The Centers for Medicare & Medicaid Services on November 14, 2025, set the 2026 standard Medicare Part B premium at $202.90 a month, up $17.90 from $185 in 2025, according to its fact sheet. Higher-income beneficiaries pay more through income-related monthly adjustment amounts, known as IRMAA, bringing the top Part B premium to $689.90. Because the surcharges are based on tax returns from two years earlier, the numbers matter both to current retirees and to people in their early 60s planning income moves now.
What changed
CMS also raised the Part B deductible to $283 from $257 and the Part A inpatient hospital deductible to $1,736 from $1,676. The agency attributed the premium increase to projected price changes and utilization growth, and said the rise would have been about $11 a month larger without steps to curb spending on skin substitutes.
The surcharge schedule for 2026 is below. Single filers and married couples filing jointly are measured against the modified adjusted gross income shown in each row.
| 2024 MAGI, single | 2024 MAGI, joint | Part B total monthly premium | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 |
| Above $109,000 to $137,000 | Above $218,000 to $274,000 | $284.10 | $14.50 |
| Above $137,000 to $171,000 | Above $274,000 to $342,000 | $405.80 | $37.50 |
| Above $171,000 to $205,000 | Above $342,000 to $410,000 | $527.50 | $60.40 |
| Above $205,000 and below $500,000 | Above $410,000 and below $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Who is affected
Any Medicare enrollee whose income in 2024 exceeded $109,000 as a single filer or $218,000 on a joint return pays a surcharge in 2026. As Kiplinger explains, the income measure is generally adjusted gross income plus tax-exempt interest, so municipal bond income counts. That catches many retirees who are not drawing wages but have large required minimum distributions, pensions, Roth conversions, capital gains from selling a business or a home, or sizable taxable portfolios. Kiplinger notes that the first four bracket thresholds are indexed to inflation each year, while the top thresholds are frozen for now.
The after-tax math
IRMAA works as a cliff, not a phase-in. Crossing a threshold by one dollar applies the full surcharge for that bracket to both Part B and Part D, for each spouse enrolled in Medicare.
Example, with round numbers: a married couple, both on Medicare, reported $405,000 of MAGI on their 2024 return. A year-end Roth conversion of $20,000 would have lifted that to $425,000.
| Item | MAGI $405,000 | MAGI $425,000 |
|---|---|---|
| Part B surcharge per person, per month | $324.60 | $446.30 |
| Part D surcharge per person, per month | $60.40 | $83.30 |
| Combined surcharges for the couple, per year | $9,240 | $12,710 |
| Added Medicare cost from the extra $20,000 | None | About $3,470 |
In that example, the extra $20,000 of income costs roughly $3,470 in Medicare surcharges before any income tax, an effective add-on of more than 17%. Kiplinger points out that 2027 surcharges will be based on 2025 returns, so income decisions made before December 31, 2025, flow directly into premiums two years later.
Moves to discuss with your advisor
- Mapping projected 2025 income against the bracket lines, including capital gain distributions from funds that arrive late in the year.
- Sizing Roth conversions to stop just below a threshold, or accepting a surcharge in one year in exchange for lower required distributions later.
- Spreading a large capital gain, such as a business sale, across tax years where the terms allow.
- Reviewing how municipal bond interest, which counts toward the IRMAA income measure, affects the choice between taxable and tax-exempt holdings.
What to watch
The 2027 brackets will be set in the fall of 2026 using inflation data through August. Because the top thresholds of $500,000 and $750,000 are not indexed for now, Kiplinger notes they could become eligible for inflation adjustments starting in 2028.
Sources
- First reported 2026 Medicare Parts A & B Premiums and Deductibles — Centers for Medicare & Medicaid Services
- Medicare Premiums 2026: IRMAA Brackets and Surcharges for Parts B and D — Kiplinger
After TAX is an independent publication. Articles are general information, not tax, legal or investment advice. Consult a licensed professional about your situation.
