Medicare Part B Premiums, IRMAA - What Nurses Need to Know

If you are a high-earning nurse making $120,000 as NP or over $200,000 as a CRNA, you probably think Medicare will be simple and affordable because you have paid your taxes for decades. However, many nurses are shocked to receive premium notices for $649 per month instead of the standard $202. This episode breaks down the "IRMAA" surcharge and why your income from two years ago dictates what you pay for Medicare today.Brett explores:The definition of IRMAA and why it treats high-earning nurses as if they haven't paid their fair share.Why your 2026 Medicare premiums are based on your 2024 tax returns.The specific 2026 income thresholds for single and married filers.Five specific strategies to potentially reduce or eliminate these surcharges.How to use the appeals process if you have recently retired or seen a drop in income.By the end of this episode, you will have a roadmap to avoid the "tax bomb" in retirement that triggers these expensive surprises.#CRNAs #NursePractitioners #Medicare #IRMAA #RetirementPlanningKey Timestamps:(0:38) Welcome to Money RX for CRNAs and NPs(1:22) The $10,000 Medicare surprise: A real-life case study(2:25) What is IRMAA? The income-related surcharge explained(4:03) Why the two-year look back catches nurses off guard(6:10) 2026 Medicare Part B premium brackets and thresholds(7:49) Strategy 1: Appealing due to life-changing events(8:21) Strategy 2: Using Qualified Charitable Distributions (QCDs)(8:50) Strategy 3: Strategic Roth conversions in gap years(9:25) Strategy 4: Leveraging 403(b) and 457 plan contributions(9:39) Strategy 5: Donor Advised Funds for tax deductions(11:05) Conclusion: Integrating Medicare into your retirement strategy For more information and resources related to this episode, please visit the show notes.