The standard Medicare Part B premium is $185.00 per month in 2025, rising to $202.90 per month in 2026. That’s what most enrollees pay, but your actual cost depends on your income, when you enrolled, and whether you qualify for financial assistance. Beyond the monthly premium, you’ll also pay an annual deductible and 20% coinsurance on most covered services.
2025 and 2026 Standard Premiums
For 2025, the standard Part B premium is $185.00 per month with an annual deductible of $257. In 2026, the premium increases to $202.90 per month and the deductible rises to $283. That $17.90 monthly increase reflects projected price changes and utilization trends consistent with historical patterns. CMS noted the increase would have been roughly $11 more per month if not for policy changes that cut spending on skin substitutes by an estimated 90%.
These premiums are typically deducted directly from your Social Security check. If you don’t receive Social Security benefits yet, Medicare will bill you quarterly.
How Income Affects Your Premium
Higher-income beneficiaries pay more through an Income-Related Monthly Adjustment Amount, commonly called IRMAA. Medicare uses your tax return from two years prior to determine your bracket. So your 2026 premium is based on your 2024 income (or 2023 if 2024 isn’t available yet).
For 2025, if you file individually and earn $106,000 or less (or $212,000 or less filing jointly), you pay the standard $185.00. Above those thresholds, premiums jump in tiers:
- $106,001 to $133,000 individual / $212,001 to $266,000 joint: $259.00 per month
- $133,001 to $167,000 individual / $266,001 to $334,000 joint: $370.00 per month
- $167,001 to $200,000 individual / $334,001 to $400,000 joint: $480.90 per month
- $200,001 to $499,999 individual / $400,001 to $749,999 joint: $591.90 per month
- $500,000+ individual / $750,000+ joint: $628.90 per month
For 2026, the brackets shift slightly upward and premiums rise across the board. At the highest income tier, the Part B premium reaches $689.90 per month. If you’re married filing separately and lived with your spouse at any point during the year, the brackets are less favorable: you jump straight to $591.90 (2025) if your individual income exceeds $106,000.
If your income dropped significantly due to a life-changing event like retirement, divorce, or the death of a spouse, you can ask Social Security to use a more recent year’s income instead. This is done by filing a reconsideration request.
Costs Beyond the Premium
Your monthly premium is only part of the picture. After you meet the annual deductible ($257 in 2025, $283 in 2026), you generally pay 20% of the Medicare-approved amount for covered services. This applies to doctor visits, outpatient procedures, durable medical equipment, and other Part B services, as long as your provider accepts Medicare assignment (meaning they agree to the Medicare-approved amount as full payment).
There is no annual out-of-pocket maximum on original Medicare Part B. That 20% coinsurance continues no matter how much you spend in a year. This is one reason many people add a Medigap supplemental policy or enroll in a Medicare Advantage plan, both of which can cap your total spending.
Late Enrollment Penalties
If you don’t sign up for Part B when you’re first eligible and don’t qualify for a Special Enrollment Period (for example, because you had employer coverage), you’ll face a permanent penalty. The surcharge is 10% added to your premium for every full 12-month period you could have enrolled but didn’t. Someone who waited two years past their eligibility window would pay 20% more than the standard premium for as long as they have Part B coverage. For most people, that means the rest of their life.
The Hold Harmless Provision
A rule called the “hold harmless provision” prevents your Social Security check from shrinking because of a Part B premium increase. If the annual cost-of-living adjustment to your Social Security benefit isn’t large enough to cover the premium hike, your premium stays where it is and your benefit payment doesn’t decrease. Most people receive a large enough cost-of-living increase that this doesn’t come into play, but in years with small adjustments, it protects a subset of enrollees.
This protection does not apply if you’re enrolling in Part B for the first time, if you pay an income-related surcharge, or if Medicaid pays your premium.
Help Paying Part B Costs
If your income is limited, Medicare Savings Programs run by your state can help cover Part B premiums, deductibles, and coinsurance. There are three main tiers, each with different income and asset limits for 2026:
- Qualified Medicare Beneficiary (QMB): Covers your Part B premium, deductible, and coinsurance. Individual income limit of $1,350 per month with resources up to $9,950 ($1,824/$14,910 for couples).
- Specified Low-Income Medicare Beneficiary (SLMB): Covers the Part B premium only. Individual income limit of $1,616 per month with the same resource limits ($2,184 for couples).
- Qualifying Individual (QI): Also covers the Part B premium. Individual income limit of $1,816 per month ($2,455 for couples), same resource limits.
Limits are slightly higher in Alaska and Hawaii, and some states use more generous thresholds than the federal minimums. You apply through your state Medicaid office.