Medicare Part B Premium 2026: Rates, IRMAA Brackets, and What Federal Retirees Pay
What the Standard Part B Premium Costs in 2026
The standard Medicare Part B premium for 2026 is $202.90 per month, deducted directly from your Social Security check or, for federal retirees not yet collecting Social Security, billed quarterly by CMS. That base rate applies to individuals with a modified adjusted gross income (MAGI) of $109,000 or less ($218,000 or less for married couples filing jointly).
For the roughly 2.1 million federal retirees enrolled in FEHB, Part B is technically optional — your FEHB plan provides primary medical coverage in retirement. But most nationwide FEHB carriers waive their standard deductibles, copayments, and coinsurance when Medicare Part B is the primary payer. That wrap-around effect means the $202.90 monthly premium can eliminate virtually all out-of-pocket costs at the point of care.
The Part A hospital deductible for 2026 is $1,736 per benefit period. If you have Part A (premium-free with 40+ quarters of Social Security-covered earnings) plus your FEHB plan, your FEHB carrier typically picks up that deductible as secondary coverage.
2026 IRMAA Brackets: The Income Surcharge Table
Medicare premiums are not flat. The Income-Related Monthly Adjustment Amount (IRMAA) adds surcharges based on your MAGI from two years prior — so your 2024 tax return determines your 2026 premiums. These are cliff thresholds: exceeding a bracket by a single dollar triggers the entire surcharge.
| Single Filer MAGI | Joint Filer MAGI | Part B Monthly Premium | Part D IRMAA Surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 (standard) | $0 |
| $109,001–$137,000 | $218,001–$274,000 | $284.10 | +$14.50 |
| $137,001–$171,000 | $274,001–$342,000 | $405.80 | +$37.50 |
| $171,001–$205,000 | $342,001–$410,000 | $527.50 | +$60.40 |
| $205,001–$499,999 | $410,001–$749,999 | $649.20 | +$83.30 |
| $500,000+ | $750,000+ | $689.90 | +$91.00 |
At the top bracket, a couple filing jointly with MAGI above $750,000 pays $689.90 per person per month for Part B alone — $8,278.80 per person per year.
Why Federal Retirees Often Land in Higher IRMAA Brackets
Federal pensions create an IRMAA vulnerability that private-sector retirees often don't face. A FERS annuity is fully taxable income (minus the small return-of-contributions exclusion). Stack that pension on top of Social Security benefits, TSP withdrawals, and any post-retirement consulting income, and you can cross an IRMAA threshold without realizing it.
The Social Security Fairness Act made this worse for some retirees. The repeal of WEP and GPO in January 2025 restored full Social Security benefits retroactive to January 2024. The SSA distributed approximately $17 billion in lump-sum retroactive payments to 3.1 million affected beneficiaries by mid-2025. Those lump sums — plus the permanently higher monthly Social Security payments — show up on 2025 tax returns, which are the lookback year for 2027 IRMAA calculations.
The lump sum itself is not a qualifying life-changing event for Form SSA-44. If you also retired and your current income is lower than the lookback year, SSA-44 can still request a recalculation based on retirement.
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How to Appeal IRMAA With Form SSA-44
Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event) lets you request that the SSA use a more recent year's income instead of the two-year lookback. Qualifying life-changing events include:
- Retirement or work reduction (the most common one for federal retirees)
- Death of a spouse
- Divorce or annulment
- Loss of income-producing property
If you retired in 2025 or 2026 and your current income is significantly lower than your 2024 working-year income, filing SSA-44 can drop you back to the standard $202.90 premium. Submit the form to your local Social Security office along with documentation of the life-changing event (your SF-50 showing separation, for example).
The appeal doesn't happen automatically. You must file SSA-44 proactively — the SSA won't adjust your IRMAA downward on its own just because you stopped working.
Part B Premium Math for FEHB Retirees
The core decision is whether $202.90 per month ($2,434.80 per year at the standard bracket) is worth paying to activate the wrap-around benefit. For most FEHB plans, the answer depends on healthcare utilization:
Low utilization (healthy, few doctor visits): FEHB alone may cost less in total than FEHB plus Part B premiums. You're paying $2,434.80 annually for coverage you rarely use.
Moderate to high utilization (regular specialist visits, prescriptions, procedures): The wrap-around benefit can save thousands. A single outpatient procedure with 20% FEHB coinsurance can cost more than a full year of Part B premiums.
Several FEHB plans also offer premium reimbursement features — BCBS Basic and Aetna Direct, for example, provide annual Health Reimbursement Arrangement (HRA) pass-throughs that partially offset the Part B premium cost.
The key planning move is to run the comparison using your specific FEHB plan's brochure, which lists how its cost-sharing changes when Medicare is primary. OPM's online plan comparison tool lets you model this during Open Season each November.
The Part B Late Enrollment Penalty
If you decline Part B at 65 and later change your mind, you face a permanent late enrollment penalty: 10% added to your Part B premium for every full 12-month period you were eligible but not enrolled. The penalty never expires — it's baked into your premium for life.
Federal employees working past 65 are protected: as long as you're actively employed with FEHB as primary coverage, you can delay Part B without penalty. When you retire, you get an 8-month Special Enrollment Period (SEP) to sign up by submitting Forms CMS-40B and CMS-L564 (certified by your agency or OPM) to prove you had active group coverage.
The trap hits retirees who skip Part B at 65 while already retired. There's no SEP for retirees who simply chose not to enroll — you'd have to wait for the General Enrollment Period (January 1–March 31) and pay the accumulated penalty on every premium payment going forward.
What's Next
Deciding whether to add Part B to your FEHB plan is one of the most consequential financial decisions in federal retirement. The FEHB & Medicare Coordination Guide walks through the plan-by-plan premium math, IRMAA planning strategies, and the exact forms you need to file — organized as a step-by-step timeline from pre-retirement through your 65th birthday and beyond.
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Download the FEHB Five-Year Rule & Medicare Timeline Checklist — a printable guide with checklists, scripts, and action plans you can start using today.