Medicare Part B Premium 2026: Why Yours Isn't $202.90
As of September 2026, the standard Medicare Part B premium is $202.90 a month and the annual Part B deductible is $283. CMS published both figures on November 14, 2025. If that is what comes out of your Social Security check, you are paying the standard amount and there is nothing to fix.
Plenty of people are not. Some pay $284.10. Some pay $689.90. Some pay $243.50 for a reason that has nothing to do with income at all. This article explains the three things that move your Part B premium off the standard number — the income adjustment, the two-year lookback that sets it, and the late enrollment penalty — and what you can actually do about each one.
The 2026 standard premium, and who pays it
The standard monthly Part B premium for 2026 is $202.90, up $17.90 from $185.00 in 2025. The annual deductible went from $257 to $283, a $26 increase. CMS attributes the increase mainly to projected price changes and assumed utilization increases consistent with historical experience.
Here is the piece that explains the whole system. Part B is not funded by premiums alone. For most enrollees the federal government covers roughly 75% of the cost of Part B and the beneficiary pays the remaining 25%. The $202.90 is not the price of Part B — it is a quarter of the price of Part B.
That 25% share is the baseline the rest of this article moves away from. Higher-income enrollees do not pay a surcharge bolted onto a fixed price; they pay a larger slice of the same underlying cost — 35%, 50%, 65%, 80%, or 85% instead of 25%. Once you see it that way, the bracket table below stops looking arbitrary.
IRMAA: the six income brackets for 2026
The income-related monthly adjustment amount, or IRMAA, is the surcharge that applies when your modified adjusted gross income clears a threshold. CMS says it affects roughly 8% of people with Medicare Part B. Small group — but if you are in it, the money is not small.
MAGI here means your total adjusted gross income plus tax-exempt interest income. Note that second part. Municipal bond interest is tax-free for income tax purposes and still counts toward IRMAA, which catches a lot of retirees by surprise.
| MAGI — individual return | MAGI — joint return | Part B total / month | Part D add-on |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 |
| Over $109,000 to $137,000 | Over $218,000 to $274,000 | $284.10 | $14.50 |
| Over $137,000 to $171,000 | Over $274,000 to $342,000 | $405.80 | $37.50 |
| Over $171,000 to $205,000 | Over $342,000 to $410,000 | $527.50 | $60.40 |
| Over $205,000 and under $500,000 | Over $410,000 and under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Source: CMS, 2026 Medicare Parts A & B Premiums and Deductibles fact sheet (released November 14, 2025). Retrieved September 2026.
Two things about this table matter more than the numbers themselves.
First, it is a cliff, not a ramp. One dollar of MAGI over $109,000 moves you from $202.90 to $284.10 — $81.20 a month, $974.40 over the year, triggered by a single dollar. There is no phase-in. A Roth conversion, a capital gain, or an unusually large required minimum distribution can cost you a full bracket.
Second, the Part D column is separate and additive. If you have both Part B and a drug plan, you pay both adjustments. And the Part D adjustment is deducted from your Social Security payment regardless of how you normally pay your drug plan premium, so it shows up in a place you were not watching.
Related: Social Security COLA 2027: The Formula and the 317.265 Base
The two-year lookback nobody warns you about
Your 2026 premium is not based on your 2026 income. Social Security uses the most recent federal tax return the IRS has provided — generally the return filed in 2025 for tax year 2024. Sometimes the IRS has only supplied the 2024-filed return for tax year 2023, in which case that is what gets used.
So the year that decides your 2026 Medicare bill is, for most people, 2024. That is a two-year gap, and it is the single most common source of confusion about Part B premiums. You retired in 2025, your income fell off a cliff, and your 2026 premium is still priced off the last full year you were working.
The practical consequence is that IRMAA planning has to happen two years early. Anything that inflates your MAGI in a given tax year — selling a rental property, converting a traditional IRA to a Roth, exercising options, taking a lump-sum distribution — sets your Medicare premium two years later. By the time the letter arrives, the tax year that caused it is closed.
If Social Security used the older tax year and you have since filed a more recent return, or you did not need to file at all, you can contact Social Security and have the record updated. The same applies if you amended a return in a way that changes your MAGI — bring a copy of the amended return and the IRS acknowledgment receipt.
The late enrollment penalty never goes away
This is the other way a premium ends up above $202.90, and it has nothing to do with income. If you could have signed up for Part B and did not, you pay an extra 10% for each full 12-month period you went without it.
Medicare's own worked example for 2026: wait two full years (24 months) without qualifying for a Special Enrollment Period and you owe a 20% penalty. That is $40.58 on top of the $202.90 standard premium — $243.48, rounded to the nearest ten cents, so $243.50 a month.
The word to underline is permanent. This is not a one-time late fee. It is added to your monthly premium for as long as you have Part B, which for most people means for life. The Part A penalty works differently — 10% for twice the number of years you did not sign up, then it stops — but Part B does not have that off-ramp. Someone who delayed two years and lives another 25 years pays that 20% every month of it.
You generally avoid the penalty entirely if you qualify for a Special Enrollment Period — typically because you had coverage through your own or a spouse's current employment — or if you enroll in a Medicare Savings Program. The trap is assuming that any coverage counts. Retiree coverage and COBRA are not current employment.
- Find the amount actually deducted from your Social Security payment, not the amount you assume.
- If it is exactly $202.90, you are at the standard rate for 2026. Stop here.
- If it is higher and matches a row in the table above, it is IRMAA — check your 2024 MAGI, including tax-exempt interest.
- If it is higher but matches no bracket, work out whether it is $202.90 plus a multiple of 10% — that is a late enrollment penalty, and it will not expire.
Related: Social Security Spousal Benefits: 6 Rules That Set Your Amount
If your income dropped, file Form SSA-44
The two-year lookback has an escape hatch, and it is badly underused. If a specific life-changing event cut your income, Social Security can recalculate your adjustment using current income instead of the two-year-old tax return. Form SSA-44 is what you file.
Social Security lists the qualifying events. You married or divorced, or your spouse died. You or your spouse stopped working or cut your hours. You or your spouse lost income-producing property through a disaster or another event beyond your control. You or your spouse had an employer's pension plan terminated or reorganized on a scheduled basis. You or your spouse received a settlement from a current or former employer because of the employer's closure, bankruptcy, or reorganization.
Retirement is on that list — "stopped working" is the single most common qualifying event, and it is exactly the situation the lookback penalizes. You will need documentation tying the event to the income drop: a letter from the employer about your retirement, a death certificate, a signed copy of the relevant return. Do not send an unsupported claim; it will come back.
Appeals are a separate track from SSA-44. If you disagree with the determination itself, you can appeal — online is the fastest route, or in writing with Form SSA-561-U2. But you do not need an appeal if you are simply reporting a life-changing event, and you do not need one if you are just correcting information Social Security used that was wrong. Using the wrong form is why these requests stall.
One more misconception worth clearing up. Medicare Open Enrollment runs October 15 to December 7, with changes effective January 1, and it is the window for joining, dropping, or switching a Medicare Advantage plan or a Medicare drug plan. It does not change your Part B premium. Nothing you do between October 15 and December 7 moves your IRMAA bracket or removes a late enrollment penalty — those run on the tax return and the enrollment history, not the plan you pick.
FAQ
How much is Medicare Part B in 2026?
The standard monthly premium is $202.90 and the annual deductible is $283. Higher-income enrollees pay more under IRMAA, ranging up to $689.90 a month, and anyone who enrolled late pays an additional 10% for each full 12-month period they went without Part B.
Why is my Medicare Part B premium higher than $202.90?
There are two causes. The income-related monthly adjustment amount applies if your modified adjusted gross income exceeded $109,000 on an individual return or $218,000 on a joint return, based generally on your 2024 tax year. Separately, a late enrollment penalty of 10% per full 12-month period applies if you delayed signing up for Part B without qualifying for a Special Enrollment Period.
What income year does Medicare use for my 2026 premium?
Social Security generally uses the federal tax return filed in 2025 for tax year 2024. If only the return filed in 2024 for tax year 2023 is available, that one is used instead, and you can contact Social Security to have the record updated.
Can I get the Part B late enrollment penalty removed?
Generally no. The Part B penalty is added to your monthly premium for as long as you have Part B. You avoid it in the first place by enrolling during your Initial Enrollment Period or by qualifying for a Special Enrollment Period, and enrolling in a Medicare Savings Program can also prevent it.
Bottom line
$202.90 is the sticker price, not your price. Check what actually leaves your Social Security payment each month, and if it is higher, identify which of the two mechanisms is responsible — because only one of them is fixable. IRMAA responds to a corrected record or a qualifying life-changing event. The late enrollment penalty does not respond to anything.
And if you are still two years out from enrolling, the useful takeaway is the lookback. The tax year you are living in right now is the one that will set a Medicare premium you have not thought about yet.
Sources
- CMS · 2026 Medicare Parts A & B Premiums and Deductibles
- Social Security Administration · Benefits Planner: Medicare Premiums
- Medicare.gov · Avoid late enrollment penalties
- Medicare.gov · Open Enrollment
This article is for general information only and is not financial, tax, or legal advice. Rules change — verify with the official sources linked above or consult a licensed professional before acting.