Medicare Part B is $202.90 a month, and $1 of income can add $1,148
The 2026 Part B premium rose 9.7%. The income surcharge starts at $109,000 and is a cliff, not a slope. 2027 figures were unpublished at October 12, 2026.
- What happened
- The standard Medicare Part B premium is $202.90 a month in 2026, up $17.90 (9.7%) from $185.00 in 2025, and the annual deductible is $283, up from $257. CMS published both on November 14, 2025. As of October 12, 2026, CMS had not published the 2027 figures.
- Why
- By law the standard premium is set at half of a per-enrollee “actuarial rate”, which is itself half of projected benefits and administrative costs, so the enrollee pays about 25% of the program's cost and general revenue pays the rest. Higher-income enrollees pay 35% to 85% through a surcharge that steps up in cliffs.
- The numbers that matter
- $202.90Standard Part B premium per month, calendar 2026 (CMS, Nov 14, 2025)$283Part B annual deductible, 2026, up from $257 in 2025$109,000Individual 2024 income above which the 2026 surcharge begins ($218,000 joint)$689.90Monthly Part B premium at the top tier, 2026 (income $500,000 or more)
- Why it matters
- For a retiree the premium is deducted from the Social Security check before it arrives, so a $17.90 monthly rise is $214.80 a year of benefit that never lands. For anyone near a bracket edge, one extra dollar of 2024 income costs $1,148.40 of 2026 premiums.
- What happens nextas we saw it on 13 Oct 2026
- CMS published the 2026 figures on November 14, 2025 and the 2025 figures on November 8, 2024. The 2027 premium, deductible and brackets were not on CMS's site as of October 12, 2026; the 2027 surcharge is based on 2025 tax returns.
The surcharge takes the premium from $202.90 to $689.90 a month across six income tiers, and each step is a cliff.
| Up to $109,000 | 202.9 |
|---|---|
| $109,001 to $137,000 | 284.1 |
| $137,001 to $171,000 | 405.8 |
| $171,001 to $205,000 | 527.5 |
| $205,001 to $499,999 | 649.2 |
| $500,000 or more | 689.9 |
A single dollar of income earned in 2024 can cost a Medicare enrollee $1,148.40 in 2026. That is not a rounding quirk. It is how the Part B surcharge is written: the brackets are cliffs, and the first one sits at $109,000 of modified adjusted gross income for an individual, $218,000 for a couple filing jointly.
Below that line the arithmetic is simpler but not small. The standard Part B premium for 2026 is $202.90 a month, up from $185.00 in 2025. The Centers for Medicare & Medicaid Services published the figure on November 14, 2025. The 2027 figures had not been published as of October 12, 2026, and this piece does not guess at them.
The 2026 numbers, and what moved
CMS's fact sheet of November 14, 2025 sets the 2026 standard monthly Part B premium at $202.90, against $185.00 in 2025, and the annual Part B deductible at $283, against $257. CMS attributes the rise mainly to projected price changes and assumed increases in use of services. It adds that without its policy on skin-substitute spending the monthly premium would have been about $11 higher still.
$202.90 × 12 = $2,434.80 for 2026. $185.00 × 12 = $2,220.00 for 2025. Difference: $214.80. Percentage rise: $17.90 ÷ $185.00 = 9.7%. The deductible rose $26, or $26 ÷ $257 = 10.1%.
Part A, the hospital side, has its own cost-sharing and most people pay no Part A premium. The same CMS release puts the 2026 inpatient deductible at $1,736, up from $1,676. This piece is about Part B, the part almost everyone pays for monthly.
How the premium is set: 25% of the bill, by statute
The Part B premium is not a price CMS chooses. It is a formula in section 1839 of the Social Security Act, and the agency publishes its working each November in the Federal Register. The 2026 notice appeared on November 19, 2025 (90 FR 52063).
The notice states that the monthly actuarial rate for enrollees aged 65 and over “is one-half of the sum of monthly amounts for” the projected cost of benefits and administrative expenses. For 2026 that rate is $405.40. The standard premium “is equal to 50 percent of the monthly actuarial rate for aged enrollees” plus, for 2026, “the $0.20 repayment amount required under current law”. Half of $405.40 is $202.70; add $0.20 and the result is $202.90.
If $405.40 is one-half of benefits plus administration, the full monthly figure is 2 × $405.40 = $810.80. Then $202.90 ÷ $810.80 = 25.0%. The notice says the standard premium “still represents 25 percent of the estimated total cost to the program of Part B coverage” for aged enrollees, and that transfers from the general fund of the Treasury pay “approximately three-fourths of these costs”. The $405.40 includes “an adjustment of $10.44 for a contingency margin”; the program targets a 17% reserve ratio and estimated 16.0% at the end of 2025.
Two consequences follow. First, every dollar of Part B spending growth shows up one-quarter in the premium and three-quarters in the federal budget, which is why the premium is a story about government finances as much as about retirees. Second, the deductible follows the same engine: the notice says the 2026 deductible is the 2025 deductible multiplied by the ratio of the 2026 aged actuarial rate to the 2025 rate.
The 2025 aged actuarial rate was $368.10 and the 2026 rate is $405.40, a ratio of 1.1013. $257 × 1.1013 = $283.04, which rounds to the published $283. The notice puts the total 2026 premium increase across “approximately 65 million Part B enrollees” at $14.0 billion.
The $0.20 is the tail of an older episode. In 2016 Congress added $3.00 a month to the premium to repay a general-revenue loan that had capped that year's increase. The notice says the 2026 repayment of $0.20 “will mark the final amounts collected”, so that line disappears from the formula after 2026.
The income surcharge: six tiers, five cliffs
Since 2007 a minority of enrollees have paid more than the standard premium. CMS says the income-related adjustment affects roughly 8% of Part B enrollees. The notice puts the resulting shares of cost at “about 35, 50, 65, 80, or 85 percent” of the total cost of Part B, instead of 25%.
| Individual return | Joint return | Surcharge | Total premium | Share of cost |
|---|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $0.00 | $202.90 | 25% |
| $109,001 to $137,000 | $218,001 to $274,000 | $81.20 | $284.10 | 35% |
| $137,001 to $171,000 | $274,001 to $342,000 | $202.90 | $405.80 | 50% |
| $171,001 to $205,000 | $342,001 to $410,000 | $324.60 | $527.50 | 65% |
| $205,001 to $499,999 | $410,001 to $749,999 | $446.30 | $649.20 | 80% |
| $500,000 or more | $750,000 or more | $487.00 | $689.90 | 85% |
The Social Security Administration, which actually applies the surcharge, says the 2026 determination generally uses “a tax return filed in 2025 for tax year 2024”, and defines the income measure as “your total adjusted gross income and tax-exempt interest income”. Municipal bond interest therefore counts even though it is not taxed. A Part D surcharge runs on the same brackets: $14.50 a month in the first tier, rising to $91.00 at the top.
An individual with 2024 MAGI of $109,000 pays $202.90 a month in 2026. At $109,001 the Part B premium becomes $284.10, a difference of $81.20 × 12 = $974.40, and the Part D surcharge of $14.50 × 12 = $174.00 applies as well. Total: $1,148.40 for the year, for one dollar of income. The top step is similar in shape: crossing $500,000 adds ($487.00 − $446.30) × 12 = $488.40 to Part B and ($91.00 − $83.30) × 12 = $92.40 to Part D.
The first individual threshold was $106,000 for 2025 and is $109,000 for 2026, a rise of $3,000 or 2.8%. The second rose from $133,000 to $137,000, the third from $167,000 to $171,000, the fourth from $200,000 to $205,000. The $500,000 and $750,000 thresholds did not move: the Federal Register notice says the Bipartisan Budget Act of 2018 specified that those levels be inflation-adjusted “beginning in 2028”. Sources: CMS fact sheets of November 8, 2024 and November 14, 2025.
There is a mechanism for a drop in income. SSA lists “life-changing events”, including marriage, divorce, death of a spouse, stopping work or reducing hours, and the loss of income-producing property through a disaster, that allow it to use a more recent year. The request goes on Form SSA-44. A large one-off capital gain, a Roth conversion or the sale of a business is not on the list; it simply lands in the two-years-later premium.
Who is protected from an increase, and who is not
Under section 1839(f), for someone whose premium is deducted from a Social Security benefit, the notice says “the premium increase will be reduced, if necessary, to avoid causing a decrease in the individual's net monthly payment”. The rule does not apply to anyone paying an income-related adjustment, to new enrollees, or to people who pay the premium directly rather than by deduction.
In practice the rule only bites when the dollar cost-of-living increase on a person's benefit is smaller than the dollar rise in the premium. How the COLA itself is computed from the CPI is covered in the site's COLA piece; the 2027 COLA depends on the September 2026 CPI, which the Bureau of Labor Statistics is scheduled to publish on October 14, 2026.
What it means for your money
Three pieces of arithmetic cover most households.
- The baseline. $202.90 a month, $2,434.80 a year, per person, before the $283 deductible and the 20% coinsurance that medicare.gov lists for most Part B services. A couple both on the standard premium pays $4,869.60 a year in premiums alone.
- The surcharge. A couple with 2024 joint MAGI of $300,000 is in the third tier in 2026: $405.80 each, $811.60 a month, $9,739.20 a year, plus Part D surcharges of $37.50 each. At the top tier a couple pays 2 × $689.90 × 12 = $16,557.60 a year for Part B.
- The timing. Income decisions made in 2026 set the 2028 premium. A withdrawal or conversion that lifts 2026 MAGI past a threshold is not visible in Medicare bills until January 2028, and then runs for a full year.
None of this says what a person should do about it. It says what the formula does. Readers weighing a Roth conversion or a large realised gain against the bracket edges can find the 2026 income tax brackets in the capital gains piece and the withdrawal arithmetic in the RMD piece.
What is not yet known
The 2027 standard premium, deductible and bracket thresholds come from CMS in the same November notice each year: November 8 in 2024, November 14 in 2025. As of October 12, 2026 none of the 2027 figures appeared on CMS's newsroom, Federal Register listings or medicare.gov. The 2026 Medicare Trustees Report of June 9, 2026 contains projections, but its premium table was not readable in the copy fetched for this piece, so no projected figure is quoted here.
Sources
- 2026 Medicare Parts A & B Premiums and Deductibles (fact sheet, November 14, 2025)Centers for Medicare & Medicaid Services · Oct 12, 2026 · Primary source
- Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rates, and Annual Deductible Beginning January 1, 2026 (CMS-8091-N, 90 FR 52063, November 19, 2025)Centers for Medicare & Medicaid Services via govinfo.gov · Oct 12, 2026 · Primary source
- 2025 Medicare Parts A & B Premiums and Deductibles (fact sheet, November 8, 2024)Centers for Medicare & Medicaid Services · Oct 12, 2026 · Primary source
- Medicare Premiums: Rules For Higher-Income BeneficiariesSocial Security Administration · Oct 12, 2026 · Primary source
- Medicare costs: What you pay in 2026Centers for Medicare & Medicaid Services (medicare.gov) · Oct 12, 2026 · Primary source
- 2026 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (June 9, 2026)Medicare Boards of Trustees / CMS Office of the Actuary · Oct 12, 2026 · Primary source
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