How Much Does Medicare Part B Cost in 2026?

When I started digging into my own Medicare enrollment this year, the very first question I had was simple: how much is this actually going to cost me? The answer turned out to be more complicated than I expected — because “how much does Medicare Part B cost” depends a lot on your income, when you sign up, and a few rules most people have never heard of until they bump into them.

So I did what I always do here: I researched it thoroughly, organized it in plain English, and I’m sharing exactly what I found. If you’re approaching 65, already on Medicare, or helping a parent sort this out, here’s everything you need to know about Part B costs in 2026.

What Medicare Part B Actually Covers

Before we get into costs, a quick refresher on what you’re paying for. Medicare Part B is the piece of Original Medicare that covers outpatient care — doctor visits, preventive screenings, lab work, durable medical equipment, and outpatient procedures. (Part A, by contrast, covers hospital stays, and is premium-free for most people who paid Medicare taxes while working.) If you want the fuller picture of how all the parts fit together, I put together a complete Medicare basics guide that walks through Parts A, B, C, and D side by side.

The 2026 Standard Part B Premium

For 2026, the standard monthly Part B premium is $202.90. This is the amount most people pay, and it’s typically deducted straight from your Social Security check, so you may not even notice it as a separate bill.

A few things that affect whether you pay the standard amount:

• Your income (more on this in a second — this is the big one)
• Whether you enrolled on time, or waited past your Initial Enrollment Period
• Whether you qualify for any state or federal assistance programs that help cover the premium

Why Some People Pay More: IRMAA Explained

Here’s the part that surprises a lot of people: if your income is above a certain level, you’ll pay more for Part B — sometimes a lot more. This extra amount is called IRMAA, which stands for Income-Related Monthly Adjustment Amount.

Medicare determines whether IRMAA applies to you using your tax return from two years earlier. So your 2026 premium is based on your 2024 income. This catches people off guard sometimes. For example, if you sold a house or had an unusually high-income year two years ago, you might see a higher premium now — even though your current income has dropped.

Here’s how the 2026 IRMAA brackets break down, based on your 2024 tax return:

Want to skip the table lookup? My free IRMAA calculator does the math for you — enter your income and filing status, and it’ll show your estimated 2026 premium in seconds.

A Few IRMAA Wrinkles Worth Knowing

If you file taxes separately from your spouse but lived with them at any point during the year, the brackets work very differently. There’s no gradual step-up. You go straight from the standard $202.90 premium at $109,000 or less to $649.20 once your income passes that threshold. Above $391,000, it rises again to $689.90.

If you also have a Medicare Part D prescription drug plan, IRMAA adds a separate surcharge to that premium too. It ranges from about $14.50 to $91.00 a month on top of your plan’s own premium, using these same income brackets.

And if you also owe a Medicare Part B late enrollment penalty (more on that below), it stacks on top of whichever IRMAA amount applies to you. That means your actual premium could end up higher than the table shows.

Major life changes count too. If you’ve retired, divorced, lost a spouse, or had a similar event since your 2024 tax return, you can request that Social Security use more recent income instead. It’s called a Medicare IRMAA appeal, and it’s worth knowing about if a one-time event — like selling a home — is inflating your bracket.

The Part B Deductible and Coinsurance

Before Medicare starts paying its share of your Part B services each year, you’re responsible for an annual deductible — $283 in 2026. Once you’ve met that, Medicare typically covers 80% of the Medicare-approved amount for most doctor visits and outpatient services, and you’re responsible for the remaining 20% — with no cap on how high that 20% can add up over a year.

That uncapped 20% is exactly why many people choose to pair Original Medicare with a Medicare Supplement (Medigap) policy, which can cover some or all of that coinsurance. If you’re comparing supplement plans, [AFFILIATE PLACEHOLDER: link to Medigap plan comparison tool once approved] is a good place to see what’s available in your area.

A Real-World Example

Numbers are easier to picture with an example, so here’s a simplified one. Say Susan is single, turning 65 this year, and her 2024 tax return showed an income right at the standard threshold — no IRMAA. Her Part B costs for the year would look roughly like this:

• 12 months of the standard premium: $202.90 × 12 = $2,434.80
• Annual deductible (paid once she starts using Part B services): $283
• 20% coinsurance on any Medicare-approved services after that, with no annual cap

So before she even uses any care, Susan’s guaranteed 2026 Part B costs come to $2,434.80 (premium) + $283 (deductible) = $2,717.80 — and that’s before any 20% coinsurance on top.

Now compare that to her neighbor Frank, who’s also 65 but whose 2024 income put him in the second IRMAA tier. Frank pays the same deductible and the same 20% coinsurance — but his monthly premium is $284.10, about $81 more than Susan’s every single month, or roughly $974 more over the year, regardless of how much care he actually uses. That’s the part that catches people off guard: IRMAA is based purely on past income, not on how much you use Medicare.

How Part B Premiums Have Changed Over Time

If you’re wondering whether 2026’s premium is unusually high, some context helps. The standard Part B premium has generally increased most years, though the size of the increase varies — some years it rises by just a few dollars, other years more substantially, largely driven by projected health care spending. It rarely goes down, though it has happened on rare occasions. The practical takeaway: it’s worth building a small annual cushion into your retirement budget for this cost to creep upward, rather than assuming it will stay flat.

Medicare Advantage: A Different Cost Structure

Everything above describes Original Medicare (Parts A and B). If you choose a Medicare Advantage plan (Part C) instead, you still pay the standard Part B premium — that doesn’t go away — but your out-of-pocket structure for actual care changes, often trading the uncapped 20% coinsurance for copays and an annual out-of-pocket maximum. Whether that trade-off is worth it depends heavily on your health needs, preferred doctors, and where you live, which is a big enough topic that I’ve covered it separately in my health insurance in retirement guide.

If you want the full breakdown of how Original Medicare, Medicare Advantage, and Medigap actually compare side by side — cost, network freedom, extra benefits — I put all three head to head in my Medicare coverage comparison guide.

What Happens If You Sign Up Late

This is one of the costliest mistakes I’ve come across in my research. If you don’t sign up for Part B when you’re first eligible — and you don’t have qualifying coverage through an employer — you may face a late enrollment penalty. That penalty adds 10% to your premium for every full 12-month period you were eligible but didn’t enroll, and unlike some penalties, this one generally lasts for as long as you have Part B. Not a one-time fee — a permanent addition to your monthly bill.

If you’re still working past 65 and have coverage through your (or a spouse’s) employer, you may be able to delay Part B penalty-free — but the rules depend on the size of the employer, so it’s worth confirming your specific situation before your enrollment window closes.

Ways to Lower Your Medicare Costs

A few options worth knowing about if the numbers above feel like a lot:

Medicare Savings Programs (MSPs). These are state-run programs that can help pay your Part B premium, deductible, and coinsurance if your income and resources fall below certain limits. Each state sets its own thresholds and administers its own application process, so it’s worth checking with your local Medicaid office even if you’re not sure you’d qualify — the limits are often higher than people expect.

Extra Help. This federal program helps with prescription drug costs under Part D. It doesn’t reduce your Part B premium directly, but by lowering what you spend on medications, it frees up room in your monthly budget to absorb Part B costs more comfortably.

Medigap or Medicare Advantage. Depending on your health needs, one of these may significantly reduce your out-of-pocket exposure to that uncapped 20% coinsurance. Medigap plans typically cost a separate monthly premium but can cover most or all of your coinsurance; Medicare Advantage plans usually fold everything into one plan with copays and an annual cap instead. I compare how these options work in more detail in my guide to health insurance in retirement.

IRMAA appeals. As mentioned above, a life-changing event — retirement, divorce, losing a spouse, or a similar qualifying circumstance — can qualify you for a reassessment using more recent income instead of the two-year-old figure Medicare would otherwise use.

Why This Is Worth Planning For

It’s tempting to treat Medicare Part B as a fixed, predictable line item once you’re enrolled, but the reality is it shifts every year, and it can shift more than you’d expect if your income crosses an IRMAA threshold. When I was building out my own retirement budget, I found it much less stressful to plan for a range — a “likely” premium and a “worst case” premium — rather than a single fixed number that might catch me off guard the following January when the new figures are announced.

Frequently Asked Questions

Is Medicare Part B ever free?
No — unlike Part A, which is premium-free for most people, Part B always has a monthly premium. Some Medicare Savings Programs can cover that premium for people with limited income, effectively making it free for those who qualify.

Does my Part B premium change every year?
Yes. CMS announces new premium, deductible, and IRMAA figures each fall for the following year, so it’s worth checking the current numbers annually, especially if your income has changed.

Can I switch out of a high IRMAA bracket?
You can’t opt out, but you can appeal if your income has dropped due to a qualifying life event, using Social Security’s IRMAA reconsideration process.

How is my Part B premium actually paid?
For most people, it’s deducted automatically from their monthly Social Security payment. If you’re not yet collecting Social Security, you’ll typically get a quarterly bill instead.

Will my spouse’s income affect my Part B premium?
If you file taxes jointly, yes — IRMAA is based on your combined household income from your joint tax return, not just your individual earnings.

Does Medicaid or a Medicare Savings Program cover the Part B premium entirely?
For many people who qualify, yes. These programs are designed specifically to make Part B affordable for people with limited income and resources, and eligibility varies by state, so it’s worth checking your state’s specific thresholds.

Where to Go From Here

Medicare Part B costs more than most people expect going in, but knowing the moving pieces — the standard premium, IRMAA, the deductible, and the enrollment deadlines — makes it a lot less overwhelming. If you haven’t already, take a look at my Medicare Basics guide for how Part B fits with the rest of Medicare, and if you’re still deciding when to start collecting benefits, my breakdown of claiming Social Security covers how that timing interacts with your Medicare enrollment too.

As always — I’m not a financial advisor or licensed agent, just someone working through these decisions myself and sharing what I learn. For guidance specific to your situation, it’s worth a conversation with a licensed Medicare counselor or your local State Health Insurance Assistance Program (SHIP), which offers free, unbiased help.