You have to take the money out. Medicare is watching what it does to your income.
Medicare sets its premiums from the income on your tax return of two years earlier. Past a certain line, your premiums step up — the whole next step, for a full year, per person. It is a cliff, not a slope. But money sent straight from your IRA to a charity never becomes income at all — so it never counts toward that line. Run your own numbers below and see exactly where you stand.
How much do you have to give to stay safe?
Medicare charges higher premiums once your income passes a line — $109,000 if you file single, $218,000 if you are married filing jointly (2026 figures). Money given straight from your IRA never becomes income, so giving pulls you back under the line. These are worked examples, figured on the income Medicare counts, before any giving:
Single
Married filing jointly
Your income
Give at least
Your income
Give at least
$109,000 or less
Nothing — you’re safe
$218,000 or less
Nothing — you’re safe
$115,000
$6,000
$225,000
$7,000
$120,000
$11,000
$230,000
$12,000
$130,000
$21,000
$240,000
$22,000
$137,000
$28,000
$274,000
$56,000
The rule, in one sentence: give at least the amount you are over the line, straight from your IRA, before December 31.
Every example in this table stops at the first step: giving at least the amount shown brings you back to the line and avoids that first step — about $1,148.40 a year in extra premiums, per person. (A couple on Medicare pays the step twice.) Higher incomes can cross higher steps, which cost more — all five steps are listed below the calculator.
One honest fence: you can only move money you take out of the IRA this way — if you’re over the line by more than your required withdrawal, giving the whole withdrawal still pulls you closer, and the calculator below works out your exact case. Medicare’s exact figure comes off your tax return; the calculator estimates yours from the numbers you enter.
Print this page, hand it to your custodian or advisor, and ask: ‘Should I do this with my required distribution this year?’
Dear Custodian,
Please make a qualified charitable distribution from my IRA directly to Cardio Renal Foundation Inc, EIN 33-4359765.
Amount: $____________________ — all or part of my required minimum distribution for this year.
Please make the check payable to Cardio Renal Foundation Inc and complete the transfer before December 31. Please send me written confirmation.
And please tell the Foundation it is coming, so it can watch for the check and send your acknowledgment letter: donations@cardiorenalfoundation.org or (646) 770-3946.
Cardio Renal Foundation Inc — 501(c)(3) tax-exempt nonprofit · Candid Platinum Seal of Transparency (2026) · EIN 33-4359765
The way out: give it straight from the IRA
A Qualified Charitable Distribution — a QCD — is a payment sent directly from your IRA to a qualified charity. You never touch the money, so it is excluded from your income entirely — and it still counts, dollar for dollar, toward your required minimum distribution. The withdrawal happens, the requirement is satisfied, and the income Medicare measures never includes it. You must be 70½ or older on the day the money leaves the IRA, it must be completed by December 31 to count for this year, and in 2026 you can give up to $111,000 per person this way.
How to do it — five steps, no homework elsewhere
Decide the amountUse the calculator below — or the table at the top of this page. Most people give the part of the RMD they don’t need — often all of it.
Call your IRA custodianThat’s the bank or brokerage holding your IRA — Fidelity, Schwab, Vanguard, your local bank. Ask for a Qualified Charitable Distribution. Many have a short form or an online version of the same request.
Name the charity exactlyGive them this name, exactly: Cardio Renal Foundation Inc, EIN 33-4359765. Ask that the check be made payable to Cardio Renal Foundation Inc and mailed directly to it — or sent to you made out to Cardio Renal Foundation Inc, so you can forward it. Never payable to you.
Keep the paperSave the custodian’s confirmation and the charity’s acknowledgment letter with your tax records.
Tell your tax preparerOne sentence: “I made a Qualified Charitable Distribution of $___ from my IRA.” That sentence is what keeps the amount off your taxable income on the return.
The exact words to say on the phone
“I’d like to make a Qualified Charitable Distribution from my IRA. Please send $15,650 directly to Cardio Renal Foundation Inc, EIN 33-4359765, and make the check payable to Cardio Renal Foundation Inc. This is for my required minimum distribution, and I need it completed before December 31. Please send me written confirmation.”
Cardio Renal Foundation Inc — 501(c)(3) tax-exempt nonprofit · Candid Platinum Seal of Transparency (2026) · EIN 33-4359765
Change the dollar amount to whatever the calculator showed you. The amount updates with the calculator.
And know what you are doing on that call. You are not parting with money you wanted. You are handing the Cardio Renal Foundation a withdrawal that was about to cost you tax, bracket room, and Medicare premiums — and we are glad to take it off your hands. That is a favor we are happy to do you: your problem becomes funding for the fight to end dialysis.
See where you stand
Four short answers. Your number updates as you type — there is nothing to submit.
$0
Your required minimum distribution this year: $0
The five steps — what crossing each line costs
Medicare’s higher premiums come in five steps. These are the 2026 lines for a single filer, and the extra premiums each step costs per person, per year:
Past $109,000 of income — about $1,148.40 more a year.
Past $137,000 — about $2,884.80 more a year.
Past $171,000 — about $4,620 more a year.
Past $205,000 — about $6,355.20 more a year.
Past $500,000 — about $6,936 more a year.
Married filing jointly, the lines are double: $218,000, $274,000, $342,000, $410,000, and $750,000. And the step is charged per person — if your spouse is on Medicare too, a couple over the line pays it twice.
Read the whole story: Will My RMD Raise My Medicare Premiums? — how the two-year lookback works, why the bill arrives two years after the income, and why this one can’t be appealed away.
More free calculators
Other free calculators from the Cardio Renal Foundation: