How Much Does Medicare Part B Cost

Most people think their Medicare Part B premium is one fixed number. It’s not, and that misconception costs some beneficiaries real money every single year.

The standard 2026 Part B premium is $185.00 per month. That’s what CMS confirmed, and it’s what most Medicare people actually pay. But depending on your income, you could be paying anywhere from $185.00 to $628.90 a month for identical coverage. Same benefits. Completely different price tag.

Here’s what I’m going to do: walk you through what Part B actually costs in 2026, explain the income-based surcharges clearly (they’re called IRMAA, and they confuse people constantly), and tell you a few things most Medicare guides skip over entirely.

The Standard Premium, the Deductible, and What Part B Actually Covers

Start with the basics. They matter.

In 2026, the standard monthly Part B premium is $185.00. Up from $174.70 in 2024, and flat from 2025. CMS held it steady this year. That’s actually good news, Part B premiums have been climbing steadily for a decade.

The annual deductible for Part B in 2026 is $257. You pay that yourself before Medicare starts covering outpatient services. After you meet it, Medicare covers 80% of approved costs, and you’re on the hook for the remaining 20%. There’s no cap on that coinsurance unless you have a Medigap policy or a Medicare Advantage plan attached.

Part B covers two big categories: medically necessary services (doctor visits, outpatient procedures, labs, medical equipment) and preventive services (annual wellness visits, certain screenings, flu shots). The 20% coinsurance applies to medically necessary care; preventive stuff is usually covered at 100% with zero cost-sharing.

One thing that blindsides people: if you see a provider who doesn’t accept Medicare assignment, they can legally charge up to 15% more than Medicare’s approved amount. That overage, called an “excess charge,” isn’t covered by Medicare at all. A Medigap Plan G covers excess charges (Plan N doesn’t). Worth knowing before you pick a supplement.

IRMAA: The Income-Based Surcharge Nobody Warned You About

Helpful resource: Medicare and You 2024 Official Handbook (Amazon) is a top-rated option for this. (As an Amazon Associate this site earns from qualifying purchases.)

IRMAA stands for Income-Related Monthly Adjustment Amount. It’s extra premium you pay on top of the standard $185.00 if your income is high enough. The Centers for Medicare & Medicaid Services calculates it every year based on your income from two years back. Your 2026 premium? That’s based on your 2024 tax return.

That two-year lag is what gets people. You retire in 2025, your income drops off a cliff, but you’re still paying a 2026 surcharge calculated from your 2024 working income. There’s actually a way to fix this, it’s called a Life-Changing Event appeal, filed on SSA Form SSA-44, but you have to know to ask for it.

Here are the 2026 IRMAA brackets, based on your 2024 modified adjusted gross income (MAGI):

Single filers:

• Up to $106,000: $185.00/month (standard)
• $106,001 to $133,000: $259.00/month
• $133,001 to $167,000: $370.00/month
• $167,001 to $200,000: $481.00/month
• $200,001 to $500,000: $591.90/month
• Above $500,000: $628.90/month

Married couples filing jointly have income thresholds roughly double ($212,000, $266,000, etc.). Married filing separately gets the short end of the stick, surcharges kick in at much lower income levels.

Here’s the thing I want to highlight that most articles gloss over: these brackets adjust annually for inflation, but only slightly. If your income is sitting just above a cutoff, run the numbers. Staying $3,000 below a bracket threshold could save you $74 a month, or $888 per year, in Part B premiums alone. That’s before you add in the identical IRMAA surcharge on Part D (drug coverage), which stacks on top.

How You Actually Pay the Premium

Related video

Medicare Part B Premium Cost - Shocking! What is IRMAA? · Medicare on Video - Medicare Specialist on YouTube

If you’re already getting Social Security, your Part B premium comes straight out of your monthly check automatically. No payment required on your end.

If you’re not drawing Social Security yet (maybe you’re 65 but delaying to grow your benefit), Medicare bills you directly. Usually quarterly. You can pay online at pay.gov, by check, or through Medicare Easy Pay, which is automatic bank withdrawal. I’d pick Easy Pay. Forgetting a quarterly bill and accidentally dropping coverage is a mess.

Railroad Retirement Board beneficiaries have premiums deducted from their RRB payments, just like Social Security.

When You Might Pay More (or Less) Than the Standard

A few scenarios change your premium outside of IRMAA.

Late enrollment penalty. If you didn’t sign up for Part B when you were first eligible and didn’t qualify for a Special Enrollment Period, you’ll pay a 10% penalty for every 12-month period you skipped coverage. These penalties are permanent. Miss two years? You pay 20% more forever. The $185.00 becomes $222.00, before any IRMAA hit on top.

Low-income help. If your income and assets are tight, Medicare Savings Programs (MSPs) can cover your Part B premium entirely. There are four MSP levels, and the most common one, the Qualified Medicare Beneficiary (QMB) program, pays your Part B premium, deductible, and coinsurance. In 2026, QMB income limits are around $1,325/month for individuals (exact limits vary by state). The AARP Medicare resource center has clear guidance on MSP eligibility. These programs are massively under-enrolled. If you might qualify, apply.

Employer or union reimbursement. Some retirees have Part B premiums covered by a former employer or union plan. This is especially common for federal retirees under FEHB. If you’ve got this, track it, if your coverage type changes, so does the reimbursement.

What the Premium Gets You, Practically Speaking

$185.00 a month is $2,220 a year for coverage that includes all outpatient care: primary care, specialists, lab work, imaging, surgical procedures in outpatient settings, most medical equipment, chemotherapy (in some settings), and a bunch of preventive screenings.

The real financial risk is that 20% coinsurance with no ceiling. A $50,000 outpatient procedure leaves you with a $10,000 bill. Most people layer Part B with either a Medigap policy or a Medicare Advantage plan to cap that exposure.

Medigap Plan G is the most comprehensive option available to new enrollees in 2026 (older plans like C and F that cover the deductible are only for people who hit 65 before January 1, 2020). Plan G premiums vary wildly by age, location, and company. A 65-year-old in a mid-sized Midwest city might find it for $110 to $160/month. In New York or California? Expect $250 or more. That’s a real difference. Compare plans through Medicare.gov’s finder or work with an independent broker who can pull quotes from multiple carriers.

The $185.00 standard premium is a starting point, not your final number. Your income, enrollment timing, state, and other coverage all shift that. Look up your specific situation before you assume the standard applies. If IRMAA’s going to hit you next year, plan around those brackets now instead of getting surprised later. A free call to your State Health Insurance Assistance Program (SHIP) is worth an hour of your time.

This article is for informational purposes only. Medicare rules change annually. Always verify current plan details at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). This site does not sell insurance or recommend specific plans.

Sources

• Medicare and You 2024 Official Handbook (Amazon)
• Centers for Medicare & Medicaid Services
• AARP Medicare resource center
• Yes4All Wooden Balance Board for Seniors
• MedCenter 31-Day Monthly Pill Organizer

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Recommended Resources

Disclosure: As an Amazon Associate, we earn a small commission from qualifying purchases at no extra cost to you. We only recommend products that genuinely support the topics covered in this article.

• Medicare For Dummies (~$22), The definitive consumer guide to Medicare, enrollment windows, Part A/B/C/D, and supplement plans.
• Get What’s Yours for Medicare (~$17), Maximize your Medicare benefits and minimize out-of-pocket costs. Covers Part D drug coverage gaps and Medigap in depth.