I Plan to Withdraw $110k From My 401(k) This Year. Will This Cause My Medicare Premiums to Go Up?

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Your 401(k) withdrawals can affect how much you spend on Medicare.

While few households pay premiums for Medicare Part A, most households do pay premiums for Medicare Part B and Part D. These premiums are based in significant part on your taxable household income. If your income goes up, such as by making a withdrawal from a taxable retirement account, your premiums can increase too. The good news is that your premiums are recalculated each year, so if your income goes back down your premiums will too.

For example, say that you plan on withdrawing an additional $110,000 from your 401(k) this year. This would almost certainly cause your Medicare premiums to temporarily increase, but not necessarily right away. Here are some things to know.

Consider speaking with a fiduciary financial advisor for specific guidance. You can use this free tool to match and speak with vetted advisors for free.

Medicare is a government health care program for Americans age 65 and older. There are four parts to this program, Parts A through D. Each part has a different cost structure:

• Medicare Part A: No costs for most households. A flat monthly premium, typically either $285 or $518, for households that do not have enough working credits to qualify for free Medicare.

• Medicare Part B: Monthly premiums that range between $185 and $628.90 based on household income.

• Medicare Part C: Monthly premiums based on the individual plan that you choose.

• Medicare Part D: Monthly premiums based on the individual plan that you choose, with an additional surcharge that ranges from $0 to $85.80 based on your household income.

As with all government programs, these numbers are periodically updated to reflect inflation. These numbers are accurate as of 2025.

Medicare Part A typically has no costs. Medicare Part C is a public-private partnership in which households buy private insurance with Medicare funding. The premiums under this program are based on the individual plan that you select.

Medicare Part B and Part D each have monthly premiums that can increase based on your annual income.

For Part B and Part D, premiums are calculated based on a concept called IRMAA, or "Income-Related Monthly Adjustment Amount." This is the index for how Medicare adjusts your monthly premiums based on your annual taxable income.

In 2025, the IRMAA for Part B is as follows:

• Below $106,000 Single/$212,000 Joint: Monthly Premium $185.00

• Between $106,001 and $133,000 Single/$212,001 and $266,000 Joint: Monthly Premium $259.00

• Between $133,001 and $167,000 Single/$266,001 and $334,000 Joint: Monthly Premium: $370.00

• Between $167,001 and $200,000 Single/$334,001 and $400,000 Joint: Monthly Premium: $480.90

• Between $200,001 and $500,000 Single/$400,001 and $750,000 Joint: Monthly Premium: $591.90

• Above $500,001 Single/$750,000 Joint: Monthly Premium: $628.90