The Medicare tax trap costing clients thousands

For many retirees, Medicare premiums are treated as a fixed expense. But an ill-timed tax planning decision — like a Roth conversion — can quickly change that. The income-related monthly adjustment amount, or IRMAA, operates with sharp cliffs: Cross a threshold by even a single dollar, and premiums can jump by thousands annually. For advisors, that makes income management just as important as portfolio management. And as surcharges rise in 2026, the cost of getting it wrong is becoming more visible to cl ...