Medicare beneficiaries can reduce IRMAA surcharges by managing their income to stay below key thresholds. For 2026, IRMAA begins at $109,000 for single filers and $218,000 for joint filers, adding extra costs to your standard $202.90 monthly Part B premium. Strategic planning can help minimize these surcharges through Roth IRA conversions, which create tax-free retirement income, minimizing capital gains by timing asset sales carefully, maximizing Health Savings Account contributions for tax-deductible medical expenses, and using Qualified Charitable Distributions from IRAs to satisfy RMDs without increasing taxable income.

For Medicare Supplement insurance premiums, comparison shopping remains your best strategy. Medigap premiums vary significantly between insurance companies for identical coverage. Consider switching to a high-deductible Plan F or G if available, which offers lower monthly premiums in exchange for a $2,870 deductible in 2026. Many insurers offer household discounts when multiple family members have policies with the same company, potentially saving 5-12% on premiums.