A $28,000 IRA Withdrawal for Dental Implants Could Leave Her Facing Higher Medicare Premiums Two Years Later

A widow may end up paying for dental implants twice: first at the dentist, and then again later when Medicare raises her premiums. How she pays for the procedure can matter as much as the treatment itself.

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Take the case of a 70-year-old widow who needs $28,000 in dental implants and plans to cover the cost with a withdrawal from her traditional IRA. Medicare will not pay for the implants, and the withdrawal could trigger higher premiums two years later.

The issue affects single filers whose ordinary income is close to Medicare’s first surcharge threshold. Roughly 8% of Part B enrollees pay any surcharge. For retirees whose income stays comfortably below the limit, taking IRA money for dental work may not lead to extra Medicare costs.

Why Medicare Does Not Usually Cover Implants

Original Medicare generally excludes routine dental care, including cleanings, fillings, extractions, dentures and implants. Coverage is only available when dental work is directly connected to a covered medical procedure. That can include an oral exam before a heart valve replacement or organ transplant, an extraction needed to remove an infection before chemotherapy, or treatment for complications related to head and neck cancer care. Replacing failing teeth with implants does not fit those exceptions.

Some Medicare Advantage plans provide dental benefits that Original Medicare does not, but those benefits vary widely. A few plans exclude implants entirely, while others limit annual dental coverage to far less than the cost of a multi-tooth implant procedure.

The $28,000 Withdrawal Can Still Be Treated as Income

Medicare’s income-related monthly adjustment amount, or IRMAA, is based on modified adjusted gross income, which includes adjusted gross income plus tax-exempt interest such as municipal bond interest. A $28,000 withdrawal from a traditional IRA would also be taxable income.

The Social Security Administration typically uses income from two years earlier, so a withdrawal made one year can affect Medicare premiums two years later. In this example, money taken from the IRA would influence premiums in the later year.

Assume her baseline MAGI is $90,000. Adding the withdrawal brings it to $118,000. Under 2026 brackets, a single filer with income from $109,000 to $137,000 pays an additional $81.20 a month for Part B. That would increase her premium from $202.90 to $284.10, or by $974.40 over the year. Part D would add another $14.50 a month, or $174 a year. Combined, the surcharges would total $1,148.40.

That $974 figure applies only to Part B and reflects 2026 rates. Medicare has not yet released 2028 brackets. While the income thresholds are adjusted for inflation, the cushion can be small: between 2025 and 2026, the single-filer threshold rose only $3,000, from $106,000 to $109,000.

Being widowed can make the situation more difficult. A married couple filing jointly faces a threshold of $218,000, compared with $109,000 for a single filer. Even if household income remains largely the same, the lower single-filer limit leaves less room before Medicare surcharges begin.

There is also no easy appeal in this case. Form SSA-44 allows beneficiaries to request a lower surcharge after certain life-changing events that reduce income, such as marriage, divorce, the death of a spouse, loss of income, or an employer settlement payment. A voluntary IRA withdrawal increases income instead, so it does not qualify.

Three Ways to Pay Differently

• Cash savings. Paying from a savings or money market account does not add to MAGI, so no surcharge is triggered.
• Taxable brokerage account. Selling investments creates MAGI only to the extent of any capital gain. The rest of the sale proceeds do not count, so selling low-gain holdings may keep her under the limit.
• An IRA withdrawal spread over two tax years. Implant procedures are often done in stages over several months. If she withdraws $14,000 in December and another $14,000 in January, her MAGI would come to $104,000 in each year. That stays below the 2026 threshold, assuming her other income does not change.

In any single year, she has $19,000 of space under the 2026 threshold. That does not mean she should postpone needed treatment just to protect that margin. Delaying care to avoid a one-year surcharge of $1,148.40 is usually a poor trade. Adjusting the timing of withdrawals may help her avoid the premium hit, though she still has to weigh the income-tax impact.

Before She Books the Procedure

1. Request a written, staged estimate. Ask the dental office to separate the surgical phase and the crown phase, including the date and cost of each. If the treatment schedule allows it, coordinate IRA withdrawals so they fall in different tax years.
2. Verify coverage in writing. If she has a Medicare Advantage plan, ask whether implants are covered and what the annual dental cap is. If not, use the current open enrollment period to compare plans with implant benefits.
3. Estimate MAGI before year-end. Add current AGI, expected income for the rest of the year, and tax-exempt interest. If the total plus the withdrawal would exceed $109,000, shift part of the withdrawal into the following year or pay part of the bill from cash.