10/23/2026
Medicare enrollment gets discussed as a health insurance decision. For a lot of my clients, it's a tax decision.
Medicare sets your Part B and Part D premiums using income from two years back. Your 2025 return determines what you pay in 2027.
The surcharges are cliffs, not slopes. One dollar past a threshold moves you into the next tier for a full year — and it applies to each spouse separately. If 2025 included a business sale, a large Roth conversion, or concentrated gains, that bill may be waiting.
There's a remedy most people never hear about. If you've since retired, sold the business, or materially cut your hours, Form SSA-44 lets you ask Social Security to use current income instead.
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