COLA Went Up in 2026, but Medicare Quietly Took $215 of It

The 2026 Social Security cost-of-living adjustment landed at 2.8%, which added roughly $56 a month, or about $672 a year, to the average retired worker’s benefit. But Medicare deducts the Part B premium before that money ever reaches a bank account. The standard premium rose to $202.90 in 2026, up $17.90 from $185.00 in 2025, and Social Security pulls it straight from the check. Annualized, that $17.90 increase eats $215 a year, or roughly 32% of the average raise.

The Math, on One Line

The Part B hike is a fixed dollar amount; the COLA is a percentage of each person’s benefit. So the smaller the benefit, the bigger the bite Medicare takes.

• Average benefit: the COLA adds about $56 a month, the Part B increase takes $17.90, and the retiree nets roughly $38.
• Benefit near $1,280 a month: a 2.8% COLA adds only about $36, the same $17.90 premium hike applies, and Medicare claims about half the raise.

A flat-dollar premium increase swallows a larger share of a small COLA than a large one, so higher-benefit retirees keep more of their raise.

Hold-Harmless Catches Most, but Not Everyone

Federal law’s hold-harmless provision stops the Part B premium increase from cutting a beneficiary’s net Social Security payment in dollar terms. Most retirees who collect Social Security and pay the standard premium through their checks will see a 2026 deposit at least as large as their 2025 deposit, even when the premium increase outruns the COLA. Three groups fall outside that shield:

• IRMAA payers. Higher-income beneficiaries pay an income-related surcharge on top of the standard premium, and hold-harmless does not reach them.
• New 2026 enrollees. They had no 2025 premium baseline to hold against, so they pay the full $202.90.
• Enrollees not yet collecting Social Security. Medicare bills them directly instead of deducting from a benefit, so no check exists to protect.

The IRMAA Layer

For higher earners, the deduction climbs fast. The first IRMAA tier in 2026 starts above $109,000 of modified adjusted gross income for singles and $218,000 for couples, adding $81.20 a month to Part B and $14.50 to Part D, with no hold-harmless cushion against either. Because IRMAA runs on a two-year lookback, a 2024 capital gain, Roth conversion, or large distribution sets the 2026 surcharge, and that window has already closed.

What Else Moved in 2026

Other costs rose alongside the premium. The Part B deductible reached $283 (up $26), the Part A hospital deductible $1,736 (up $60), hospital coinsurance $434 a day for days 61 through 90, and skilled nursing coinsurance $217 a day for days 21 through 100. Medicare bills these separately from the Social Security check, so they add to the out-of-pocket exposure the COLA was meant to help offset.

Items to Track in 2026

• Compare your January 2026 Social Security deposit with December 2025. Most enrollees on the standard premium will see a higher deposit, but by less than the headline COLA implies.
• If your income sits near an IRMAA threshold, remember that the 2024 return sets your 2026 surcharge and the 2025 return sets 2027. The cliffs fall at $109,000 single and $218,000 joint.
• If a qualifying life-changing event cut your income in 2025 or 2026 (work stoppage, work reduction, death of a spouse, divorce, or loss of pension income), file Form SSA-44 to ask for an IRMAA recalculation ahead of the standard lookback.