What will Medicare actually cost you in 2026?
Most people are quoted the standard premium and then get a letter raising it. Medicare charges you on the tax return you filed two years ago. Your 2026 premium is set by your 2024 income, and it goes up in cliffs, not gradually. One dollar over a line costs you the whole step.
By Hans Goldstein, EA, founder, Retirement Literacy Foundation · Updated
Admitted to practice before the IRS.
Reviewed by Hans Goldstein, EA · Nonprofit education, nothing sold
Worked example (2026)
A married couple, both on Medicare, filed a joint 2024 return with MAGI of $230,000. That is over the $218,000 line, so each of them is in the first IRMAA tier: $284.10 a month for Part B plus $14.50 on top of the drug plan, $298.60 each, $597.20 a month for the two of them and $7,166.40 for the year. At $218,000 or less they would pay $202.90 each, $4,869.60 a year. The extra cost of being over the line is $2,296.80. Amounts from CMS, 2026 Medicare Parts A and B premiums and deductibles.
What to do next
- Find line 11 plus line 2a on your 2024 Form 1040 and run it above.
- If your income has dropped since 2024 because you retired, lost a spouse or divorced, read how to appeal with Form SSA-44.
- Before a Roth conversion or a sale this year, check your 2026 total against the lines. It sets your 2028 premium.
The moves that change this number
Your premium is set by a return you already filed, so 2026 is locked, and 2027 is set by your 2025 return. What you do this year and next decides 2028 and 2029. The free one-page sheet has the brackets, the cliffs, and the handful of decisions that move you across them.
- A Roth conversion raises MAGI in the year you do it, and your premium two years later. Size it to stop below a cliff.
- An RMD counts. So does a big capital gain, a property sale, or exercising options.
- Form SSA-44 undoes it when income dropped for a life-changing reason. Most people never file it.
Free from a 501(c)(3). Nothing is sold.
2026 IRMAA brackets
2026 IRMAA brackets, per person, based on 2024 MAGI
| MAGI single | MAGI joint | Part B total / month | Part D add-on / month | Extra per person / year |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0.00 | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | $14.50 | $1,148 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | $37.50 | $2,885 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | $60.40 | $4,620 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 | $83.30 | $6,355 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 | $6,936 |
Related on RLF: Does Medicare pay for a nursing home? · How much long-term care costs
Source: CMS, 2026 Medicare Parts A and B premiums and deductibles fact sheet, checked October 10, 2026. Last column = (Part B total minus $202.90, plus the Part D add-on) times 12, calculated by the Retirement Literacy Foundation.
2027 Part B premium (projected)
Projected: the standard Part B premium is expected to be $209.50 a month in 2027 ($2,514 a year), up $6.60 from the official $202.90 in 2026. The official 2027 amount is not set yet; CMS usually announces it in November. Source: 2026 Medicare Trustees Report, dated June 9, 2026, intermediate estimate; figures checked October 18, 2026.
Part A, B and D amounts: official 2026 and projected 2027
| Item | 2026 (official) | 2027 | Status |
|---|---|---|---|
| Part B standard premium, per month | $202.90 | $209.50 | Projected |
| Part B annual deductible | $283 | $292 | Projected |
| Part A inpatient deductible, per benefit period | $1,736 | $1,788 | Projected |
| Part D base beneficiary premium | $38.99 | $41.33 | Official (CMS, July 2026) |
Source: 2026 Medicare Trustees Report (June 9, 2026), Tables V.E2 and V.E3 and the Part B financing discussion; 2026 official amounts from the CMS 2026 fact sheet. A projection can change. Some outside forecasters expect the final 2027 premium to land higher than the Trustees estimate; we show the Trustees figure because it is the government’s own. This page will be updated when CMS publishes the official 2027 amounts.
The 2027 premium is also set by your income two years back. For 2027 that is your 2025 return. The 2027 income lines and the surcharge amounts by bracket are on the 2027 IRMAA brackets page, and you can test your own number in the IRMAA calculator.
People also ask
How much does Medicare Part B cost in 2026?
The standard Part B premium is $202.90 a month and the deductible is $283 for 2026. Higher incomes pay IRMAA: $284.10 to $689.90 a month per person for Part B, based on 2024 MAGI.
How much does Medicare Part D cost?
Part D premiums depend on the plan you choose. If your income is above the IRMAA thresholds, Medicare adds $14.50 to $91.00 a month per person to whatever your plan charges, based on your 2024 MAGI.
How much does Medicare Part A cost?
About 99% of beneficiaries pay no Part A premium because they or a spouse have 40 quarters of Medicare-covered work. In 2026 the inpatient hospital deductible is $1,736 per benefit period, and skilled nursing coinsurance is $217.00 a day for days 21 to 100.
Related
Sources: CMS 2026 Medicare Parts A and B premiums and deductibles; Medicare.gov costs. Checked October 10, 2026.
Also see: Medicare costs at a glance, 2026