IRMAA and Roth conversions

I have a client that whose last years (2021) total income was a combined income was slightly north of 275k (roughly 155k(Husband) & 125k (Wife) respectively)

The wife retired midway through 2022 (so her income was roughly 75k for the half year for here. Total income slightly north if 200k) and the husband plans to retire March of next year (2023) and they would then switch to Medicare.

Given IRMAA has a look back of 2 years, they were asking about their eligibility to file SSA form 44 for exemption for and IRMAA given the change in employment income (their retirement income planned would be 125-150k).

According to my research, they would be eligible for the exemption (please confirm this or let me know if I’m wrong) but my question is we plan on doing Roth conversions this year potentially. Given that we must provide tax return for the form 44, could a Roth conversion mess up our IRMAA exemption eligibility? It would obviously inflate their 2022 taxable income. Could this somehow keep them except from IRMAA is 2024 as well? Do we need to maintain a certain threshold to ensure the exception given the 2year look back?

Thank you for your help on this



  • The 2023 inflation adjustments have been announced, but there is no good way to tell what the adjustments might be for 2024 IRMAA thresholds to which your joint 2022 AGI plus muni income would be applied. Your expected IRMAA for 2023 can be determined from the following link, but I am not familiar enough with the appeal process to know the affects of appealing your incomes due to retirement.
  • 2022 2023 2024 Medicare Part B IRMAA Premium MAGI Brackets (thefinancebuff.com)

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