Nobody looks forward to the letter that says your Medicare premium has gone up again. For 2026, the standard Medicare Part B premium is $202.90 a month. Over a full year, the standard premium now comes to nearly $2,435 before you’ve claimed a penny of care.
That $202.90 is only the starting figure. What you actually pay depends on your income, on a surcharge called IRMAA, and on whether you’ve claimed the help you might already be owed. Some of it you can’t change. A surprising amount of it you can.
Below are nine legal, above-board ways to pay less. Not one of them involves dropping your coverage or cutting corners on care.
First, Know What You’re Actually Paying
The standard Part B premium for 2026 is $202.90 a month. On top of that sits an annual deductible of $283, up from $257 last year, which you pay before Medicare starts covering its share. After that, Part B typically covers 80 percent, and you’re left with the other 20.
Most people pay that standard premium and nothing more. But if your income is above a set threshold, you pay a surcharge on top of that called IRMAA, short for the Income-Related Monthly Adjustment Amount. About one in twelve people on Medicare end up paying it.
The catch that trips people up is timing. Your 2026 premium is based on the income you reported for 2024, two years back. So, a good year in 2024, a house sale, a big withdrawal, can push up what you pay now without you seeing it coming.
Here’s what the 2026 brackets look like. The income figure is your MAGI, which is your adjusted gross income with any tax-free interest, like municipal bond income, added back in.
| Your 2024 income (single) | Your 2024 income (married, joint) | You pay each month in 2026 |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 |
| $205,001 to $499,999 | $410,001 to $749,999 | $649.20 |
| $500,000 or more | $750,000 or more | $689.90 |
Married and filing separately puts you in a steeper set of brackets, so check those directly if that’s you.
Notice the jumps. Go one dollar over a line, and the surcharge applies to the whole year. That’s why several of the steps below are simply about staying on the right side of a threshold.
If Your Income Is Modest, Start Here
1. Check If You Qualify for a Medicare Savings Program
This is the biggest win most people miss. These are state-run programs that help pay your Medicare costs, and one of them, the Qualified Medicare Beneficiary program, can cover your entire Part B premium plus deductibles and coinsurance. Two others, SLMB and QI, help cover the premium alone.
Qualifying also signs you up for Extra Help with drug costs, worth roughly $6,000 a year. The income limits are more generous than people assume, so it’s worth checking with your State Health Insurance Assistance Program even if you think you earn too much.
2. Look for a Part B Giveback Plan
Some Medicare Advantage plans hand part of your Part B premium back to you, so the amount taken from your Social Security check is smaller. It’s a real saving, but it comes with trade-offs.
You have to use the plan’s network of doctors and follow its rules, so weigh the giveback against the coverage you’d be swapping. Be wary, too, of any cold call promising to lower your premium.
Medicare scams are everywhere, and it pays to know how to spot a financial scam before you hand over a single detail.
If a Higher Income Is Pushing Your Bill Up
1. Fix the Number if It’s Simply Wrong
Before you do anything, make sure the income Medicare is using is correct. If you filed an amended return, or the IRS passed on old or wrong figures, you could be paying a surcharge you don’t owe.
Call Social Security at 1-800-772-1213 and ask them to check the record. This is the quickest fix on the list, and it costs you nothing but a phone call.
2. Appeal After a Life Change
IRMAA looks at your income from two years ago, which is unfair if your circumstances have changed since then. If you’ve retired, cut your hours, lost a spouse, divorced, or lost a pension or a source of income, you can ask for your premium to be based on what you earn now instead.Â
You do it with Form SSA-44, where you note the life event and give your current income. If your income has dropped since 2024, don’t sit on this. It’s one of the most valuable steps here.
3. Keep Your Income Below the Next Bracket
Because those brackets are hard cliffs, a little planning goes a long way. Drawing income from a Roth account or a Health Savings Account doesn’t count toward your MAGI, while money from a traditional IRA or 401(k) does.Â
Taking just enough from the taxable accounts to stay under a threshold, then topping up from the tax-free ones, can keep you a whole tier lower. It’s worth mapping out with a tax adviser before the year-end.
4. Give to Charity Straight From Your IRA
If you’re 70½ or older and you give to good causes anyway, this is a neat trick. A Qualified Charitable Distribution lets you send money, up to about $108,000 in 2026, directly from your IRA to a charity.
Because it never lands in your income, it doesn’t lift your MAGI the way a normal withdrawal followed by a donation would. It can also count toward your required minimum distribution.
5. Convert to Roth Before Medicare Starts Counting
Moving money from a traditional account into a Roth means paying tax on it now, but it takes future withdrawals out of the income Medicare measures. The trick is timing.Â
A big conversion in one year can spike your income and trigger IRMAA, so people often convert in smaller amounts over several years, ideally before Medicare’s two-year lookback window comes into play. Again, one to plan with an adviser rather than rush.
6. Tidy Your Investments for Tax
How your portfolio is built affects your MAGI more than you’d think. High-turnover funds that throw off dividends and capital gains each year push your income up, whether you spend the money or not.Â
Swapping some of those for low-turnover index funds and ETFs, and choosing carefully which year you sell things, can keep your taxable income smaller and hold you under a bracket.
8. Pick the Right Medigap So One Bill Doesn’t Wipe You Out
A Medigap policy won’t lower your Part B premium, but it protects you from the thing that really hurts, that open-ended 20 percent you’d otherwise owe on big bills.
A comprehensive plan, such as Plan G, covers most of what Medicare leaves behind after the deductible, so a serious illness doesn’t turn into an uncapped bill. Paying a steady premium beats gambling on a year of good health.
Where To Start
If you do nothing else, check two things. Make sure the income Medicare is using is right, and find out whether you qualify for a Medicare Savings Program. Those two cost nothing and help the most people.
Every dollar you keep here is one more for the rest of your retirement, and there are plenty of other ways to trim a midlife budget without feeling the pinch.Â
Healthcare is one of the highest costs of getting older, which is partly why some Americans look hard at retiring somewhere where healthcare costs are much lower.Â