IRMAA, Medicare, Spousal RMD, HSAs, Life Insurance: Q&A# 2643

October 24, 2026

IRMAA, Medicare, Spousal RMD, HSAs, Life Insurance: Q&A# 2643

Jim and Chris discuss listener emails on choosing a life-changing event for an IRMAA reduction request, declining Medicare Part A to keep making HSA contributions, the hypothetical retroactive spousal RMD rule, using HSA funds for pre-65 health premiums, and using guaranteed universal life insurance as a tax-efficient inheritance.

(10:30) George asks if it matters which qualifying life event he selects on Form SSA-44, since two apply, when requesting a reduction in IRMAA. He also wonders whether the adjustment is still avoided if 2027 modified adjusted gross income (MAGI) comes in higher than estimated but stays under the first married filing jointly bracket.

(22:00) A listener inquires whether someone over 65 can decline Medicare Part A when starting a Social Security survivor benefit in order to keep contributing to a health savings account (HSA).

(44:15) The guys get a request to explain the purpose of the hypothetical retroactive spousal RMD rule for IRAs and to walk through the example from a recent EDU episode more slowly.

(57:45) Jim and Chris respond to a note saying that retirees who stay on their former employer’s health plan can use HSA money to pay premiums before age 65.

(1:01:30) A listener seeks guidance on using a guaranteed universal life insurance policy to tax-efficiently pass an inheritance to trusts for two adult children.

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