Yes — a $60,000 traditional IRA withdrawal counts as income and can push your Medicare premiums higher, but not right away. Modified adjusted gross income (MAGI), the figure Medicare uses to set surcharges, includes traditional IRA withdrawals roughly dollar-for-dollar in the year you take them, according to SSA's methodology for IRMAA. The surcharge, called IRMAA (Income-Related Monthly Adjustment Amount), doesn't hit your premium the same year you take the withdrawal. It shows up two years later, based on a lookback built into how Medicare calculates it.
Official resources:
- Read the official guidance from Ssa — Use this primary source to verify the official guidance.
- Read the official guidance from Ssa — Use this primary source to verify the official guidance.
Table of Contents
- Why the Premium Increase Doesn't Happen This Year
- How Much Would a $60,000 Withdrawal Actually Cost?
- The Cliff Effect — Why $1 Can Cost You a Full Tier
- Can You Avoid or Appeal the Surcharge?
Why the Premium Increase Doesn't Happen This Year
Medicare sets your IRMAA for a given year using the tax return you filed two years earlier. A withdrawal taken in 2026 would affect premiums in 2028, not 2026, according to SSA's Form SSA-44 guidance. This two-year lag catches many retirees off guard.
Someone who withdraws $60,000 from a traditional IRA this year to cover a home repair or help a grandchild with tuition won't see any premium change on their next Medicare bill. The increase arrives on a statement two years out, often after the withdrawal itself is a distant memory. The lag cuts both ways. If your income drops back down the following year, your IRMAA two years later reflects that lower income — the surcharge isn't permanent, it resets annually based on whatever MAGI appears on the return from two years prior.
How Much Would a $60,000 Withdrawal Actually Cost?
Whether the withdrawal triggers a surcharge at all depends on where it lands relative to the IRMAA thresholds. For 2026, surcharges begin once MAGI exceeds $109,000 for single filers or $218,000 for married couples filing jointly; MAGI at or below those amounts pays only the standard premium, according to coverage of CMS's 2026 announcement from MOAA. A retiree already living near the top of their bracket could cross a threshold with a $60,000 withdrawal and trigger a real cost. The 2026 standard Part B premium is $202.90 a month.
The first IRMAA tier adds an $81.20 Part B surcharge plus a $14.50 Part D surcharge — about $95.70 a month, or roughly $1,148 a year, according to tipswatch.com's November 2025 breakdown of 2026 Medicare costs. At the top tier, MAGI of $500,000 or more (single) adds a $487.00 Part B surcharge plus a $91.00 Part D surcharge. A retiree with little other income who withdraws $60,000 and stays under $109,000 in total MAGI pays no surcharge at all. The withdrawal only matters if it's enough, combined with other income, to cross a bracket line.
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The Cliff Effect — Why $1 Can Cost You a Full Tier
IRMAA brackets don't phase in gradually. They work as a cliff: crossing a threshold by even $1 of MAGI triggers the full surcharge for that entire tier, not a prorated amount on just the excess, according to the Northern Trust Institute's analysis of IRMAA cliffs. This makes the exact size of a withdrawal matter more than it would under an ordinary graduated tax bracket.
Withdrawing $59,000 instead of $60,000 could keep a retiree under a threshold entirely, while the extra $1,000 that tips them over triggers the full annual surcharge for that tier — often well over $1,000 a year in added premiums, not a few dollars. The surcharge also applies for all 12 months of the premium year once triggered, because IRMAA is calculated annually from a single year's MAGI rather than prorated by month, according to SSA's rules on the sliding-scale tables. A withdrawal taken in January carries the same full-year consequence as one taken in December. And it applies the same way regardless of whether you have Original Medicare or Medicare Advantage, since SSA's IRMAA overview notes the surcharge is based on income, not plan type.
Can You Avoid or Appeal the Surcharge?
If you're 70½ or older, routing some or all of the withdrawal as a qualified charitable distribution (QCD) — a direct transfer from a traditional IRA to a qualifying 501(c)(3) charity, capped at $111,000 per person in 2026 — keeps that amount out of AGI and therefore out of MAGI entirely, according to a summary of the QCD rule under IRC §408(d)(8). That makes a QCD one of the few ways to withdraw IRA funds for a charitable purpose without raising IRMAA-relevant income. A large one-time withdrawal, on its own, doesn't qualify for an SSA appeal.
Form SSA-44 only accepts income reductions tied to eight specific life events: marriage, divorce, spousal death, work stoppage or reduction, loss of income-producing property, loss of pension income, or an employer settlement payment, according to SSA's Form SSA-44. "I took an unusually large withdrawal" isn't one of them, so there's no appeal path based solely on the withdrawal being a one-off. The practical lever is timing and size, not appeal. Spreading a large withdrawal across two tax years, or sizing it to stay just under the nearest threshold, avoids the cliff instead of trying to argue it away after the fact.
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