The standard Medicare Part B premium for 2026 is $202.90 a month, up from $185.00 in 2025. Beneficiaries with 2024 modified adjusted gross income above $109,000 (single) or $218,000 (married filing jointly) pay an added charge called IRMAA, or Income-Related Monthly Adjustment Amount, on top of that base rate. IRMAA is calculated on a five-tier sliding scale that pushes the total Part B premium as high as $689.90 a month for the highest earners, with a matching surcharge on Part D prescription drug plans.
2026 Part B Costs at a Glance
| Cost Item | 2026 Amount | 2025 Amount |
|---|
| Standard monthly premium | $202.90 | $185.00 |
| Annual deductible | $283 | $257 |
| Coinsurance after deductible | 20% | 20% |
| Highest IRMAA tier (Part B total) | $689.90/month | $628.90/month |
Part B is the outpatient portion of Original Medicare. It covers doctor visits, outpatient hospital care, durable medical equipment, preventive screenings, and outpatient mental health and therapy services. It does not cover dental, vision, hearing aids, or most prescription drugs, which fall under separate coverage.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge the Social Security Administration adds to your Part B and Part D premiums if your income is above a set threshold. The Social Security Administration, not Medicare directly, determines whether you owe IRMAA, and it uses tax return data from two years earlier. Your 2026 IRMAA is based on the modified adjusted gross income (MAGI) reported on your 2024 tax return.
MAGI for IRMAA purposes means your adjusted gross income plus tax-exempt interest income. It includes wages, self-employment income, investment gains, pension and retirement account withdrawals, and Social Security benefits that are subject to tax.
2026 IRMAA Brackets: Full Table
Single Filers and Head of Household
| 2024 MAGI (Single) | Part B Total Premium | Part B Surcharge | Part D Surcharge |
|---|
| $109,000 or less | $202.90 | $0 | $0 |
| $109,001 to $137,000 | $284.10 | $81.20 | $14.50 |
| $137,001 to $171,000 | $405.80 | $202.90 | $37.50 |
| $171,001 to $205,000 | $527.50 | $324.60 | $60.40 |
| $205,001 to $500,000 | $649.20 | $446.30 | $83.30 |
| Above $500,000 | $689.90 | $487.00 | $91.00 |
Married Filing Jointly
| 2024 MAGI (Joint) | Part B Total Premium | Part B Surcharge | Part D Surcharge |
|---|
| $218,000 or less | $202.90 | $0 | $0 |
| $218,001 to $274,000 | $284.10 | $81.20 | $14.50 |
| $274,001 to $342,000 | $405.80 | $202.90 | $37.50 |
| $342,001 to $410,000 | $527.50 | $324.60 | $60.40 |
| $410,001 to $750,000 | $649.20 | $446.30 | $83.30 |
| Above $750,000 | $689.90 | $487.00 | $91.00 |
Married Filing Separately
Couples who file separate tax returns use a compressed scale. Anyone married filing separately with 2024 MAGI above $109,000 and below $391,000 pays $649.20 a month for Part B. At $391,000 or above, the premium jumps straight to $689.90. There is no middle tier for this filing status.
The Part D surcharge is a flat dollar amount added directly to whatever premium your Part D plan or Medicare Advantage drug plan already charges. It is not a percentage of the plan premium.
IRMAA Is a Cliff, Not a Slope
IRMAA brackets work as cliffs, not gradual phase-ins. Earning $1 over a threshold moves your entire premium into the next tier for the full year, not just the income above the line. A single filer with $136,999 in MAGI pays $284.10 a month. A single filer with $137,001 pays $405.80, a jump of more than $121 a month for a $2 difference in income. This makes year-end income timing (Roth conversions, capital gains realization, required minimum distributions) worth planning around if you are close to a threshold.
How Part B Premiums Are Paid
Most beneficiaries have their Part B premium, including any IRMAA surcharge, deducted automatically from their monthly Social Security or Railroad Retirement Board benefit check. If you are not yet collecting Social Security, Medicare bills you directly, usually quarterly. Payment options include:
- Medicare Easy Pay, an automatic bank draft
- Online payment through pay.gov
- Check or money order by mail
- Debit or credit card through your online Medicare account
Falling behind on premium payments risks losing Part B coverage, so setting up automatic deduction or Easy Pay is the safest option if your premium is not already coming out of a Social Security check.
How to Appeal or Reduce Your IRMAA Surcharge
IRMAA is based on tax returns from two years prior, but the Social Security Administration allows you to request a new determination if your income has dropped since then due to a life-changing event. Qualifying events include:
- Marriage, divorce, or death of a spouse
- Work stoppage or reduction in work hours
- Loss of income-producing property due to a disaster or other event beyond your control
- Loss of pension income
- An employer settlement payment that inflated a prior year's income
To request a reduction, file Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event) with the Social Security Administration. You will need documentation of the life-changing event and an estimate of your current year income. If approved, SSA adjusts your premium going forward. It does not retroactively refund surcharges already paid before the life-changing event.
If your IRMAA is based on an incorrect or outdated tax return (for example, the IRS has since amended your filing), you can request a new determination using more recent tax data rather than filing a life-changing-event appeal.
Lowering Part B Costs If Your Income Is Limited
Beneficiaries with income far below the IRMAA thresholds may qualify for help paying the standard Part B premium itself through a Medicare Savings Program (MSP). These state-run programs can cover part or all of the Part B premium, and in some cases deductibles and coinsurance, for beneficiaries with limited income and assets. Eligibility and income limits vary by state and program tier (QMB, SLMB, QI), so checking your state's specific limits is the fastest way to know if you qualify.
Frequently Asked Questions
What is the standard Medicare Part B premium for 2026?
The standard Medicare Part B premium for 2026 is $202.90 a month. This is the amount most beneficiaries pay, before any IRMAA surcharge is added.
What income triggers an IRMAA surcharge in 2026?
For 2026, IRMAA applies to single filers with 2024 MAGI above $109,000 and joint filers with 2024 MAGI above $218,000. Income at or below these amounts means you pay only the standard premium.
What is the highest Part B premium someone can pay in 2026?
The top IRMAA tier brings the total monthly Part B premium to $689.90 for single filers with 2024 MAGI above $500,000 and joint filers above $750,000.
Does IRMAA also apply to Part D prescription drug plans?
Yes. IRMAA adds a separate surcharge to Part D premiums, ranging from $14.50 to $91.00 a month in 2026 depending on income tier. This is added to whatever your specific Part D or Medicare Advantage drug plan already charges.
Can I appeal an IRMAA surcharge?
Yes. If your income has dropped since the tax year used to calculate your IRMAA due to a life-changing event like retirement, divorce, or loss of pension income, you can file Form SSA-44 with the Social Security Administration to request a new determination based on current income.
Whose income counts toward IRMAA for a married couple?
IRMAA uses the combined MAGI reported on your tax return. If you file jointly, both spouses' income counts toward the joint thresholds, even if only one spouse is enrolled in Medicare.
Is the Part B deductible separate from the premium?
Yes. The $283 annual deductible for 2026 is what you pay out of pocket for Part B services before Medicare starts covering its share. It is separate from the monthly premium and applies regardless of income.
How far in advance does Social Security notify you of an IRMAA surcharge?
The Social Security Administration typically mails an IRMAA determination notice in the fall before the new premium year begins, explaining which income bracket applies and how the amount was calculated.
