The $170 Medicare Myth: 5 Surprising Ways Your Part B Premium Will Be $0, $202.90, Or Up To $689.90 In 2026
Contents
The New 2026 Standard Cost and Why the $170 Figure is Obsolete
The standard monthly premium for Medicare Part B covers medically necessary services and preventive services, such as doctor visits, outpatient care, and durable medical equipment. This standard rate is the benchmark for the majority of beneficiaries, but two major factors prevent it from being a universal cost: the Hold-Harmless Provision and the Income-Related Monthly Adjustment Amount (IRMAA). The $170 figure was last close to the standard premium in 2022 ($170.10), illustrating how quickly Medicare costs can escalate. For 2026, the standard monthly premium has been set at $202.90. Additionally, the annual Part B deductible is also increasing to $283.00 for 2026.1. How the Hold-Harmless Provision Can Make You Pay LESS Than the Standard Rate
A significant number of Medicare beneficiaries will actually pay *less* than the standard $202.90 premium for 2026, thanks to the Hold-Harmless Provision of the Social Security Act. * What it is: This provision protects most people who have their Part B premium automatically deducted from their Social Security benefit checks. * How it works: The law prevents your Part B premium increase from exceeding the dollar amount of your Social Security Cost-of-Living Adjustment (COLA) for that year. * The Impact: If your COLA is relatively small, the premium increase may be limited, meaning you would pay a premium lower than the official $202.90 standard rate. This is especially relevant in years with high premium increases, like 2026. * Who is Exempt: The hold-harmless rule does not apply to beneficiaries paying the IRMAA surcharge, those who are new to Medicare in 2026, those who pay their premiums directly, or those enrolled in Medicaid.2. The Zero-Dollar Premium: Medicare Savings Programs (MSPs)
For low-income beneficiaries, the monthly Part B premium can be completely eliminated. This is achieved through enrollment in one of the four Medicare Savings Programs (MSPs), which are state-run programs that help people with limited income and resources pay for their Medicare costs. Three of the four main MSPs cover the Part B premium: * Qualified Medicare Beneficiary (QMB) Program: Covers Part A and Part B premiums, deductibles, co-payments, and co-insurance. * Specified Low-Income Medicare Beneficiary (SLMB) Program: Covers the monthly Part B premium ($202.90 in 2026). * Qualifying Individual (QI) Program: Covers the monthly Part B premium ($202.90 in 2026). Enrolling in an MSP can save a beneficiary over $2,400 a year in Part B premiums alone, making the cost for these individuals $0.3. The High-Income Surcharge: IRMAA Tiers for 2026
The most significant factor causing beneficiaries to pay more than the standard rate is the Income-Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to the standard Part B premium for individuals and couples whose Modified Adjusted Gross Income (MAGI) exceeds a certain threshold. The income determination is based on your tax return from two years prior (e.g., your 2024 tax return determines your 2026 premium). For 2026, the total monthly Part B premium for high-income earners will range from $284.10 to $689.90.2026 Medicare Part B IRMAA Income Tiers and Total Monthly Premiums
The following table details the five IRMAA tiers for 2026, showing the income thresholds and the total monthly premium you will pay, which includes the standard $202.90 Part B premium plus the IRMAA surcharge.- Tier 1 (Standard Premium)
- Single MAGI: Less than or equal to $109,000
- Married Filing Jointly (MFJ) MAGI: Less than or equal to $218,000
- Total Monthly Part B Premium: $202.90
- Tier 2
- Single MAGI: Above $109,000 up to $137,000
- MFJ MAGI: Above $218,000 up to $274,000
- Total Monthly Part B Premium: $284.10
- Tier 3
- Single MAGI: Above $137,000 up to $165,000
- MFJ MAGI: Above $274,000 up to $330,000
- Total Monthly Part B Premium: $365.30
- Tier 4
- Single MAGI: Above $165,000 up to $193,000
- MFJ MAGI: Above $330,000 up to $386,000
- Total Monthly Part B Premium: $446.50
- Tier 5
- Single MAGI: Above $193,000 and up to $500,000
- MFJ MAGI: Above $386,000 and up to $750,000
- Total Monthly Part B Premium: $527.70
- Tier 6 (Highest Premium)
- Single MAGI: Above $500,000
- MFJ MAGI: Above $750,000
- Total Monthly Part B Premium: $689.90
4. The Part D IRMAA Surcharge
It is crucial to note that IRMAA does not only apply to Part B. If you are subject to the Part B IRMAA, you will also pay an additional IRMAA surcharge on your Medicare Part D prescription drug coverage premium. * The Part D surcharge is an amount added to your Part D plan’s premium. * For 2026, the Part D surcharges will range from $14.50 to $91.00 per month, depending on your income tier. * This means high-income beneficiaries pay a significantly higher total monthly cost for their overall Medicare coverage (Part B + Part D).5. Other Factors Affecting Your Part B Premium
Beyond income and assistance programs, other factors can influence your final monthly cost: * Late Enrollment Penalty: If you do not enroll in Part B when you are first eligible and do not have other creditable coverage, you may face a permanent late enrollment penalty. This penalty is an additional 10% of the standard premium for every 12-month period you could have had Part B but did not sign up. * Employer Coverage: If you are still working and covered by a group health plan, your initial enrollment period may be delayed without penalty. * Medicare Advantage (Part C): While you must still pay your Part B premium to the government, some Medicare Advantage plans offer a "giveback" benefit that covers a portion of the Part B premium, effectively reducing your out-of-pocket cost. In conclusion, the $170 Medicare premium is a figure of the past. For 2026, the true cost of Medicare Part B is highly individualized, ranging from the $0 premium for those in Medicare Savings Programs, a protected rate (less than $202.90) for those under the Hold-Harmless Provision, the $202.90 standard rate, or a premium as high as $689.90 for high-income earners subject to the IRMAA surcharge. Beneficiaries must review their annual Social Security and CMS notices to confirm their exact premium and explore potential cost-saving programs.
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