First Time on Medicare: New Beneficiary Guide
Your 65th birthday is a deadline, not just a milestone. Three months before, start learning Medicare, enroll in Part B and D, and choose a plan. Late moves cost you.
Medicare Part B Premiums Explained
Medicare Part B covers doctor visits and outpatient care. The standard premium is one price for everyone, but your income determines whether you pay more through IRMAA surcharges.
Standard Part B premium and what it covers
Part B covers doctor visits, lab tests, imaging, ambulance services, and outpatient procedures. The premium is deducted from your Social Security check, not paid separately.
The standard 2026 Part B premium is $164.90/month for most beneficiaries. This is the starting point; your actual premium may be higher if you have higher income.
Income-related premiums (IRMAA)
If your modified adjusted gross income (MAGI) exceeds certain thresholds, you pay more — potentially hundreds of dollars extra per month. Single beneficiaries with MAGI over $103,000 and married couples over $206,000 face surcharges.
The surcharge is income-tiered, so higher income means higher premiums. A beneficiary with MAGI over $206,000 (single) or $412,000 (married) pays up to $560.50/month in 2026.
How MAGI is calculated
MAGI includes your adjusted gross income (AGI) plus tax-exempt interest. Social Security benefits don't count, but investment income and distributions do.
Medicare uses your MAGI from two years prior. If your income dropped significantly, you can request a reduction in your premium surcharge by providing evidence of the change.
Other Part B costs besides premium
Premium is only one cost. You also pay a deductible ($240 in 2026), copays for services, and coinsurance (typically 20% of the service cost).
Many beneficiaries pair Part B with supplemental insurance (Medigap) or choose Medicare Advantage to cap their out-of-pocket costs.
Frequently asked questions
Why is my Part B premium different from my neighbor's?
Higher income triggers IRMAA surcharges. Your modified adjusted gross income (MAGI) from two years ago determines your 2026 premium.
Can I appeal my IRMAA surcharge?
Yes, if your income dropped significantly due to life changes like retirement, job loss, or death of a spouse. File a formal appeal within 60 days of receiving your notice.
Does Social Security count as income for IRMAA?
No. IRMAA is based on modified adjusted gross income (AGI + tax-exempt interest), which does not include Social Security benefits.
What if I delay Part B — can I avoid the premium?
If you delay Part B, you may face a permanent 10% premium increase for each year you don't enroll. Generally, enroll when you first become Medicare eligible.
General educational information only, not tax or legal advice. Part B premiums, IRMAA thresholds, and deductibles are set by CMS and change annually. Confirm your specific premium with Social Security or Medicare.
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