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June 21st, 2026

How Do Roth Conversions Affect Your Medicare Part B Premiums?

Are you planning a Roth conversion to save on future Retirement taxes? Make sure you don’t accidentally spike your Medicare premiums in the process.

Roth conversions are an incredibly popular strategy for tax planning, allowing you to move tax-deferred funds into a tax-free vehicle. However, doing too much at once can trigger a hidden financial trap: the Income-Related Monthly Adjustment Amount (IRMAA).

Because a Roth conversion counts as taxable income, pushing your income past specific IRS thresholds can significantly increase what you pay for Medicare Part B and Part D premiums. To maximize your long-term tax savings without overpaying for healthcare, you must balance your current tax bracket with the IRMAA limits.

Key Factors for a Strategic Roth Conversion:
– The Tax Bracket Window: Finding the "gap" between your current income and the top of a reasonable tax bracket (like the 24% bracket) to fill with conversion amounts.

– The IRMAA Threshold: Mapping your conversions carefully so your total modified adjusted gross income stays below the limits that trigger higher Medicare premiums.

– Custom Software Planning: Utilizing comprehensive financial planning tools to model exact scenarios and find the ideal dollar amount to convert each year.

The best retirement strategies don’t just focus on tax returns—they take a holistic view of your entire financial landscape.

Questions? Email us at [email protected], call us at (919) 535-8261, or visit our website at https://cardinalguide.com/

Hans Scheil Hans “John” Scheil, CFP®

Hans “John” Scheil is the author of The Complete Cardinal Guide and has over 40 years of experience specializing in helping individuals at or near retirement. John’s insurance career began at the age of 18, when he sold insurance while attending college full time. His years in the insurance industry included positions as a Branch Manager, National Sales Director, and Senior Vice President for several nationally recognized insurance companies. John holds a Bachelor of Science degree from Northern Illinois University (1980) and a Master of Science in Management from The American College (2007).

John resides in Cary, North Carolina, with his wife, Ronda, and dog, Ellie, and has two grown sons. He is involved locally with StepUp Ministries and the Alzheimer’s Association. John enjoys golf, traveling the world, and leadership.