2026 Medicare Part B Premium: Costs, Income Brackets & IRMAA

2026 Medicare Part B Premium: Costs, Income Brackets & IRMAA

The 2026 Medicare Part B premium is $202.90 per month for most beneficiaries, up from $185.00 in 2025. That's a 9.7% increase, the largest since 2022's 14.5% jump. The numbers came out in November of 2025 from the Centers for Medicare & Medicaid Services. Approximately 92% of those who are enrolled in Medicare pay this standard premium. Those who earn more than this pay surcharges called Income-Related Monthly Adjustment Amount (IRMAA) of between $81.20 and $487.00 per month on top of their income.

This guide will outline the 2026 Medicare Part B rate, the IRMAA income brackets, the changes to the Part B deductible, why the increase, and how to appeal if your income has decreased since 2024. Medicare.gov, CMS and the Social Security Administration provide information. 

What the 2026 Medicare Part B premium covers

Medicare Part B covers outpatient medical care, including doctor visits, preventive services, durable medical equipment, mental health services, and some home health care. It pays 80% of the Medicare-approved amount for covered services after you meet the annual deductible. The remaining 20% is your coinsurance, which a Medigap supplement plan can cover.

Other 2026 Medicare cost changes alongside the Part B premium increase:

• Part B deductible: $283 (up from $257 in 2025) - $26 increase

• Part A deductible: $1,736 (up from $1,676 in 2025) - $60 increase

• Part A coinsurance days 61-90: $434 per day

• Part A coinsurance lifetime reserve days: $868 per day

• 2026 Social Security COLA: 2.8% (about $56/month average increase)

The 2.8% Social Security COLA will partially offset the $17.90 monthly Part B premium increase for most beneficiaries. For someone receiving $2,000 monthly from Social Security, the COLA adds $56 and the Part B increase takes $17.90, leaving a net $38.10 monthly increase.

For the previous year's Part B deductible analysis, see our Medicare Part B deductible 2026 explainer.

Why the 2026 increase is so large

CMS cited three primary drivers of the 9.7% Part B premium increase:

Rising Part B drug costs. Biologics and cancer infusions administered in clinical settings are increasingly expensive. New cancer immunotherapies, gene therapies, and biosimilar reimbursement changes have all increased Part B drug spending significantly. Drug costs under Part B (administered drugs, not Part D pharmacy drugs) grew approximately 9% in 2025.

Increased outpatient service utilization. Medicare beneficiaries are using more outpatient services post-pandemic, including diagnostic imaging, mental health services, and specialty consultations. Telehealth expansion has also increased per-beneficiary service counts.

Part B Trust Fund reserve requirements. CMS is required to maintain reserves in the Supplementary Medical Insurance (SMI) Trust Fund that funds Part B. Building back reserves after lower-than-expected revenue years contributes to premium increases.

These cost drivers will likely continue into 2027, suggesting Part B premiums will probably continue rising faster than general inflation. Premium increases averaging 5% to 10% annually have become the norm rather than the exception.

2026 IRMAA brackets: who pays more

About 8% of Medicare beneficiaries pay IRMAA surcharges based on income from their 2024 tax returns (filed in 2025). The two-year lookback means your 2026 Medicare premium is determined by your 2024 income.

The 2026 IRMAA income brackets are:

For married filing separately, the brackets differ: anyone with income at or above $109,001 pays $649.20 monthly, jumping to $689.90 at income of $391,000 or higher.

Part D prescription drug coverage has separate IRMAA surcharges that range from $14.50 to $91.00 per month added to whatever your Part D plan premium is.

The IRMAA cliff effect: $1 can cost $1,000+

The IRMAA structure has what financial advisors call the "cliff effect." Each bracket is a hard cutoff, not a gradient. Earning $1 more than the bracket threshold triggers the full surcharge for that bracket. For example:

• A single filer with 2024 MAGI of $109,000 pays $202.90 in 2026

• A single filer with 2024 MAGI of $109,001 pays $284.10 in 2026

• That single extra dollar of income costs $974.40 in additional Part B premiums for the year ($81.20 × 12)

This makes year-end tax planning critical for Medicare beneficiaries near IRMAA thresholds. Strategies include managing Roth conversion timing, capital gain harvesting, deferring required minimum distributions when possible, and timing one-time income events (home sales, large IRA distributions) carefully.

How to appeal IRMAA if your income has dropped

If your income has dropped significantly since 2024 due to a "life-changing event," you can appeal IRMAA using Form SSA-44. Qualifying life-changing events include:

• Marriage, divorce, or annulment

• Death of spouse

• Work stoppage or reduction (retirement, layoff, reduced hours)

• Loss of income-producing property (other than personal property sale)

• Loss of pension income

• Employer settlement payment

The most common appeal is retirement. If you were working in 2024 and earned $150,000, but retired in 2025 and your 2026 income is $50,000, you'd otherwise pay IRMAA based on your 2024 working income. Filing SSA-44 with documentation of retirement allows SSA to use your current (lower) income for the IRMAA determination.

Appeals are free and the success rate for legitimate life-changing events is typically high. File the form at your local SSA office or mail to the address on the form. SSA processes appeals within 30 to 60 days.

Strategies to reduce 2026 Medicare costs

Several approaches can reduce Medicare costs for 2026:

Income management. Stay just below IRMAA brackets through Roth conversion planning, capital gain timing, and required minimum distribution management. The 2-year lookback means decisions made in 2026 affect 2028 premiums.

Medicare Savings Programs (MSPs). For low-income beneficiaries (income below $1,761 single / $2,389 joint monthly in 2026), state Medicaid programs may pay your Part B premium through QMB, SLMB, or QI programs.

Medicare Advantage with $0 premium. Some Medicare Advantage plans offer "Part B givebacks" that refund part of your Part B premium. For 2026, some Advantage plans return $50 to $100 monthly.

Medigap insurance timing. During your initial 6-month Medigap Open Enrollment Period, you can enroll in any Medigap plan without medical underwriting. Missing this window can result in much higher premiums later if you have health conditions.

Form SSA-44 appeals. As described above, life-changing event appeals can dramatically reduce or eliminate IRMAA.

For broader Medicare cost analysis, see our Medicare tax rate 2026 and Medicare Part B guides.