Don Graves: The Immediate Impact of IRMAA Planning on Your Practice

Don Graves is a well-respected personality in the retirement income industry — and, just as importantly, an amazing human being. We were lucky enough to work with him when he joined the growing ranks of IRMAA Certified Planners, and shortly after completing the training he shared a note with us about his experience.

What makes his story worth publishing is how quickly the knowledge paid off. This wasn't a theoretical exercise or a marketing hypothetical. Within days of finishing the certification, Don sat down with an advisor and that advisor's clients — and caught a nearly seven-figure mistake before it happened.

If you've ever wondered whether Medicare's IRMAA surcharge is really something financial advisors need to plan around, or whether it's a niche detail best left to Medicare brokers, this case study answers the question in the most concrete way possible: with real numbers, a real client meeting, and a real change of course.

In Don's own words:

"I wanted to share a recent experience that perfectly illustrates how I've been able to apply the knowledge gained through the IRMAA certification in my practice.

Today, I was meeting with an advisor and his clients who were in the process of making a series of steps to prepare themselves for a lower tax future. One of those steps involved rolling over $927,000 from a 401(k) into another instrument using a specific strategy. While they understood the income tax consequences of this move, what they hadn't fully grasped was the impact it would have on their Medicare Part B premiums."

Pause on that for a moment, because this is where most planning conversations stop. The clients had done their homework on the income tax side. They knew a large conversion would generate a big tax bill in the year it happened, and they had accepted that cost in exchange for a lower-tax future. What nobody in the room had modeled was the second-order effect: what that one year of inflated income would do to their Medicare premiums.

That blind spot is extremely common. Income tax consequences show up on the very next tax return, so everyone plans for them. IRMAA consequences arrive two years later, on a Social Security notice most clients have never seen before — which is exactly why they get missed.

Here's where Don's IRMAA training changed the conversation. Continuing from his letter:

"When I explained that their Medicare Part B would likely increase from $175 per person to nearly $600 per person two years after this year's tax return, they were understandably concerned. This equates to nearly $425 more taken out of each month per person! The question that immediately came up was, 'What is IRMAA?'"

Those figures reflect the 2024 Medicare landscape, when this case took place: the standard Part B premium was about $175 per month, and beneficiaries in the highest IRMAA bracket paid nearly $600 per month for Part B alone. For a married couple, that's roughly $850 per month in additional premiums — over $10,000 in a single year — triggered by one transaction.

And notice the timing Don flagged: the increase would land two years after this year's tax return. That's the signature of IRMAA's two-year lookback. The Social Security Administration determines each year's surcharge using the most recent complete tax return available from the IRS, which is generally from two years prior. A 2024 income spike becomes a 2026 premium problem. If you want the full mechanics, we walk through them in how IRMAA is calculated.

The clients' question — "What is IRMAA?" — is one every advisor should expect. Only a small minority of Medicare beneficiaries pay the surcharge, so most people have simply never encountered it. The ones who do encounter it are disproportionately the clients financial advisors serve: households with meaningful retirement accounts, capital gains, and conversion opportunities.

Explaining a surcharge is one thing. Showing clients exactly where their own numbers land is what actually moves a planning conversation. Don did precisely that:

"At that point, I took them to your website and walked them through how the $927,000 rollover would impact not only their Modified Adjusted Gross Income (MAGI) but also place their Medicare Part B in the highest IRMAA level for at least one year. Additionally, it would increase the taxes they pay on their Social Security to the highest levels as well."

Two distinct costs were stacking on top of each other here, and both key off the same number:

• IRMAA: The rollover would inflate the couple's MAGI far past the top threshold of the IRMAA brackets, putting both spouses in the highest surcharge tier for Part B (and Part D) for at least one year.
• Social Security taxation: The same MAGI spike would push the taxable portion of their Social Security benefits to the maximum level — up to 85% of benefits included in taxable income.

This stacking effect is what makes large one-year conversions so expensive in practice. The marginal cost of the transaction isn't just the income tax bracket it lands in — it's the income tax, plus the Medicare surcharges on both spouses, plus the additional tax on Social Security benefits, all triggered by the same line on the tax return.

The clients were stunned by the potential cost implications — and, as Don noted, incredibly appreciative of the insight. Nobody enjoys hearing that their plan has a flaw. But every client prefers hearing it before the transaction rather than two years after, when the IRMAA determination letter arrives from Social Security.

Identifying the problem was only half of Don's contribution. The other half was the redesign:

"When they asked what they could do, I explained that while they wanted to roll over the entire amount in one year, a more structured conversion over time might allow them to keep their MAGI under the $206k threshold or at least better manage their IRMAA brackets. I was able to show them how the Reverse Mortgage Line of Credit can also assist and be utilized now and in the future!"

The core move is multi-year bracket management. Instead of recognizing $927,000 of income in a single tax year — guaranteeing the top IRMAA tier and maximum Social Security taxation — the conversion gets spread across several years, with each year's amount sized against the thresholds that matter. In 2024, the first IRMAA threshold for a married couple filing jointly sat at $206,000 of MAGI; staying under it meant paying only the standard Part B premium. (Those thresholds adjust annually — see the 2025 IRMAA brackets for how they've moved since.)

Even when staying under the first threshold isn't realistic, managing the brackets still saves real money. IRMAA is a cliff structure: one dollar over a threshold triggers the full surcharge for that tier. Landing deliberately in the second bracket instead of accidentally in the fifth is worth thousands of dollars per year, per spouse.

Don also brought his own specialty to the table — housing wealth. A reverse mortgage line of credit can supply spendable, non-MAGI cash flow during conversion years, letting clients meet their income needs without adding taxable withdrawals on top of the conversion amounts. That's the kind of cross-disciplinary sequencing that separates a transaction from a plan. For clients who do get caught by a one-time income event, an IRMAA appeal using Form SSA-44 is sometimes available — but only for qualifying life-changing events, which a voluntary rollover is not. Planning ahead is the only reliable protection.

Don closed his note this way:

"This was my first opportunity to apply what I've learned from the IRMAA certification, and it made a substantial impact on the clients' financial planning. Your resources have been invaluable, and I'm excited to continue incorporating this expertise into my work.

Thank you for the excellent training and the tools you've provided. I'm looking forward to more opportunities to use this knowledge in meaningful ways."

Notice what happened in that meeting from a practice-growth perspective. Don wasn't the clients' primary advisor — he was in the room alongside another advisor. By surfacing a five-figure annual cost that nobody else had seen, he instantly demonstrated differentiated value to both the clients and the advisor. That's the "immediate impact" in this case study's title: IRMAA knowledge converted directly into credibility, on day one.

It also reframed the planning relationship. The clients came in with a transaction; they left with a multi-year strategy that requires ongoing monitoring — annual conversion sizing, threshold tracking as brackets adjust, and coordination of cash-flow sources. Every one of those touchpoints is a reason for the client to stay engaged year after year.

This case study originally appeared on the IRMAA Certified Planner site, the education program where Don completed his IRMAA training. The specific dollar figures — the $175 standard premium, the nearly-$600 top-bracket premium, the $206,000 married-filing-jointly threshold — are 2024 numbers, and they're preserved here as-is because they're the real numbers from the real case. The thresholds and premiums adjust every year, but the pattern repeats every year too.

The transferable lessons:

• Screen every large income event for IRMAA. Rollovers, Roth conversions, business sales, large capital gains — anything that spikes MAGI deserves a two-years-forward premium projection before it's executed.
• Model the stack, not just the tax. Income tax, IRMAA on both spouses, and Social Security taxation move together. Quoting only the income tax cost understates the real price of a transaction.
• Respect the cliffs. IRMAA brackets aren't marginal. Sizing conversions against thresholds — not just tax brackets — is where the savings live.
• Show, don't tell. The turning point in Don's meeting came when he put the clients' own numbers on screen. Visual, client-specific projections turn an obscure acronym into an obvious decision.

RetirementAdvisorPro was built to make that fourth point effortless. Our planning software models MAGI year by year, flags IRMAA bracket crossings before they happen, and lets you show clients — in one screen — what a proposed rollover or conversion will do to their Medicare premiums two years out. If you'd like to see how it would have handled Don's $927,000 case, schedule a demo.