@Haley Sewell Size conversions using both your tax bracket and Medicare exposure. Smaller conversions spread across years can help manage income spikes. But avoiding IRMAA at all costs isn’t necessarily the best outcome—compare the added premiums and conversion tax with the expected longer-term tax benefit.marinerwealthadvisors+1 1. Pay particular attention starting around age 63. For someone enrolling in Medicare at 65, income from the calendar year they turn 63 generally affects their first year’s premiums. Earlier conversions can therefore provide a planning window, though the relevant enrollment years of both spouses matter.schwab+1 2. Don’t confuse today’s Medicare thresholds with the thresholds that will apply later. A 2026 conversion generally feeds into 2028 premiums, so calculate its effect using the applicable premium-year thresholds when available, and leave room for other income.marinerwealthadvisors 3. Remember the longer-term benefit: qualified Roth withdrawals generally don’t count toward Medicare’s income calculation. A conversion can raise premiums in the near term while creating a source of retirement spending that won’t raise that income measure later.marinerwealthadvisors If retirement or another qualifying life-changing event reduces your income, you may be able to request a lower IRMAA through Social Security using Form SSA-44. That relief depends on the qualifying event and income reduction; it isn’t an automatic exemption for conversion income. I was just talk with a colleague who shared her Medicare is close to 1k a month because she didn’t know to take the money out of the 401k. She also provided advice not to take the supplemental because that was a waste of money and to always take the gap insurance with Medicare because it picks up where Medicare don’t pay.