns 73 this year has a deceptively simple decision: take the first required minimum distribution by December 31, or use the one-time option to delay it until April 1 of the following year. The delay can look harmless. But it may put two RMDs into one tax year, push modified adjusted gross income across an IRMAA bracket, and raise Medicare premiums two years later.

Only about 8% of Medicare beneficiaries with Part B pay any IRMAA surcharge at all. The risk is concentrated among retirees whose household MAGI is near the 2026 thresholds of $218,000 for joint filers or $109,000 for single filers. If a first RMD lands on top of Social Security, pension income, and taxable interest, one calendar-year timing decision can add thousands of dollars in Medicare premiums.

IRMAA generally uses MAGI from two years back. Your 2026 tax return will usually drive your 2028 Part B and Part D premiums. That means an RMD taken this year, based on the December 31, 2025 account balance, can shape the Medicare bill you pay 24 months from now. For a voluntary RMD, there is usually no appeal simply because income later falls.

Most Americans suspect they're behind on retirement and never find out. Advisor.com's free matching tool pairs you in about three minutes with a vetted fiduciary advisor who can help you with investing, taxes, retirement, estate planning, and more. No minimums. No sales call. Find out where you stand.

MAGI here is AGI (Form 1040 line 11) plus tax-exempt interest (line 2a). Municipal bond income that feels tax-free still counts. Readers routinely miss this and land a bracket higher than they modeled.

Here are the 2026 CMS figures for the first three IRMAA tiers most likely to be affected by a first-RMD timing decision. The amounts are monthly and per person: total Part B premium, plus the Part D IRMAA add-on that stacks on top of any separate drug plan premium.

Joint MAGI

Single MAGI

Part B total/mo

Part D IRMAA/mo

≤ $218,000

≤ $109,000

$202.90

$0.00

$218,001–$274,000

$109,001–$137,000

$284.10

$14.50

$274,001–$342,000

$137,001–$171,000

$405.80

$37.50

$342,001–$410,000

$171,001–$205,000

$527.50

$60.40

Move a joint filer from the standard tier to the first surcharge tier and each spouse pays an extra $81.20 for Part B and $14.50 for Part D every month. For the couple, that is $2,296.80 a year in surcharges. Cross into the second tier and the added annual cost is $5,769.60 for the household.

The temptation is to defer the first RMD to April 1 of the following year. Do that and two RMDs land in the same tax year: the deferred first one and the mandatory second one. A retiree with a $900,000 traditional IRA who defers could add roughly $70,000 of taxable income in a single year, depending on the next year's account balance. That can push joint MAGI past $218,000 or $274,000 in one move.

Take the first RMD in the year you turn 73 instead, and the income splits across two calendar years, keeping MAGI lower in each. Under current law, the starting age is 73 for people born in 1951 through 1959 and 75 for those born in 1960 or later.

When one spouse dies, the survivor may eventually file as single. The single brackets are roughly half the joint ones. A household that sat below $218,000 as a couple can leave the survivor closer to, or above, the $109,000 single threshold with the same portfolio and RMD structure. Death of a spouse is an SSA-44 life-changing event, but the lower single thresholds still matter after the transition.

Form SSA-44 lets the Social Security Administration reconsider IRMAA after a qualifying life-changing event: marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, certain losses of income-producing property, loss of pension income, or an employer settlement payment. A large RMD, Roth conversion, or voluntary home sale does not qualify by itself. If you voluntarily raise MAGI, the surcharge usually stands.

Consider taking the first RMD in the calendar year you turn 73, not during the April 1 grace period, unless your CPA has run the two-year IRMAA math and confirmed the deferral wins.

If you are charitably inclined and at least 70½, direct up to the annual QCD limit from the IRA to a qualified charity. For 2026, that limit is $111,000. QCDs can satisfy an RMD without adding to AGI, making them one of the cleanest IRMAA defenses available.

If your projected joint MAGI is within $20,000 of a threshold, ask a fee-only advisor to model withdrawal timing, capital gains, QCDs, and taxable interest before December 31.

The first RMD decision is not just a tax deadline. It is also a Medicare premium decision that can show up two years later. Deferring until April 1 can be useful in the right tax year, but retirees near an IRMAA threshold should treat that grace period as a planning tool, not a default setting.

Sources: 2026 Medicare premium and IRMAA figures come from the CMS "2026 Medicare Parts A & B Premiums and Deductibles" fact sheet. RMD timing and first-year deferral rules come from IRS RMD guidance. SSA-44 qualifying events come from Social Security Administration Form SSA-44. The 2026 QCD limit comes from IRS Notice 2025-67.

Most Americans have no idea where they actually stand. Most guess, or hope Social Security and a 401(k) will work out. Advisor.com's new matching tool gives you a real answer, free.

They pair you with a fiduciary (required by law to put YOUR interest first) with questions related to taxes, estate planning, retirement, insurance analysis, and more. See you who you match with today, and get the answers you need.

 

Contact editorial@247wallst.com for any questions or corrections.