Roth conversions can be an effective part of your retirement planning strategy for good reason. By moving money from a traditional IRA or 401(k) into a Roth IRA, you pay taxes up front in exchange for tax-free gains and tax-free withdrawals later on.
Just as importantly, a Roth conversion can help you avoid or minimize required minimum distributions, or RMDs. Those mandatory withdrawals can drive up your tax bills in retirement and, in some cases, interfere with your legacy plans.
Image source: Getty Images.
But Roth conversions come with a hidden downside that many people overlook. And it's important to be aware of one big pitfall before moving forward.
How Roth conversions can increase Medicare premiums
Although Roth conversions don't count as earned income, the amount you convert is treated as taxable income in the year of the conversion. This means that if you do a large Roth conversion in a single year and your taxable income rises substantially, you risk getting hit with surcharges on your Medicare premiums known as income-related monthly adjustment amounts, or IRMAAs.
Medicare determines whether you owe IRMAAs by looking at your modified adjusted gross income from two years earlier. That means a Roth conversion completed in 2026 could increase your Medicare premiums in 2028.
If you're doing a smaller Roth conversion, IRMAAs may not be an issue. But if you're converting hundreds of thousands of dollars to a Roth IRA, you could end up having to pay IRMAAs if you move all of that money over within the same year. And then, depending on your income, that surcharge could add hundreds of dollars a month to the cost of your Medicare premiums.
How to avoid the IRMAA surprise
IRMAAs are an expense you'd probably rather avoid. And one way to do so is to spread your Roth conversion across several tax years if it's a large one.
Also, know when to initiate that conversion. It pays to take advantage of low-income years, such as if after retirement your paycheck stops, but you're not claiming Social Security for another year or two and are living on capital gains and dividends from a taxable account.
Granted, you may not have such a window. Not everyone does. But if you do, maximize it.
For many retirees, Roth conversions are a powerful tax-planning tool. And in the long run, they could work to your financial benefit. But it's important to understand that a large conversion in a single year could trigger other consequences, so plan accordingly.





