The letter shows up in December, and for millions of retirees it's the moment they learn how much of their Social Security cost-of-living raise will actually survive the trip to their bank account.
For 2026, the standard Medicare Part B premium is $202.90 a month, up from $185.00 in 2025.
That's a $17.90 jump, or roughly $215 more per year pulled straight out of most retirees' checks before they ever see a dime.
The 2026 Social Security cost-of-living adjustment came in at 2.8%, which for the average retired worker adds about $56 a month to their gross benefit.
Subtract the higher Part B premium, and a typical retiree keeps somewhere in the neighborhood of $38 of that raise.
The rest never touches their hands. **Who pays more than the standard rate** The $202.90 figure only applies to single filers with modified adjusted gross income at or below $106,000, or joint filers at or below $212,000.
Above those thresholds, an income-related monthly adjustment amount, or IRMAA, kicks in and stacks on top of the base premium.
At the top tier, high earners pay $628.90 a month for Part B alone in 2026.
The catch that trips people up: IRMAA is based on your tax return from two years ago, so a one-time windfall like selling a house or cashing out an IRA in 2024 can raise your 2026 premiums even if your income has since dropped back down. **What you can actually do about it** First, check whether you're paying the right amount.
If your income fell because of a life-changing event — retirement, divorce, death of a spouse, or loss of a pension — you can file Form SSA-44 and ask Social Security to use your current income instead.
This is one of the most underused forms in the Medicare system, and it costs nothing to submit.
These plans often advertise $0 premiums and bundle in dental, vision, and drug coverage.
But they typically come with network restrictions, prior authorizations, and out-of-pocket maximums that can run past $9,000 in-network.
Run the math on your actual doctors and prescriptions before switching, not just the headline premium.
Third, if you're still working and covered by an employer plan through a company with 20 or more employees, you may be able to delay Part B entirely without penalty.
Many people turning 65 enroll anyway and pay for coverage they don't need.
Talk to your HR department before signing up. **The quiet budget killer** Part B premiums are deducted automatically from Social Security benefits, which is why so many retirees feel like their raise vanished.
The premium has roughly doubled over the past decade, and it's indexed to rise faster than most retiree incomes.
If you're on a tight budget, the Medicare Savings Programs can help.
These are state-run programs that cover Part B premiums for people with limited income and assets, and many eligible retirees never apply because they assume they earn too much.
The thresholds are higher than most people expect — in many states, a single person can qualify with income well above the federal poverty line. **Our take** The Part B premium isn't just a line item — it's a slow squeeze on the fixed incomes of people who already did everything right.
Retirees shouldn't have to file obscure forms and shop networks just to keep a cost-of-living raise, but until the system changes, knowing the rules is the only leverage most households have.
Final Thoughts
Spend twenty minutes checking your IRMAA bracket and your state's savings program before the next open enrollment window closes.