The standard Medicare Part B premium is $202.90 per month in 2026, up from $185.00 in 2025. Most people on Medicare pay this base amount, but higher earners pay more through a surcharge called IRMAA, and lower-income beneficiaries may pay nothing at all through Medicare Savings Programs. This guide covers every cost tier, income bracket, and option available to reduce what you owe.
What Medicare Part B Covers
Part B is the outpatient side of Original Medicare. It covers:
- Doctor visits and specialist consultations
- Outpatient hospital services and surgery
- Preventive care (annual wellness visits, screenings, vaccines)
- Durable medical equipment (walkers, wheelchairs, CPAP machines)
- Mental health services
- Outpatient physical, occupational, and speech therapy
- Lab tests and diagnostic imaging
- Home health care (when medically necessary)
Part B does not cover dental, vision, hearing aids, or most prescription drugs. For drugs, you need a separate Part D plan or a Medicare Advantage plan that includes drug coverage.
2026 Medicare Part B Base Costs
| Cost Item | 2026 Amount |
|---|
| Monthly premium (standard) | $202.90 |
| Annual deductible | $283 |
| Coinsurance after deductible | 20% of Medicare-approved amount |
| Out-of-pocket maximum | None (Original Medicare has no cap) |
The 20% coinsurance has no annual ceiling under Original Medicare. That is why most people pair Part B with a Medigap supplemental policy or enroll in Medicare Advantage instead.
2026 IRMAA Brackets: What You Pay If Your Income Is Higher
IRMAA stands for Income-Related Monthly Adjustment Amount. It is an additional charge added to your Part B (and Part D) premium if your modified adjusted gross income (MAGI) exceeds certain thresholds. CMS uses your income from two years prior, meaning your 2026 IRMAA is based on your 2024 tax return.
Single Filers and Married Filing Separately
| 2024 MAGI (Single) | Monthly Part B Premium |
|---|
| $109,000 or less | $202.90 |
| $109,001 to $137,000 | $284.10 |
| $137,001 to $171,000 | $405.80 |
| $171,001 to $205,000 | $527.50 |
| $205,001 to $500,000 | $649.20 |
| Above $500,000 | $689.90 |
Married Filing Jointly
| 2024 MAGI (Joint) | Monthly Part B Premium |
|---|
| $218,000 or less | $202.90 |
| $218,001 to $274,000 | $284.10 |
| $274,001 to $342,000 | $405.80 |
| $342,001 to $410,000 | $527.50 |
| $410,001 to $750,000 | $649.20 |
| Above $750,000 | $689.90 |
Married Filing Separately (Different Scale)
Beneficiaries who are married but file a separate tax return face a compressed bracket structure. Those with MAGI above $109,000 and below $391,000 pay $649.20 per month. Those at or above $391,000 pay $689.90. This means filing separately often triggers much higher premiums than filing jointly.
IRMAA operates as a cliff system. Going $1 over a threshold moves you into the next bracket for the entire year. If your income is close to a cutoff, this distinction can mean hundreds of dollars per month.
How Part B Premiums Are Paid
For most people, the Part B premium is automatically deducted from their monthly Social Security check. If you are not yet collecting Social Security, you receive a quarterly bill from Medicare. You can pay by:
- Check or money order mailed to Medicare
- Online through Medicare's secure pay portal (pay.gov)
- Automatic bank draft (Medicare Easy Pay)
- Credit or debit card
Missing payments can result in losing coverage, so setting up automatic payments is recommended if you do not have Social Security deductions covering the cost.
Medicare Savings Programs: Pay $0 for Part B
If your income is low enough, a Medicare Savings Program (MSP) can pay your Part B premium for you, and in some cases cover deductibles, coinsurance, and copayments as well. These are state-administered programs funded jointly by federal and state governments.
There are four types:
QMB (Qualified Medicare Beneficiary)
The most comprehensive MSP. QMB covers Part A and Part B premiums, deductibles, and cost-sharing. Providers are also prohibited from billing you for cost-sharing beyond what Medicaid pays.
| Monthly Income Limit | Asset Limit |
|---|
| Individual | $1,350 | $9,660 |
| Married couple | $1,824 | $14,470 |
SLMB (Specified Low-Income Medicare Beneficiary)
Pays the Part B premium only. Does not cover deductibles or coinsurance.
| Monthly Income Limit | Asset Limit |
|---|
| Individual | $1,616 | $9,660 |
| Married couple | $2,184 | $14,470 |
QI (Qualifying Individual)
Similar to SLMB but with slightly higher income limits. Pays the Part B premium. Applications are granted on a first-come, first-served basis each year, and you must reapply annually.
| Monthly Income Limit | Asset Limit |
|---|
| Individual | $1,816 | $9,660 |
| Married couple | $2,455 | $14,470 |
QDWI (Qualified Disabled and Working Individuals)
Pays the Part A premium for certain disabled individuals who have returned to work and lost premium-free Part A. Income limits are higher (around 200% of the federal poverty level).
Income limits in Alaska and Hawaii are higher than the figures above. Many states also exclude certain assets from the calculation, such as your home, one car, and personal belongings. Some states have eliminated asset tests entirely. Check with your state Medicaid office for the exact rules where you live.
Enrolling in any MSP also automatically qualifies you for the Part D Low Income Subsidy (Extra Help), which reduces prescription drug costs significantly.
How to Apply for a Medicare Savings Program
- Contact your state Medicaid office or Benefits.gov to get the application for your state.
- Gather documents: proof of Medicare enrollment, proof of income (Social Security award letter, pay stubs, or tax return), and proof of assets (bank statements, investment account statements).
- Submit the application by mail, online, or in person at your local Medicaid office.
- Your state will review the application and notify you of eligibility. Approval can take several weeks.
- If approved for QMB, notify your doctors and providers so they stop billing you for cost-sharing.
You can also apply through the Social Security Administration if you apply for Extra Help at the same time. SSA will forward your information to the state Medicaid office automatically.
Use our free screener at benefitsusa.org/screener to check whether you may qualify for a Medicare Savings Program based on your income and household size before you contact your state.
How to Appeal an IRMAA Surcharge
IRMAA is based on income from two years ago. If your income dropped significantly since then, you can ask Social Security to use a more recent year for the calculation. This is called a life-changing event appeal.
Qualifying life-changing events include:
- Marriage or divorce
- Death of a spouse
- Work stoppage or reduction (including retirement)
- Loss of income-producing property due to a disaster
- Reduction or loss of pension income
- Receipt of an employer settlement payment
To appeal, file Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount Life-Changing Event). You can download the form at SSA.gov or pick it up at any Social Security office. Attach documentation of the event and your current or expected income. Submit in person or by mail to your local Social Security office.
You have 60 days from the date of the IRMAA notice to file a standard appeal. But for life-changing event appeals, there is no strict deadline, as long as you are still in the benefit year affected.
If your appeal is denied, you can request a hearing before an administrative law judge.
Part B Late Enrollment Penalty
If you do not enroll in Part B when you are first eligible (usually when you turn 65 or stop working), you may face a permanent penalty. The penalty is 10% of the standard premium for each 12-month period you were eligible but did not enroll.
For example, waiting two full years past your enrollment window adds a 20% permanent surcharge. At 2026 rates, that would raise your base premium from $202.90 to roughly $243.48 per month, every month, for the rest of your life.
Exceptions apply if you had qualifying employer coverage during the period you delayed. In that case, you get a Special Enrollment Period when that coverage ends, with no penalty.
Part B vs. Medicare Advantage: A Quick Comparison
| Original Medicare (Part B) | Medicare Advantage |
|---|
| Premium | $202.90/month base | Often $0 to $50/month additional |
| Deductible | $283/year | Varies by plan |
| Cost-sharing | 20% with no cap | Fixed copays, annual out-of-pocket max |
| Network | Any provider accepting Medicare | Usually network-restricted |
| Extra benefits | None | Often includes dental, vision, hearing |
| Drug coverage | Separate Part D plan needed | Usually included |
Medicare Advantage plans bill their own premium on top of Part B. Most people still pay the $202.90 Part B premium even when enrolled in Advantage. A few plans offer a Part B giveback benefit that reduces what you pay, but these plans are plan-specific and vary by county.
Frequently Asked Questions
What is the Medicare Part B premium for 2026?
The standard monthly premium is $202.90 in 2026. The annual deductible is $283. Higher-income beneficiaries pay more through IRMAA surcharges ranging from $284.10 to $689.90 per month.
Who pays more than the standard Part B premium?
Anyone whose 2024 modified adjusted gross income exceeded $109,000 (single) or $218,000 (joint) pays an IRMAA surcharge on top of the base premium. The surcharge is determined by CMS and billed by Social Security.
Can I get help paying my Part B premium?
Yes. Medicare Savings Programs (QMB, SLMB, QI) can pay some or all of your Part B premium if your income is below roughly $1,816 per month for an individual. Apply through your state Medicaid office or check eligibility at benefitsusa.org/screener.
How does CMS decide my IRMAA?
CMS uses income data reported to the IRS. For 2026, they look at your 2024 federal tax return. If your income situation has changed since then due to retirement or another life event, you can file Form SSA-44 to request a lower bracket.
What happens if I miss a Part B premium payment?
Consistent non-payment can result in disenrollment from Part B. You would lose coverage for doctor visits, outpatient care, and most services. If you are having trouble paying, contact your state Medicaid office about Medicare Savings Programs before missing payments.
Does Part B cover prescription drugs?
Generally, no. Part B covers a limited set of drugs administered in a medical setting (infusions, injections in a doctor's office, some oral cancer drugs). Retail prescriptions are covered under Part D plans or Medicare Advantage with drug coverage.
When can I enroll in Part B?
Your Initial Enrollment Period runs for 7 months around your 65th birthday (3 months before, the month of, and 3 months after). If you miss it and do not have qualifying employer coverage, the General Enrollment Period runs January 1 through March 31 each year, with coverage starting July 1.
Is the Part B deductible separate from Part A?
Yes. Part A has its own deductible ($1,676 per benefit period in 2026 for inpatient hospital stays). Part B's $283 annual deductible applies separately to outpatient services.
