A Medicare Part B premium can look like a simple monthly bill until income enters the picture. In 2026, the standard premium is $202.90 per month, but higher-income beneficiaries can pay as much as $689.90 per month for Part B before adding any Part D IRMAA.
The number that controls your 2026 IRMAA is usually not your 2026 income. Social Security generally starts with your 2024 tax return. That two-year lag is the part worth planning around.
For 2026, the standard Medicare Part B premium is $202.90 a month and the annual Part B deductible is $283. IRMAA begins above $109,000 of MAGI for most individual filers and above $218,000 for married couples filing jointly. The highest 2026 Part B premium is $689.90 a month per person.
The practical question is not just “What does Part B cost?” It is: Which tax year is Medicare using, what income counted in that MAGI, and is there anything you can still change?
Key Takeaways Ahead
What Is the Medicare Part B Premium for 2026?
The Centers for Medicare & Medicaid Services set the standard 2026 Medicare Part B premium at $202.90 per month. That is $17.90 more than the $185.00 standard premium in 2025.
| Part B cost | 2025 | 2026 | Change |
|---|---|---|---|
| Standard monthly premium | $185.00 | $202.90 | +$17.90/month |
| Annual standard premium | $2,220.00 | $2,434.80 | +$214.80/year |
| Annual deductible | $257 | $283 | +$26 |
For a married couple who both pay the standard Part B premium, the premium increase alone is $429.60 for the year. That is before Medigap, Medicare Advantage, Part D, dental, vision, hearing, or out-of-pocket medical costs.
CMS says the 2026 increase mainly reflects projected price changes and utilization. It also says a payment-policy change for skin substitutes reduced what otherwise would have been an even larger Part B premium increase.
What the hold-harmless rule actually does
The Social Security “hold harmless” rule can limit a year-to-year Part B premium increase for some people when the increase would otherwise reduce their net Social Security benefit. But it is not a blanket discount for everyone already collecting Social Security.
SSA policy says people paying an income-related Part B premium do not receive this protection. New Part B enrollees and people whose premiums are not deducted in the required way may also fall outside the rule.
I would not use “Do I get hold harmless?” as a Social Security claiming strategy. It is a Medicare premium protection rule with eligibility conditions. The larger retirement-planning question is whether delaying or claiming Social Security makes sense for your lifetime income plan; the Part B billing mechanics are a secondary input, not the decision engine.
2026 Part B Deductible Amount
The 2026 Part B deductible is $283, up from $257 in 2025. The deductible is separate from the monthly premium. You pay the premium to keep Part B coverage; for many Part B services, you then satisfy the annual deductible before Medicare begins paying its share.
After the deductible, Original Medicare generally pays 80% of the Medicare-approved amount for many Part B services and you are responsible for the remaining 20%, unless other coverage changes that result. The Medicare.gov cost page is the cleanest place to verify current Part B costs.
Who Pays Higher Part B Premiums? (IRMAA)
IRMAA is the Income-Related Monthly Adjustment Amount. It increases Part B and Part D costs when your modified adjusted gross income exceeds the applicable threshold.
For 2026 premiums, Social Security generally uses your 2024 MAGI. The SSA definition of IRMAA MAGI starts with adjusted gross income and adds tax-exempt interest.
| 2024 MAGI: individual | 2024 MAGI: married filing jointly | 2026 Part B premium per person |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| Over $109,000 to $137,000 | Over $218,000 to $274,000 | $284.10 |
| Over $137,000 to $171,000 | Over $274,000 to $342,000 | $405.80 |
| Over $171,000 to $205,000 | Over $342,000 to $410,000 | $527.50 |
| Over $205,000 to under $500,000 | Over $410,000 to under $750,000 | $649.20 |
| $500,000 or more | $750,000 or more | $689.90 |
At the top tier, the Part B IRMAA portion is $487 per month above the standard premium. That is $5,844 more per year per person for Part B alone. Part D IRMAA is separate.
If you want the arithmetic instead of reading the table, use my IRMAA Medicare surcharge estimator.
The M.A.G.I. Control Check for Optimal IRMAA Timing
The two-year lookback creates a strange planning problem: by the time you see the Medicare premium, the tax year that created it is usually over. So I split the decision into four questions.
- M — Map the Medicare year to the tax year. For 2026 premiums, start with 2024 MAGI.
- A — Add the income that actually counts. Roth conversions, taxable IRA withdrawals, realized capital gains and tax-exempt interest can all matter. Do not guess at the MAGI number.
- G — Gauge the next threshold, not just whether IRMAA exists. Crossing one tier by a small amount can create a meaningful premium jump, but avoiding a tier is not automatically worth a bad tax or investment decision.
- I — Identify what is still actionable. If the tax year is closed, planning cannot rewrite that return. A qualifying life-changing event or corrected tax information may still support a new determination by Social Security.
That distinction matters with Roth conversions. A conversion generally raises MAGI in the conversion year and can raise Medicare premiums two years later. It may also reduce future traditional IRA balances and future RMDs. Whether that tradeoff is worthwhile depends on the tax brackets, IRMAA tier, RMD path, estate goals and time horizon—not on a rule that says “never cross IRMAA.”
If you are sizing a conversion, my Roth conversion before IRMAA guide walks through that calculation. If you are not sure what belongs in the MAGI number in the first place, use the IRMAA Income Checker.
Keep the Two-Year Medicare Tax Calendar Straight
IRMAA is one of those retirement rules where the bill arrives long after the decision that created it. I send readers practical notes on the tax moves, Medicare dates and income thresholds that collide across different years.
- Which tax year controls the Medicare premium you are paying now
- When a Roth conversion or capital gain can spill into a future IRMAA tier
- When an SSA-44 request may actually change the result
How to Appeal Higher Part B Premiums
First, separate an IRMAA appeal from a request for a new initial determination. They can lead to a similar practical result, but Social Security does not treat them as the same process.
If a qualifying life-changing event caused a significant drop in MAGI, SSA’s current policy says it can use more recent information to make a new initial determination. In many of those cases, SSA specifically says there is no need to appeal the prior determination.
Qualifying events include death of a spouse, marriage, divorce or annulment, work reduction, work stoppage, loss of income-producing property, loss of employer pension income, and certain employer settlement payments.
If your situation fits, Social Security lets you request a lower IRMAA online or use Form SSA-44. My SSA-44 IRMAA guide covers the documentation and filing steps.
A Roth conversion, large RMD or capital gain can increase MAGI, but the income spike itself is not one of SSA’s listed life-changing events. If the IRS data is wrong, an amended return was filed, or SSA used older tax information because the normal return was unavailable, other IRMAA redetermination routes may apply.
Frequent Reader Questions
What is the Medicare Part B premium for 2026?
The standard 2026 Medicare Part B premium is $202.90 per month. Higher-income beneficiaries can pay more through IRMAA, up to $689.90 per month for full Part B coverage.
What is the Part B deductible for 2026?
The 2026 Part B deductible is $283, up from $257 in 2025.
What income triggers IRMAA in 2026?
For 2026, IRMAA begins above $109,000 of MAGI for most individual filers and above $218,000 for married couples filing jointly. The premium generally uses 2024 tax information.
Do Roth conversions affect Medicare premiums?
Yes. A taxable Roth conversion generally increases MAGI in the conversion year and can affect Medicare IRMAA two years later. Whether the conversion is still worthwhile depends on the broader tax and retirement plan.
Does everyone on Social Security get hold-harmless protection?
No. Hold-harmless protection has eligibility conditions, and people paying an income-related Part B premium do not receive the protection.
Can retirement lower an IRMAA surcharge?
Potentially. Work stoppage or work reduction can qualify as a life-changing event. If it caused a significant MAGI reduction, Social Security may use more recent income information for a new initial determination.
The Bottom Line on Medicare Part B Premium 2026
The 2026 Medicare Part B standard premium is $202.90 per month, the deductible is $283, and higher-income beneficiaries can pay up to $689.90 per month for Part B through IRMAA.
But the useful planning lesson is the calendar. Your Medicare bill can be driven by income from two years earlier. A Roth conversion, capital gain or retirement distribution can matter long after the tax return is filed. And if retirement or another qualifying life event materially lowers your income, the right move may be a new IRMAA determination—not simply accepting the old tax year forever.
Before making a tax move solely to avoid IRMAA, compare the Medicare savings with the tax, investment and retirement-income consequences. Crossing a Medicare threshold can be expensive. Making a worse financial decision just to stay under one can be more expensive.
Sources
- Centers for Medicare & Medicaid Services, 2026 Medicare Parts A & B Premiums and Deductibles.
- Medicare.gov, Medicare Costs.
- Social Security Administration POMS, Modified Adjusted Gross Income (MAGI).
- Social Security Administration POMS, 2026 IRMAA Sliding Scale Tables.
- Social Security Administration POMS, Variable SMI Premium / Hold Harmless.
- Social Security Administration, Request to Lower an Income-Related Monthly Adjustment Amount.
- Social Security Administration POMS, New Initial Determinations Using Beneficiary Information.
