Question: I was told my Medicare Part B would cost $202.90, but my premium is much higher than that. Why?

Answer: The Medicare Part B premium for most Americans in 2026 is $202.90. There are some that find they pay more than that and this can be for two reasons. One is that they enrolled in Medicare Part B late and so you have an enrollment penalty of 10% for each year they did not enroll. This penalty will continue to be an additional premium added to the monthly premium for the rest of your life. The only way to erase the Late Enrollment Penalty is by applying for and receiving Medicaid benefits. The other, much more common reason individuals pay a higher Medicare Part B premium is that you have a high income. Your monthly Part B premium will be higher if your individual tax return shows your annual income is more than $109,000, or if you are married and you filed joint tax returns showing your annual income is more than $218,000. Above these income amounts, you pay what we call an IRMAA, or Income-Related Monthly Adjusted Amount.

Social Security will use the income reported two years ago on your IRS income tax return to determine your current premium. This means that if you started Medicare this year, the income reported on your 2024 tax return will be used to determine your monthly Part B for 2026.

Once you are above those income thresholds, there are series of rate increases through IRMAA. The Medicare Part B rates could be as high as $689.90 for those individuals with annual incomes of over $500,000, and couples over $750,000.

Remember there are six steps between that $202.90 and $689.00 rate. These increments and rates you pay are based on the income reported on your tax return. The charts and further information related to this question can be found at www.ssa.gov and www.medicare.gov. These websites provide abundant information and answers to many of your Medicare Questions. You can also call Medicare to ask questions at 1-800-MEDICARE.

Your Medicare Part B premium is usually paid through your Social Security Benefit, and the premium will be deducted from the amount before your check is deposited in the bank. For those individuals who are still working or don’t collect Social Security, you will receive a bill in the mail for your Medicare Part B premium. This premium bill is sent quarterly from Centers for Medicare Services (CMS). Once you receive this bill, you can set up an automatic payment from your bank account or even a credit card. Once you file for Social Security benefits, your Part B premium will be deducted from your monthly benefit, and you will no longer receive the quarterly bill.

It is also important to remember that when you get your quarterly bill, it will be three or sometimes four months of your Part B premium. Mathematically that makes it $202.90 X 3 months = $608.70. If it is a four-month bill, that would be $202.90 X 4 months = $811.60. So you may not have an IRMAA, but you may just be paying multiple months of the premium.

If your income has decreased since 2024, you can ask that the income from a more recent tax year or current income, be used to determine your premium. In order for this request to be accepted, the reason for your income change must meet certain criteria. There are 8 reasons that would be accepted, and those are: Marriage, Divorce/Annulment, Death of a Spouse, Work Stoppage, Work Reduction, Loss of Income-Producing Property, Loss of Pension Income, or Employer Settlement Payment. These 8 qualifying Life Events allow you to request an adjustment to your IRMAA and potentially reduce your Part B premium amount. The form used to report this information is called an SSA-44 and can be requested from SSA office or you can print the form off of www.ssa.gov.

As you age, and your income adjusts each year, you may find that your Medicare Part B rate adjusts as well. This will happen automatically unless you complete the SSA-44 form and one of those qualifying events applies.

I hope this explains your Medicare Part B premium situation. If you feel it might be something different, feel free to reach out and we can research it together! Or call Social Security Administration to review your situation.

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.