The standard Medicare Part B premium for 2026 is $202.90 per month, up about 9.7% from 2025, with the annual deductible rising to $283. Most people pay exactly that. Higher earners pay more through IRMAA surcharges — based not on this year’s income, but on your 2024 tax return.
Here is the full bracket table, why the lookback works that way, and how to appeal a surcharge if your income has dropped since 2024.
How Much Is Part B in 2026 at Each Income Level?
IRMAA (the income-related monthly adjustment amount) kicks in above $109,000 of modified adjusted gross income for single filers, $218,000 for joint filers — from your 2024 return:
| 2024 MAGI (single) | 2024 MAGI (joint) | 2026 monthly premium |
|---|---|---|
| Up to $109,000 | Up to $218,000 | $202.90 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 |
| Higher brackets | Higher brackets | Increasing to $689.90 at the top |
Married filing separately is treated harshly: above $109,000, the premium jumps straight to $649.20, and to $689.90 at or above $391,000. Full bracket detail is in Kiplinger’s 2026 IRMAA table.
IRMAA also adds a surcharge on top of your Part D drug plan premium at the same income thresholds.
Why Is the Premium Based on 2024 Income?
Because IRMAA always uses the most recent tax return the IRS has fully processed — a two-year lookback. Your 2026 premium reflects 2024 income; your 2027 premium will reflect 2025 income.
The practical consequence: a one-time income spike — selling a house, a Roth conversion, a large capital gain — shows up as higher Medicare premiums two years later, even if your income has returned to normal.
Can You Get an IRMAA Surcharge Reduced?
Yes, if your income dropped because of a life-changing event. SSA form SSA-44 lets you ask for the premium to be based on your current, lower income instead of the 2024 return. Qualifying events include:
- Retirement or reduced work hours
- Death of a spouse
- Marriage or divorce
- Loss of income-producing property (disaster, not sale)
- Loss or reduction of a pension
A one-time capital gain is not a qualifying event — if the 2024 spike was a sale or conversion, the surcharge generally stands for that one year and falls off automatically the next.
File the SSA-44 with documentation as soon as the IRMAA notice arrives; you can also appeal within 60 days if you think the income figure itself is wrong.
How Do Most People Pay the Premium?
It is deducted from your Social Security payment before the deposit lands — the amount that arrives on your August 2026 payment date is already net of Part B. If you’re not drawing Social Security yet, Medicare bills you quarterly.
A premium increase this size also feeds the annual COLA conversation — how much of the 2027 cost-of-living adjustment survives depends partly on how much Part B eats.
For people with limited income and assets, Medicare Savings Programs pay the Part B premium entirely — eligibility runs through your state Medicaid office, and if you’re denied, the Medicaid appeal and reapplication options apply there too.
FAQ
Does everyone pay the 9.7% increase?
Most do, but the "hold harmless" rule protects some Social Security recipients: your net Social Security check generally can’t shrink because of a Part B increase, which can cap your premium below the standard rate in low-COLA years.
Is the $283 deductible per year or per visit?
Per year. After you meet it, Part B generally covers 80% of approved outpatient costs and you owe 20% coinsurance.
What counts as MAGI for IRMAA?
Adjusted gross income plus tax-exempt interest. Municipal bond interest counts, which surprises many retirees.
Will the IRMAA brackets change in 2027?
The thresholds adjust with inflation each year, and your premium will be recalculated from your 2025 return — nothing you need to file for; it happens automatically.
As of July 2026, the figures above are the current published amounts — the official statement of your own premium comes in your annual notice from SSA, and any discrepancy is worth checking at ssa.gov before paying.