If you are a high-earning nurse making $120,000 as NP or over $200,000 as a CRNA, you probably think Medicare will be simple and affordable because you have paid your taxes for decades. However, many nurses are shocked to receive premium notices for $649 per month instead of the standard $202. This episode breaks down the "IRMAA" surcharge and why your income from two years ago dictates what you pay for Medicare today.

Brett explores:

• The definition of IRMAA and why it treats high-earning nurses as if they haven't paid their fair share.
• Why your 2026 Medicare premiums are based on your 2024 tax returns.
• The specific 2026 income thresholds for single and married filers.
• Five specific strategies to potentially reduce or eliminate these surcharges.
• How to use the appeals process if you have recently retired or seen a drop in income.

By the end of this episode, you will have a roadmap to avoid the "tax bomb" in retirement that triggers these expensive surprises.

#CRNAs #NursePractitioners #Medicare #IRMAA #RetirementPlanning

Key Timestamps:

(0:38) Welcome to Money RX for CRNAs and NPs

(1:22) The $10,000 Medicare surprise: A real-life case study

(2:25) What is IRMAA? The income-related surcharge explained

(4:03) Why the two-year look back catches nurses off guard

(6:10) 2026 Medicare Part B premium brackets and thresholds

(7:49) Strategy 1: Appealing due to life-changing events

(8:21) Strategy 2: Using Qualified Charitable Distributions (QCDs)

(8:50) Strategy 3: Strategic Roth conversions in gap years

(9:25) Strategy 4: Leveraging 403(b) and 457 plan contributions

(9:39) Strategy 5: Donor Advised Funds for tax deductions

(11:05) Conclusion: Integrating Medicare into your retirement strategy 

For more information and resources related to this episode, please visit the show notes.