Medicare Part B costs $202.90 a month in 2026 for a single filer with a modified adjusted gross income, or MAGI, of $109,000 or less. One dollar above that line puts the premium at $284.10, an extra $81.20 a month, or about $974 a year, according to the Social Security Administration.
Married couples filing jointly face the same step at $218,000. Social Security generally uses the return from two years earlier, so 2026 income can set premiums in 2028.
Retirees who give to charity have one tool that works on that income line. It is a qualified charitable distribution, or QCD, and the IRS limit for 2026 is $111,000, up from $108,000.
What the IRS requires
You must be at least 70½ when you make the distribution. The money must go directly from your IRA trustee to an organization eligible to receive tax-deductible contributions. The IRS describes a QCD as generally a nontaxable distribution, and it can come from an IRA other than an ongoing SEP or SIMPLE IRA.
A QCD can also satisfy all or part of your required minimum distribution. In the IRS example, a retiree with a $10,000 RMD who sends $5,000 to charity still has $5,000 left to withdraw. RMDs begin at 73 or later, depending on birth year, so some retirees can use QCDs before withdrawals are mandatory.
Why the Medicare line matters here
The Social Security Administration defines MAGI as adjusted gross income plus tax-exempt interest. Any traditional IRA withdrawal you keep is taxable income that increases your adjusted gross income. A QCD is not counted as taxable income, so the gift does not add to the figure that sets your premium bracket.
Whether that keeps you below a threshold depends on your other income, and bracket amounts change over time.
The tradeoff is the deduction. The IRS says you cannot claim a charitable deduction for a QCD that was not included in your income, so the benefit comes from keeping the money out of income rather than from deducting it.
Retirees who take the standard deduction can now deduct up to $1,000 in cash gifts to charity, or $2,000 for married couples filing jointly, under a federal change that took effect in 2026. A QCD is not capped at that amount, because the money never counts as income in the first place.
It’s worth reviewing the details of the two-year Medicare lookback alongside it.
When a planner could help
If your income sits near a Medicare line, the order of withdrawals, conversions and gifts can get complicated. Mistakes also carry costs, such as the 25% penalty for missing an RMD. Coordinating it all is the kind of tax-efficient withdrawal planning a fiduciary advisor handles.
SmartAsset matches you with up to three fiduciary advisors. SmartAsset provides matching, not advice, and the match questionnaire takes about 10 minutes, roughly 37 questions, and asks for a phone number near the end. You control whether and when you respond to anyone. Money Talks News may earn compensation if you use the link.
Have $100,000 or more in investments? Get matched free with advisors who can look at your income, your giving and your Medicare premiums together.
Timing the gift
QCDs are reported on Form 1099-R for the calendar year the distribution is made, so a gift meant to count for 2026 needs to be completed within 2026. Ask your IRA custodian how long its charity payments take, and have the charity’s legal name and address ready before you call.
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