Medicare Part B Premium to Top $200 a Month in 2026

Accelerating health care costs mean greater increases

Rising Medicare inflation resulted in a 2.8 percent cost-of-living adjustment (COLA) for 2026 for people receiving Social Security and Supplemental Security Income (SSI) payments. That’s up from a 2.5 percent COLA in 2025.

2026 will be the third straight year that the Part B standard monthly premium has gone up faster than Social Security's COLA, according to The Senior Citizens League, a nonpartisan, nonprofit advocacy group based in Alexandria, Virginia.

The rate hike won’t be large enough for most beneficiaries to sidestep at least part of the rise through the Social Security Act’s hold-harmless provision. The rule prevents Medicare Part B premium increases from reducing some recipients’ monthly benefits to less than what they received the previous year.

But because both the Part B premium and deductible increases are far higher than inflation overall in the past year, they will further squeeze the finances of older Americans who struggle with food, housing and energy costs.

“Medicare Part B premiums consistently overtaking Social Security COLAs degrades American seniors’ quality of life over time,” says Shannon Benton, executive director of The Senior Citizens League. “Our members constantly tell us that they feel like their benefits aren’t keeping up, and this is a great example of that experience in action.”

Older adults who rely on their Social Security check for 100 percent of their income will be especially affected, she says.

About 8 percent of Part B and Part D recipients have incomes higher than $109,000 for individuals or $218,000 for those who file income taxes jointly. They are assessed an income-related monthly adjustment amount (IRMAA) in addition to their standard premiums.

While a nearly 10 percent Part B premium bump will hurt, 312 insurers that offer policies in the Affordable Care Act (ACA) marketplaces nationwide are proposing an average premium increase of 20 percent, the largest rate change insurers have requested since 2018, according to the Peterson-KFF Health System Tracker. ACA enrollees, especially older adults, who have relied on enhanced premium tax credits to make health insurance more affordable have seen what they will pay rise by more than 75 percent because of expiring tax credits.

No payroll taxes go toward Part B premiums

One of the two Medicare trust funds, the Supplementary Medical Insurance Trust Fund, finances Medicare’s Part B physician and outpatient services and Part D prescription drug benefits. Medicare taxes that were deducted from your paycheck don’t go into this fund.

The revenue and premiums needed to meet Part B and Part D costs for the coming year are calculated annually so that this trust fund doesn’t face a shortfall, according to KFF, a nonpartisan health policy nonprofit with offices in Washington, D.C. But higher anticipated Part B spending because of increased use of services, inflation or legislative changes can mean higher premiums.

Health care inflation often exceeds other inflation because of the introduction of new, high-priced drugs; technological advancements in medicine; the rising use of services since an aging population has more health care needs and chronic conditions; and expansions in insurance coverage. Medical care has its own subcategory in the Consumer Price Index, but it generally lags further behind other CPI data, according to the Peterson-KFF Health System Tracker.

The Social Security COLA announced at the end of October will boost the average for retirees by $56.

The payment bump will easily cover the $17.90 Part B premium increase for most who get Social Security. That means the hold-harmless rule wouldn’t apply to most Part B enrollees in 2026, says Rachel Schmidt, research professor at the Medicare Policy Initiative at Georgetown University’s Center on Health Insurance Reforms..

How the hold-harmless provision works

If the Part B premium goes up $10 and the annual Social Security COLA increases a monthly benefit payment by $8, “then I would pay last year’s premium plus $8. I would be ‘held harmless’ from $2 of the $10 increase,” says Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center. The national nonprofit advocacy organization is based in New York.

In addition to covering doctor and outpatient bills, Medicare Part B also helps pay for certain home health services; durable medical equipment such as wheelchairs, walkers and braces; as well as some medical and health services that Medicare’s Part A hospital benefit doesn’t include.

If you’re retired and receiving Social Security, the monthly Part B premium is typically deducted from your monthly benefit. The hold-harmless rule protects only those who use this deduction.

With the 2026 Medicare Part B premiums and the Social Security COLA increase announced, the hold-harmless rule would protect a small number of people whose Social Security check falls well below the average monthly benefit for retirees. The same is true for people who received far less than the August average monthly survivor benefit of $1,575 or the August average Social Security Disability Insurance payment of $1,446.

Only eligible recipients whose monthly Social Security benefit is $639 or less will be protected from the full premium increase by the hold-harmless rule since the Part B premium increase is $17.90 and the cost-of-living allowance is 2.8 percent. That’s because $17.90 is 2.8 percent of $639.

“Luckily, there’s that provision so that they don’t actually lose money,” Benton says. But these recipients’ entire COLA could go toward their Part B premium increase.

Hold-harmless rule doesn’t cover everyone

The hold-harmless provision will not protect you, Schwarz says, if you:

• Are new to Medicare in 2026
• Receive a quarterly bill for Part B
• Pay a higher Part B premium because your income is higher, or
• Are enrolled in a Medicare Savings Program (MSP), the eligibility groups through which state Medicaid programs pay Medicare premiums and cost-sharing for Medicare beneficiaries with limited incomes. But states end up feeling much of the pinch.

“Most of the time, the hold-harmless provision either applies to everybody or it applies to only those with very low Social Security” payments, Schwarz says.

In the past 10 years, the Medicare Board of Trustees’ annual Part B premium projections have been accurate three times. They were off by just 10 cents for 2024 and 30 cents for 2020.

But four times in the past decade, their projections were at least 3 percentage points higher than the actual Part B premium amounts. That includes 2016 when the trustees predicted Part B premiums would increase by 52 percent from 2015 because of high Part B spending in 2014, a need to boost the Part B trust fund reserves and the lack of a Social Security COLA for 2016, according to KFF.

In 2015, the Centers for Medicare & Medicaid Services said, “We’re going to have to really increase the Part B premium a lot” in 2016 for the 30 percent of enrollees who wouldn’t be protected by the hold-harmless rule, Schmidt says. That’s because they’re “going to have to cover the cost of the 70 percent” who would be protected by the rule.

“Then Congress stepped in and said, ‘Whoa, don’t do that. We want you to figure out what the premium increase would have looked like if there weren’t a hold-harmless’ ” rule, she says.

The Bipartisan Budget Act of 2015 provided money that led to a more reasonable 16 percent increase in Part B premiums in 2016 for the 30 percent of unprotected enrollees, according to KFF. The other 70 percent of enrollees, who came under the hold-harmless rule, paid the same monthly Part B premium as they did in 2015, $104.90.

“They made a change in law for that one year,” Schmidt says.