Dollar MoreIRMAA brackets

Capital gains planning

Capital gains IRMAA calculator

Capital gains can raise modified adjusted gross income. This page helps you test whether a planned sale could create a Medicare premium cliff.

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Before you decide

  • Estimate the taxable gain after basis and exclusions.
  • Include other income already expected for the tax year.
  • Check whether harvesting gains over multiple years reduces IRMAA exposure.

Test a capital gain against 2026 IRMAA

Taxable gain

$40,000

Projected MAGI

$143,000

Annual IRMAA increase

$2,884.80

Current tier

Standard premium

Projected tier

Tier 2 IRMAA

This gain crosses a 2026 IRMAA threshold and raises estimated annual IRMAA by $2,884.80.

Where people get surprised

Gross sale price is not the gain

Use the taxable gain after basis, selling costs, and any available exclusion or loss offset.

One-time income still matters

IRMAA can be triggered by one-time income events such as selling investments, a rental, or a second home.

Appeal may be limited

A capital gain alone is not always a life-changing event. Keep documentation and confirm before assuming relief.

Official sources