Will Selling My House Raise My Medicare Premiums?

What is IRMAA and why does it show up two years after my sale?

IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge added to Medicare Part B and Part D premiums for people whose modified adjusted gross income (MAGI) exceeds annual thresholds. Social Security uses your tax return from two years prior, so 2024 income sets 2026 premiums. That lag is exactly why home sellers get blindsided: the closing check clears, life moves on, and then a higher Medicare bill arrives two years later. Depending on how far over the threshold you land, the 2026 surcharge ranges from roughly $1,148 to $6,936 per person, per year.

Does selling my primary residence count as income?

Only the taxable portion of the gain counts. Under the IRS home sale exclusion, if the home was your primary residence for at least two of the five years before the sale, you can generally exclude up to $250,000 of gain as a single filer or $500,000 married filing jointly. For many sellers in Vermillion, Yankton, and Sioux Falls, that shields the entire gain and Medicare never notices. The exposure comes from rental and investment property, second homes, land, and homes held for decades in fast-appreciating areas where the gain exceeds the exclusion.

What is form SSA-44?

Form SSA-44, the Medicare Income-Related Monthly Adjustment Amount Life-Changing Event form, lets you ask Social Security to recalculate your surcharge using more recent income after a qualifying life-changing event. The qualifying events are marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, and an employer settlement payment. You file after receiving your IRMAA determination letter, attach proof of the event and your reduced income, and each spouse files their own form. The official form and instructions are at ssa.gov/forms/ssa-44.pdf, and appeals are typically processed within about 30 to 90 days, sometimes with retroactive refunds.

Can I use SSA-44 to undo the Medicare spike from selling my house?

No, and this is the part almost everyone gets wrong. A home sale is not a qualifying life-changing event. The category called loss of income-producing property sounds like it should apply, but it only covers losses from events like natural disaster, arson, fraud, or theft. A voluntary sale, even one with a painful tax bill, does not qualify. If a sale alone caused your surcharge, the surcharge generally stands for that year and falls off once the two-year lookback moves past your sale year.

When does SSA-44 actually help a home seller?

When the seller has also retired. Many downsizers sell within a year or two of stopping work. Retirement counts as a work stoppage, which is a qualifying event. A new retiree whose premiums are still based on their old working income can file SSA-44 and ask Social Security to use their new, lower income instead. The savings frequently run into four figures per person per year. The sale did not qualify; the retirement did. Same person, same season of life, very different paperwork outcome.

What should I do before listing my home?

1. Ask your CPA to estimate the taxable gain and whether it could cross an IRMAA threshold for the sale year.
2. Confirm your primary residence exclusion coverage, including any complications from rental use, home offices, or inherited basis.
3. If you retired recently, ask your financial advisor about filing SSA-44 once your IRMAA determination letter arrives.
4. Choose an agent who raises these questions before the sign goes in the yard, not after the bill arrives.

Michelle Maloney is Broker/Owner of Maloney Real Estate, with offices in Vermillion, Sioux Falls, and Yankton, South Dakota. She holds the Seniors Real Estate Specialist (SRES) designation and has guided Southeast South Dakota homeowners through downsizing, estate, and relocation sales for decades. Sources for this article include the Social Security Administration (ssa.gov/medicare/lower-irmaa and Form SSA-44).

This content is educational only and is not tax, legal, financial, or Medicare advice. Everyone’s situation is different. Before making decisions about selling a home, capital gains, or Medicare premiums, consult a CPA, financial advisor, or your State Health Insurance Assistance Program (SHIP). Michelle Maloney is a licensed real estate broker in South Dakota, not a tax or financial professional.