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How your health insurance costs could rise because of a Roth IRA conversion

A doctor holds his stethoscope
Putting money from a traditional IRA retirement account into a Roth IRA boosts your income, which could affect what you pay for Medicare and Affordable Care Act insurance.
(Hannah McKay / Associated Press)

Dear Liz: With the recent stock market correction, I am considering doing a Roth conversion on an existing IRA now that it is worth less. I can handle the accompanying income tax hit. But while I see plenty of ink spilled on how a Roth conversion can increase Medicare premiums, what about Affordable Care Act costs? Is it the same story there: Will a one-time income spike this year due to Roth conversion impact what I pay all next year for ACA health insurance?

Answer: Potentially, yes. Roth conversions count as income for Affordable Care Act subsidies, so a large enough transaction could increase the premiums you pay.

A conversion allows you to transfer money from a regular IRA or 401(k), which would be taxable in retirement, to a Roth IRA, which would be tax free. If you expect to be in a higher tax bracket in retirement, conversions can make sense — you’re paying income taxes at the lower rate now, rather than the higher rate later. But obviously higher health insurance premiums would offset some of that benefit.

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A tax pro can help you model conversions of different sizes to see the effects on all your finances, not just your tax bill. It’s possible that a partial conversion could help you take advantage of the current downturn without dramatically increasing your health insurance costs.

The Secure Act dramatically limited “stretch IRAs,” which allowed people to draw down an inherited IRA over their lifetimes.

Social Security and divorce

Dear Liz: I was married for 25 years. Most of the time, I was a full-time housewife and worked part time here and there. Social Security keeps telling me that I can’t collect on my ex’s Social Security until he dies. He is 74 and I am 72. I started collecting at 62 and don’t get that much in Social Security. Is it true that I have to wait until he dies to get more?

Answer: Technically, you’re eligible for a divorced spousal benefit that’s up to 50% of your ex’s benefit if your marriage lasted at least 10 years and you haven’t remarried. If that amount is less than your own benefit, though, you wouldn’t get anything extra.

The math changes if your ex should die. Then you would be eligible for a survivor’s benefit that is equal to what he was receiving. If that amount is larger than your own benefit, you would get the larger amount.

A husband asks when his wife should apply for Social Security to maximize her benefit payments.

Switching back to original Medicare

Dear Liz: I’m 75 and I’ve been on an Advantage plan since I started on Medicare at 65. I’m interested in switching to original Medicare with a supplemental policy. I know I will have to enroll in a drug policy also. Will I be subject to any penalties for late enrollment for any of the three policies?

Answer: You won’t be subject to penalties but you will be subject to underwriting for the supplemental policy. That means the private insurance companies that offer these plans can deny you coverage or charge you more for preexisting conditions.

There are a few exceptions. Insurers can’t subject you to underwriting if you’re still within the first 12 months of having a Medicare Advantage plan, for example, or if you move out of the plan’s service area. In addition, four states — Connecticut, Maine, Massachusetts and New York — require Medigap companies to offer coverage to all Medicare beneficiaries.

Start shopping around and make sure your application for a supplemental policy has been approved before canceling your current plan.

Traditional medicare doesn’t cover everything, so many people also buy supplemental policies. Also: Q&As about 529 college savings plans, credit scores.

Medicare Part A

Dear Liz: You recently answered a question from someone who was delaying signing up for Medicare because he had health insurance through his job. You mentioned that if the employer had 20 or more employees, he didn’t have to sign up until that employment ended. That’s correct, but there’s typically no cost for Medicare Part A so there’s no reason not to sign up.

Answer: That’s an excellent point. Medicare Part A covers hospital visits and typically is premium-free, so signing up at age 65 is a good idea even if you have insurance coverage through work. The other parts of Medicare require monthly premiums and can impose penalties if you don’t apply when you’re first eligible.

Liz Weston, Certified Financial Planner, is a personal finance columnist for NerdWallet. Questions may be sent to her at 3940 Laurel Canyon, No. 238, Studio City, CA 91604, or by using the “Contact” form at asklizweston.com.


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