Key Takeaways
- The 2026 standard Medicare Part B premium is $202.90/month (up from $185) with a $283 annual deductible.
- Part A is premium-free for most, but the inpatient hospital deductible is $1,736 per benefit period in 2026.
- IRMAA surcharges kick in above $109,000 single / $218,000 joint MAGI - based on your 2024 income - and push total Part B premiums as high as $689.90/month.
- IRMAA brackets are cliffs: $1 over a threshold costs the full surcharge, so manage Roth conversions and capital gains near bracket lines.
- Income dropped since 2024 due to retirement or another life event? File Form SSA-44 to use your current income instead.
The headline number for 2026: the standard Medicare Part B premium is $202.90 per month, one of the larger year-over-year jumps in the program’s history, with the Part B annual deductible at $283. For most retirees the premium comes straight out of the monthly Social Security check — which is why the size of each year’s Social Security COLA matters so much; Part B increases eat a real chunk of it.
Here are all the 2026 amounts from the CMS fact sheet, plus the income surcharges that catch higher-income retirees off guard.
Part A (Hospital Insurance) — 2026
Most people pay no Part A premium — you’ve prepaid it through 40+ quarters of Medicare payroll taxes. If you have 30-39 quarters, the buy-in premium applies, and fewer than 30 quarters pays the full premium.
The costs you can actually face under Part A are the per-benefit-period amounts:
| Part A cost | 2026 amount |
|---|---|
| Inpatient hospital deductible (per benefit period) | $1,736 |
| Daily coinsurance, days 61–90 | $434 |
| Daily coinsurance, lifetime reserve days | $868 |
| Skilled nursing facility coinsurance, days 21–100 | $217 |
Part B (Medical Insurance) — 2026
The standard monthly premium is $202.90 (up from $185.00 in 2025) and the annual deductible is $283 (up from $257). After the deductible, you generally pay 20% coinsurance on covered services — which is the gap Medigap and Medicare Advantage plans exist to manage.
New enrollees and anyone weighing Advantage vs Original Medicare should factor the premium jump into the whole-package comparison, including the grocery and supplemental benefit changes that hit Medicare Advantage plans this year.
IRMAA: The Income Surcharge Brackets for 2026
If your modified adjusted gross income (MAGI) from 2024 (IRMAA always looks back two years) exceeded $109,000 single / $218,000 joint, you pay an income-related surcharge on both Part B and Part D:
| 2024 MAGI (single) | 2024 MAGI (joint) | 2026 total Part B premium | Part D surcharge |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $202.90 | $0 |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | $14.50 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 | $37.50 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 | $60.40 |
| $205,001–$499,999 | $410,001–$749,999 | $649.30 | $83.30 |
| $500,000+ | $750,000+ | $689.90 | $91.00 |
Two IRMAA points I flag for readers every year. First, it’s a cliff, not a slope — one dollar of MAGI over a threshold triggers the full surcharge for the year, so year-end Roth conversions and capital gains near a bracket line deserve real care. Second, if your income has dropped since 2024 because of a life-changing event (retirement, death of a spouse, divorce), file Form SSA-44 to ask Social Security to use your more recent, lower income instead of the two-year lookback.
Quick example: Tom and Sue retired in 2025. Their 2024 MAGI (his final working year) was $290,000, so in 2026 they’re each billed $405.80/month for Part B. Since retirement is a qualifying life-changing event and their income is now ~$120,000, an SSA-44 filing gets them back to the standard $202.90 each — saving them roughly $4,870 for the year. That form is criminally under-used.
Why the Big Premium Jump This Year
CMS attributes the increase to overall medical cost growth and higher projected spending. For retirees the practical effect is that the 2026 Social Security COLA was partially absorbed by the Part B increase before it ever hit bank accounts — the “hold harmless” rule protects most beneficiaries from a net-negative check, but the squeeze is real for those with smaller benefits.
Looking Ahead: 2027
The 2027 premium, deductible, and IRMAA numbers will be announced by CMS in the fall (typically October-November 2026), alongside the 2027 Social Security COLA. Based on current medical-cost trends, I’d expect another meaningful Part B increase — the trustees’ reports have flagged continued spending growth — and IRMAA thresholds will get their usual inflation adjustment, with 2027 surcharges keyed to your 2025 income.
If you’re doing Roth conversions or realizing gains this year, remember 2026 income sets your 2028 IRMAA. I’ll update this page when CMS publishes the 2027 amounts.
Common Issues to Watch Out For
- Forgetting the two-year lookback. Your 2026 IRMAA is based on 2024 income — and this year’s income sets 2028’s premiums. Plan conversions and gains accordingly.
- Not filing SSA-44 after retiring. If your income dropped due to retirement or another life event, you don’t have to wait out the lookback — file the form.
- Tripping an IRMAA cliff by $1. The brackets aren’t marginal; crossing a line costs the full surcharge on 12 months of premiums for both spouses.
- Ignoring the Part A benefit-period structure. The $1,736 hospital deductible is per benefit period, not per year — multiple hospitalizations can trigger it more than once.
- Comparing plans on premium alone. The Part B jump plus 2026’s supplemental-benefit cutbacks in many Advantage plans mean the total cost picture changed more than usual this year.
