Medicare 2026

How the 2027 Part B Premium Is Set, When You'll See It, and How the Hold-Harmless Rule Works

If you're trying to plan for 2027, one of the biggest unknowns is the Medicare Part B premium. Here's a plain-English look at how that number is built, when it's announced, and the hold-harmless rule that protects many — but not all — Social Security recipients from a drop in their net check.

Where the Part B premium comes from

Part B is funded by a mix of general federal revenues and the premiums enrollees pay. Section 1839 of the Social Security Act lays out the formula. In short, the standard monthly premium equals 50 percent of the monthly "actuarial rate" for enrollees 65 and older — which works out to about 25 percent of the expected average total cost of Part B coverage for that group. Taxpayers cover roughly the other 75 percent.

Each year, the Centers for Medicare & Medicaid Services (CMS) looks at projected Part B spending — doctor visits, outpatient care, most Part B drugs, lab work, durable medical equipment, and more — and translates that into a per-person figure. The standard premium follows from that calculation. For 2026, the premium also includes a small $0.20 repayment amount required under current law; whether any similar adjustment applies in 2027 won't be known until CMS releases the official numbers.

The annual Part B deductible is built on the same foundation. It rises each year in step with the growth in the Part B aged actuarial rate, which approximates the growth in per-person Part B spending.

When the 2027 numbers will be announced

By law, HHS is directed to determine and announce the next year's Part B premium during September. In practice, the formal release typically lands later in the fall. Recent Federal Register notices of the Part B amounts were published on October 17, 2023 (for 2024), November 14, 2024 (for 2025), and November 19, 2025 (for 2026). CMS released the full 2026 Part A and Part B premiums, deductibles, and coinsurance on November 14, 2025.

So for 2027, the pattern suggests a fall 2026 release. Until CMS publishes those figures, the 2027 Part B standard premium, the 2027 Part B deductible, and the 2027 IRMAA income brackets and surcharges are not available — and no credible source will give you a firm number.

For context, the 2026 standard Part B premium is $202.90 a month, the 2026 Part B deductible is $283, and the 2026 Part A inpatient hospital deductible is $1,736.

IRMAA: what higher-income enrollees pay

People with higher incomes pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of the standard Part B premium. Instead of covering about 25 percent of program costs, IRMAA payers end up paying a total Part B premium equal to roughly 35, 50, 65, 80, or 85 percent of the total cost of Part B coverage, depending on income tier.

For 2026, IRMAA kicks in when modified adjusted gross income exceeds $109,000 on an individual return or $218,000 on a joint return. The 2027 IRMAA brackets will be published with the Part B figures in the fall; until then, no accurate 2027 thresholds exist.

Social Security uses tax returns from two years earlier to decide whether IRMAA applies. If your income has dropped due to a life-changing event — such as retirement, a spouse's death, or divorce — you can ask Social Security to reconsider.

The hold-harmless rule, in plain English

Hold-harmless, found at Section 1839(f) of the Social Security Act, is a consumer protection. It says: if you're entitled to Social Security benefits for November and December, and your Part B premium for December and the following January is deducted from those benefits, then any Part B premium increase is reduced if needed so your net monthly Social Security payment doesn't actually go down.

In practice, that means in years when the Social Security cost-of-living adjustment (COLA) is small and the Part B increase is large, protected enrollees see their Part B premium capped at an amount their COLA can absorb. For 2027, the Social Security Administration announced on October 14, 2026 a 3.6 percent COLA for benefits payable beginning January 2027. Whether hold-harmless comes into play will depend on how the 2027 Part B premium compares with each person's COLA dollars.

Important: hold-harmless does not apply to everyone. The 2026 Medicare Trustees Report notes that roughly 30 percent of Part B enrollees are not eligible, including:

• People new to Medicare during the year
• Enrollees who don't receive a Social Security check (and so pay Part B directly)
• Higher-income enrollees who pay IRMAA
• People with both Medicare and Medicaid, whose premiums are paid by state Medicaid programs

What else is already confirmed for 2027

While Part B specifics wait on CMS, several Part D figures for 2027 are set:

• The Part D out-of-pocket cap will be $2,400 (up from $2,100 in 2026).
• The maximum Part D deductible any plan may charge will be $700.
• The Part D base beneficiary premium — a national figure used in the late-enrollment penalty calculation — will be $41.33. Actual plan premiums are set plan by plan.

Annual Enrollment runs October 15 – December 7, 2026; choices take effect January 1, 2027.

A note for people with Medicaid or Extra Help: since 2025, there's a monthly Special Enrollment Period you can use to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

Choosing coverage: a neutral note

Many people weigh Medicare Advantage against Original Medicare paired with a Medigap policy and a stand-alone Part D plan. Each path has trade-offs — networks, out-of-pocket limits, extra benefits, prescription coverage, provider access, and portability all differ. There's no universal "best" choice; it depends on your health, budget, providers, and preferences.

Where to go next

For official figures as soon as they're released, and for personalized help:

• Visit Medicare.gov (search "Medicare costs" and "IRMAA").
• Call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week; TTY 1-877-486-2048.

Watch for CMS's fall announcement — that's when the 2027 Part B premium, deductible, and IRMAA brackets become real numbers you can plan around.