A required minimum distribution (RMD) from a traditional IRA or most employer retirement plans is generally taxable income. That extra income can make a larger share of your Social Security benefits taxable and may increase Medicare Part B and Part D premiums through the income-related monthly adjustment amount (IRMAA)—usually two years later.
The practical way to avoid surprises is to coordinate three dates: the year you take the RMD, the tax return on which that income appears, and the Medicare premium year that uses the return from two years earlier. Your account type, filing status, basis, beneficiary status and other income determine the result.
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What an RMD is and when it starts
An RMD is a withdrawal the tax rules require from a traditional individual retirement account (IRA) and most employer retirement plans. The withdrawal is not optional once the applicable starting age is reached, even if you do not need the money for spending.
Current starting age and deadlines
Under the current IRS guidance, most people begin RMDs at age 73. The first distribution is generally due by April 1 of the year after the year you reach 73. Every later RMD is generally due by December 31 of that year. IRS Publication 590-B (2025) states: “You must begin receiving required minimum distributions by April 1 of the year following the year you reach age 73.”
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| Distribution | General deadline | Planning consequence |
|---|---|---|
| First RMD | April 1 of the year after you reach 73 | If you wait until this date, you may also have to take the next year’s RMD by December 31 of the same calendar year, creating two taxable withdrawals in one year. |
| Each later RMD | December 31 annually | Missing the deadline can create a tax problem and requires prompt correction under current IRS procedures. |
Your exact required beginning date can depend on your birth year and the plan involved. Employer-plan rules can also require action when you retire, and inherited accounts follow separate beneficiary rules. Confirm the rule with the plan administrator or a tax professional before relying on a general age-73 timetable.
How the amount is calculated
- Use the account balance on the preceding December 31.
- Identify the applicable IRS life-expectancy table and factor for your situation.
- Divide the prior-year balance by that factor to determine the year’s RMD.
Publication 590-B includes worksheets and tables. A spouse beneficiary, a non-spouse beneficiary, an inherited IRA, or a participant with a different beneficiary designation can require a different calculation. Keep separate records for each account so that an RMD is taken from the correct arrangement and documented.
Why an RMD can make more Social Security taxable
Social Security benefits are not automatically 100% taxable or 100% tax-free. The IRS worksheet uses “combined income,” also called provisional income in many explanations. It adds your modified adjusted gross income (MAGI), one-half of your Social Security benefits and tax-exempt interest.
In formula form:
Combined income = modified adjusted gross income + ½ Social Security benefits + tax-exempt interest
A traditional-IRA RMD generally enters gross income as ordinary income. Subject to basis and other exceptions, that raises the first term in the formula. When combined income moves into a higher range on the current Publication 915 worksheet, a larger percentage of benefits can be included in taxable income. The RMD does not change the benefit reported by the Social Security Administration; it changes the tax calculation applied to that benefit on your federal return.
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What is included in the calculation
- Taxable RMDs from traditional IRAs and most pre-tax employer plans.
- Wages, pensions, interest, dividends, capital gains and other income reported on your return.
- One-half of your Social Security benefits.
- Tax-exempt interest, even though it is not generally taxable by itself.
Use the worksheet in the current IRS Publication 915 for the tax year being filed. Filing status matters, and married couples who file jointly use different worksheet ranges from single filers. A distribution that seems modest by itself can still increase taxable benefits when it is added to pension income, investment income or a spouse’s earnings.
Why the first-RMD choice matters
You can generally take the first RMD during the year you turn 73 or postpone it until April 1 of the following year. Postponement does not eliminate an RMD; it can place two distributions in the following calendar year. That bunching may increase the taxable share of Social Security for that year and produce a larger one-year tax bill than taking the first distribution earlier.
How IRMAA links today’s RMD to a later Medicare bill
IRMAA is the income-related surcharge added to Medicare Part B and Part D premiums for beneficiaries whose income exceeds the applicable ranges. Medicare generally uses the modified adjusted gross income reported on your federal tax return from two years earlier. The Medicare & You Handbook 2026 explains that Medicare uses the IRS return from two years ago to determine whether you pay IRMAA.
That lag means an unusually large RMD, a Roth conversion, a property sale or another one-time event can affect premiums after the event has passed. For example, income on your 2024 return can be used to set 2026 premiums.
2026 figures reported by Medicare
For 2026 coverage, the Medicare.gov handbook published in 2025 reports a standard Part B premium of $202.90 per month. It reports IRMAA thresholds of $109,000 for individual filers and $218,000 for married couples filing jointly, based on 2024 MAGI. These are year-specific figures; Medicare updates premiums, brackets and surcharges, so do not carry them into another premium year without checking that year’s handbook.
| Item | 2026 figure or rule | Qualification |
|---|---|---|
| Standard Part B premium | $202.90 per month | Medicare.gov, 2025 publication for 2026 coverage. |
| IRMAA threshold for an individual filer | $109,000 | Based on 2024 MAGI for 2026 premium determinations. |
| IRMAA threshold for married filing jointly | $218,000 | Based on 2024 MAGI for 2026 premium determinations. |
| Look-back period | Two years | Medicare normally uses the federal return from two years earlier. |
The threshold is not a forecast of your tax bracket, and crossing it can affect both Part B and Part D costs. The exact surcharge depends on the applicable filing-status tier and the premium year. Check the current notice and handbook rather than estimating from an old table.
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One large withdrawal versus spreading withdrawals
You must satisfy each year’s RMD, but you can often choose when during the year to take it. If you also need extra money, compare the tax and premium effects of taking that optional amount at once with taking smaller withdrawals over several years.
| Approach | Potential benefit | Risk to model |
|---|---|---|
| Take only the required amount each year | Keeps the distribution closer to the amount the law requires. | Other income could still make Social Security taxable or put MAGI over an IRMAA range. |
| Take one large additional distribution | Provides cash for a major expense or simplifies an account. | Concentrated ordinary income can increase taxable Social Security and affect Medicare premiums two years later. |
| Spread optional withdrawals across years | May smooth taxable income and reduce the chance of a single-year IRMAA jump. | Future tax rates, investment returns and RMD amounts are uncertain; spreading does not guarantee lower total tax. |
Model the withdrawal year and the two-year Medicare look-back year together. A distribution that keeps current-year tax manageable can still produce a later IRMAA notice, while a distribution that avoids IRMAA may leave more money in a tax-deferred account subject to future RMDs.
Account type changes the answer
| Account or distribution | General treatment | What to verify |
|---|---|---|
| Traditional IRA | RMDs generally count as ordinary income, except to the extent of after-tax basis or another applicable exception. | Basis records and the current IRS distribution rules. |
| Pre-tax 401(k) or similar employer plan | Most plans require RMDs and taxable distributions generally raise MAGI. | Plan document, retirement status and whether separate plan RMD rules apply. |
| Owner’s Roth IRA | Qualified Roth distributions are treated differently, and an owner generally has no lifetime RMD. | Whether a distribution is qualified and whether the account is inherited. |
| Inherited IRA | Beneficiary RMD timing and amounts can differ from owner rules. | Original owner’s death date, beneficiary category and current IRS requirements. |
| Qualified charitable distribution (QCD) | A qualifying transfer to charity can have different tax treatment from a payment made to you. | Eligibility, age, direct-transfer procedure and annual limits under current IRS rules. |
Do not assume that a Roth conversion, QCD or inherited-account withdrawal follows the same path as a normal traditional-IRA RMD. Each can change both taxable income and the amount used for Medicare’s two-year look-back.
How to pay the resulting tax
Federal withholding is generally available on IRA distributions. IRS withholding guidance says a nonperiodic payment defaults to 10% withholding, and Form W-4R can be used to request a different rate. RMDs generally are not eligible rollover distributions, so the mandatory withholding and rollover rules that apply to a direct rollover do not work the same way here.
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Withholding from the distribution
Tell the custodian how much federal tax to withhold before the payment is sent. Withholding is credited during the year, which can help avoid an estimated-tax underpayment even if the distribution occurs late in the year. State withholding, if available, follows separate rules.
Quarterly estimated payments
You can instead make estimated payments based on projected total income. This approach may be useful when you need the full RMD in cash or when income varies. Recheck the projection after a sale, bonus, conversion or second distribution. Your tax preparer can test whether the withholding or estimated-payment safe-harbor rules fit your facts.
A practical planning process
- Identify the accounts and deadlines. List each traditional IRA, employer plan and inherited account. Record the prior December 31 balance, the applicable life-expectancy factor and the deadline for every RMD.
- Separate mandatory and optional cash needs. Decide how much you must withdraw and how much you want for spending, gifting, debt repayment or a purchase. Analyze optional money separately so a large one-time payment does not hide its effect.
- Project current-year MAGI. Add the RMD to wages, pensions, investment income, conversions and other expected items. Include tax-exempt interest when evaluating Social Security taxability.
- Recalculate Social Security taxation. Use the current Publication 915 worksheet with your filing status and the year’s benefits. Do not assume the prior year’s taxable percentage carries forward.
- Look two years ahead for Medicare. Compare projected MAGI with the premium-year thresholds in the current Medicare handbook. For 2026, the relevant return is generally 2024; a 2026 distribution would generally be considered for a later premium year.
- Choose withholding or estimated payments. Set the federal withholding rate on Form W-4R or schedule estimated payments. Include any additional tax created by the RMD and the newly taxable Social Security.
- Keep an audit file. Save the custodian’s RMD calculation, distribution confirmations, Form 1099-R, withholding election, tax worksheet and Medicare notice. These records make a correction or appeal easier.
Illustrative timing example
Suppose a taxpayer turns 73 in 2026 and has a traditional IRA RMD. Taking it in 2026 places the taxable distribution on the 2026 federal return and generally makes that return the reference point for a 2028 Medicare determination. Delaying the first RMD until April 1, 2027 can create two RMDs in 2027: the postponed first amount and the 2027 amount due by December 31. The second approach may concentrate more ordinary income, potentially increasing the taxable share of 2027 Social Security and the MAGI used for 2029 Medicare premiums.
This example does not predict a surcharge. The outcome depends on the actual RMD, all other income, filing status and the thresholds published for the relevant premium year.
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Common mistakes and how to correct them
Waiting for the April 1 deadline without modeling two withdrawals
First-year deferral is legal in many cases, but it can bunch income. Compare both calendar-year schedules before deciding.
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Using an old Medicare table
IRMAA brackets and premiums change. Use the handbook for the premium year at issue and identify the tax return Medicare will use.
Forgetting tax-exempt interest
Although tax-exempt interest is generally not taxable, it is included in the Social Security combined-income worksheet and in the MAGI concept used for Medicare calculations.
Assuming withholding equals the final tax
The default 10% withholding on a nonperiodic IRA payment may be too low or too high for your total income. Reconcile it with your complete projection.
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Beneficiary schedules, Roth qualification and QCD requirements can change the result. Verify the specific rule before withdrawing or transferring money.
If your income later falls
Medicare sends an IRMAA determination notice with appeal information. Keep it. If your income dropped because of a qualifying life-changing event, follow the Social Security instructions for a reconsideration or adjustment and submit the requested evidence. A later reduction in income does not automatically change the premium; you must use the process described in the notice.
When professional help is worthwhile
Consider a fee-only retirement tax adviser, enrolled agent or Medicare specialist when you are coordinating a first RMD, a large one-time withdrawal, a Roth conversion, an inherited account, substantial after-tax basis, a QCD or an IRMAA appeal. Bring your prior-year tax return, account statements, RMD calculations, Social Security benefit statement and Medicare notice. Professional advice cannot change the statutory deadlines, but it can help coordinate the tax year, withholding and appeal documentation.
Bottom line
A traditional-IRA RMD can affect three separate bills: income tax on the distribution, income tax on a larger share of Social Security and Medicare premiums set two years later. Calculate the RMD from the prior December 31 balance, test the distribution in the current Social Security worksheet, project the MAGI used for the relevant Medicare year, and arrange withholding or estimated payments before the money arrives.
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