For most people who receive Social Security, Medicare premiums are paid automatically. The premium is subtracted before your monthly payment reaches your bank account. That is convenient, but it can also be confusing when the amount you see in your account does not match the benefit amount you expected.
Which premiums are deducted
- Part B (medical insurance): If you receive Social Security or Railroad Retirement benefits, your Part B premium is normally deducted automatically. The standard premium is $202.90 a month in 2026.
- Part A (hospital insurance): Most people pay no Part A premium because they or a spouse worked long enough. If you buy Part A, that premium can also be deducted.
- Part D and Medicare Advantage: These premiums are paid to your plan. You can choose to have them deducted from your Social Security, or pay the plan directly. Ask your plan to set up the deduction if you want it.
The 2027 Part B premium is usually announced in November. Our guide to Medicare Part B costs has the latest figures.
Income-related charges (IRMAA)
People with higher incomes pay more for Part B and Part D. These extra charges are called income-related monthly adjustment amounts, or IRMAA. Social Security sets them using your modified adjusted gross income from the tax return filed two years earlier. For 2026 premiums, that is your 2024 return.
For 2026, the extra charges start when that income is above $109,000 for a single filer or $218,000 for a married couple filing jointly. Part B premiums for higher earners range from $284.10 to $689.90 a month, and Part D adds a separate surcharge.
If your income has dropped
If your income fell because of a life-changing event, you can ask Social Security to use a more recent year. Qualifying events include:
- Retiring or cutting back your work hours.
- Marriage, divorce or the death of a spouse.
- Loss of income from property or a pension plan.
Use Form SSA-44 and include proof, such as a letter from your former employer. Many people pay IRMAA in their first years of retirement only because their income from their last working years was high. It is worth asking.
The hold harmless rule
If your Part B premium is deducted from Social Security, a rule called "hold harmless" generally prevents your net payment from going down from one year to the next because of a Part B premium increase. If the premium rises more than your cost-of-living adjustment in dollars, your premium increase is limited.
The rule does not apply to people who pay IRMAA, people newly enrolled in Part B, or people whose state pays their premium through Medicaid.
How to read your yearly notice
Each December, Social Security sends a notice showing your new benefit for January. Look for these lines:
- Your monthly benefit before deductions: the amount including your cost-of-living increase.
- Medicare premium: the Part B premium deducted, and any Part D or Medicare Advantage premium you chose to have deducted.
- Federal tax withheld: if you asked for withholding.
- The amount you will receive: what will actually be deposited.
You can see the notice in your my Social Security account, often before the paper copy arrives.
If you do not receive Social Security yet
If you have Medicare but have not started Social Security, Medicare bills you directly, usually every three months. You can pay online through your Medicare account, by automatic deduction from your bank account through Medicare Easy Pay, or by mail. When you start Social Security, the premium will usually switch to automatic deduction.
