The standard Medicare Part B premium crossed a new line in January: beneficiaries with income below the first surcharge tier now pay $202.90 a month, up $17.90 from $185.00 in 2025. That is a 9.7 percent jump, and for a household where both spouses enroll, the standard premium alone now tops $4,800 a year, which Social Security deducts from the couple’s checks before disbursement.
This article speaks to current Part B enrollees and anyone within a year or two of enrolling. If your modified adjusted gross income sits comfortably below $109,000 single or $218,000 joint, you pay the standard premium and nothing more. The surcharge structure below applies only to the roughly 8 percent of Part B enrollees above those thresholds.
What Drove the Increase
CMS attributes the 2026 increase to projected price changes and assumed utilization increases, both consistent with historical experience. The agency also noted that without its policy action on skin substitute reimbursement in the 2026 Physician Fee Schedule Final Rule, the Part B premium would have risen by roughly $11 more per month.
The Part B annual deductible climbed alongside the premium, reaching $283 in 2026, up $26 from $257. The deductible applies once per calendar year before Part B pays its 80 percent share of approved services.
For context, the broader Consumer Price Index rose 4.2 percent over the 12 months ending in May 2026, and the Federal Reserve’s preferred core PCE measure climbed 3.3 percent over the 12 months ending in April 2026. Medicare’s 9.7 percent premium increase outpaces both.
The IRMAA Tiers Above the Standard Premium
For higher-income enrollees, the Income-Related Monthly Adjustment Amount stacks on top of the standard premium. Here are the 2026 brackets for full Part B coverage, drawn from CMS:
| MAGI (single) | MAGI (joint) | IRMAA surcharge | Total monthly premium |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $0.00 | $202.90 |
| $109,001 to $137,000 | $218,001 to $274,000 | $81.20 | $284.10 |
| $137,001 to $171,000 | $274,001 to $342,000 | $202.90 | $405.80 |
| $171,001 to $205,000 | $342,001 to $410,000 | $324.60 | $527.50 |
| $205,001 to under $500,000 | $410,001 to under $750,000 | $446.30 | $649.20 |
| ≥ $500,000 | ≥ $750,000 | $487.00 | $689.90 |
Every figure in the surcharge and total columns is per person, per month, for full Part B coverage. When both spouses land in the first surcharge tier, each pays an extra $81.20, or roughly $1,950 a year above the standard household premium. At the top tier, a two-person household pays close to $16,560 a year for Part B alone. A separate, smaller Part D surcharge applies at the same income tiers, starting at $14.50 a month in the first tier.
The Two-Year Lookback Most Enrollees Forget
IRMAA uses a two-year income lookback. The 2026 Part B premium is set by the modified adjusted gross income reported on the 2024 tax return. MAGI for this purpose is adjusted gross income from Form 1040 line 11 plus tax-exempt interest from line 2a, so municipal bond income that feels tax-free still counts toward the bracket.
That timing matters because the events that push retirees into a surcharge tier are usually one-time: a Roth conversion, a home sale, a large required minimum distribution, or a severance payment. A retiree who converted $100,000 from a traditional IRA in 2024 may see the surcharge appear in 2026, two years after the cash was moved.
The interaction with retirement account withdrawals is direct. As Suze Orman has put it on her podcast, “The money that you take out from a traditional retirement account will count towards income and probably increase your Medicare B premiums.” The same withdrawal can also push more Social Security into taxable income, layering a second cost onto the conversion.
The Survivor Trap and the Limits of SSA-44
Two follow-on mechanics are worth knowing. First, when one spouse dies, the survivor begins filing as single. The single brackets run roughly half the joint brackets, so a household whose income never changed can newly trigger IRMAA, or jump a tier, the year after a death. The bracket shifted even though the income held steady.
Second, Form SSA-44 lets a beneficiary request an IRMAA recalculation when income drops because of a qualifying life-changing event: marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, or an employer settlement. SSA-44 does not unwind a voluntary income event. A Roth conversion or a home sale, however much it raises MAGI, will not qualify.
Implications of the 2026 Numbers
Three things follow from the 2026 figures.
Your 2024 tax return, specifically line 11 plus line 2a, determines your 2026 IRMAA exposure. Households within roughly $10,000 of the next bracket threshold should watch any late-cycle 2026 income event closely.
If a qualifying life event has cut your income, Form SSA-44 is how you request an IRMAA recalculation. File it with documentation such as a retirement letter, death certificate, divorce decree, or employer notice, and the recalculation can apply to the current premium year.
If your combined income sits within roughly $10,000 of an IRMAA bracket, the two-year Medicare premium effect becomes a real variable in any Roth conversion decision, on top of the standard tax-bracket math.
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