Medicare Part B Premium 2027: Projected Cost and What It Means

If you are on Medicare, the Part B premium is one of the most important numbers of your year — because for most people it is deducted straight from the Social Security check. That means the premium increase and the COLA are not separate stories; they combine into a single number you actually receive. This guide explains the projected 2027 premium, when the official figure is announced, how it interacts with the COLA, and the hold-harmless rule that protects most beneficiaries.

How Much Will the Medicare Part B Premium Be in 2027?

The 2027 standard Part B premium is projected at $209.50 per month, according to the Medicare Trustees report estimate cited by independent analysts — an increase of about $6.60 from the $202.90 standard premium in 2026. This is a projection, not the official figure: the Centers for Medicare & Medicaid Services (CMS) announces the final 2027 premium in November 2026.

To put it in context, the 2026 standard premium of $202.90 was itself a $17.90 increase (9.7%) over the $185 premium in 2025 — the second-largest Part B premium increase in the program's history. If the 2027 projection holds, the increase is far more modest, but it still matters because it comes out of your monthly benefit.

When Is the 2027 Part B Premium Announced?

The official 2027 Part B premium and the annual Part B deductible are announced by CMS in November 2026, after the Medicare Trustees report and the agency's premium fact sheets are published. This timing means you know your 2027 net benefit before the year begins, which gives you time to plan — including during the Medicare Annual Enrollment Period (October 15 – December 7, 2026), when you can compare and switch plans for 2027.

How the Part B Premium Interacts With the Social Security COLA

For the roughly 75 million Social Security beneficiaries, the Part B premium is deducted directly from the monthly benefit. So the raise you hear about in October is rarely the amount that actually lands in your bank account in January — the premium increase is subtracted first. The 2027 COLA is not yet official: the Social Security Administration announces it in mid-October 2026 (expected around October 14), and current independent projections range from about 3.6% to 4.7%. A $209.50 premium would absorb a meaningful share of that COLA for many recipients.

Item	2026	2027 (projected)
Standard Part B premium (monthly)	$202.90	$209.50
Social Security COLA	2.8%	Not official (3.6%–4.7% projected)
Premium announcement	November 2025	November 2026

The Hold-Harmless Provision

The hold-harmless provision is the key protection for most beneficiaries. It prevents your Social Security benefit from dropping below the prior year's amount if the Part B premium increase is larger than the dollar gain from your COLA. In practice, that means most people never see a net benefit reduction — the premium increase is capped by the size of the COLA for those covered by the rule.

But hold-harmless does not apply to everyone. It does not protect new Medicare enrollees (who pay the full premium regardless) or people subject to IRMAA — the income-related monthly adjustment amounts that raise the premium for higher-income beneficiaries. If you pay IRMAA or enrolled recently, your premium is not capped by the COLA, so the full premium amount applies to you.

Who Pays the Income-Related (IRMAA) Premium?

Beneficiaries with higher incomes pay an income-related monthly adjustment amount (IRMAA) on top of the standard premium. IRMAA is based on your tax return from two years earlier, and it is reviewed each year. Even a modest COLA can push your income into a higher IRMAA bracket, raising both your Part B and Part D premiums. If your income changed, you can file a form with Social Security to request a reconsideration.

What You Can Do Before 2027

• Watch the October 2026 COLA announcement (expected mid-October) to estimate your 2027 benefit.
• Watch the November 2026 premium announcement from CMS for the official Part B amount and deductible.
• Use the Annual Enrollment Period (October 15 – December 7, 2026) to compare Medicare Advantage and Part D plans, including plans with a Part B "giveback" that credits part of the premium.
• Check your IRMAA status if your income is near a threshold, and file a reconsideration if your income dropped.

What Medicare Part B Actually Covers

Medicare Part B is medical insurance, and it covers the services that keep you out of the hospital. In broad terms it pays for doctor visits, outpatient care, preventive screenings, durable medical equipment like wheelchairs and walkers, ambulance services, and some home health care. It also covers many vaccines, clinical laboratory tests, and outpatient mental health services. What it does not cover — and this surprises many beneficiaries — is most dental care, routine vision care and eyeglasses, hearing aids and fittings, and most prescription drugs you take at home. Those drugs fall under Medicare Part D, a separate voluntary plan with its own premium and costs.

Understanding the coverage boundary matters because the Part B premium is what buys that outpatient safety net. Once you are enrolled, Medicare generally pays 80% of the Medicare-approved amount for covered services, and you pay the remaining 20% plus the annual deductible. There is no annual out-of-pocket maximum in Original Medicare for Part B services, which is one of the reasons many beneficiaries add a Medigap plan — also called Medicare Supplement — to cap their exposure, or choose Medicare Advantage to replace cost sharing with plan copays. Before you decide what to do with your 2027 budget, it helps to review exactly what Part B has paid for over the past year; the annual Medicare Summary Notice, mailed each quarter, lists every approved service and what Medicare paid.

How the Part B Premium Is Calculated Each Year

The Part B premium is not set by committees — it is driven by a formula. By law, the standard monthly premium is calculated to cover about one quarter of the projected costs of the Part B program, with the other three quarters funded by general federal revenue and, in part, by income-related surcharges paid by higher-income beneficiaries. When actual program spending comes in higher than expected — driven by physician-administered drugs, outpatient utilization, and a growing beneficiary population — the premium formula rises to match.

This is why the 2026 premium jumped nearly 10%, from $185.00 to $202.90. The 2025 increase was restrained in part by CMS policies that cut projected spending on certain services, and the 2026 price reflected those one-time dynamics unwinding plus new cost pressure. For 2027, the Medicare Trustees projected a much smaller 3.25% increase to around $209.50. Because the formula uses spending projections that are updated each fall, the final number announced in November 2026 can land above or below that estimate — an important distinction between a confirmed price and a projection.

Who Pays the Part B Premium, and How

Most beneficiaries never write a check for Part B, because the premium is automatically deducted from their Social Security benefit check each month. If you receive Social Security or Railroad Retirement Board benefits, the deduction happens before you even see the money. For beneficiaries who are not yet collecting Social Security — for example, someone who delays benefits while still paying the Part B premium — Medicare bills the premium directly, usually every three months. There is also a Medicare Easy Pay option that lets you schedule automatic payments from a bank account instead.

Knowing which group you are in matters for budgeting and for the hold-harmless rule, which shields most Social Security recipients from large premium increases in any single year. Beneficiaries who pay their premium directly are not protected by hold-harmless, which means they are on the hook for the full premium increase immediately — another reason to know exactly how your premium is being paid before a big year like 2027 arrives.

The Late Enrollment Penalty and How to Avoid It

Part B comes with a late enrollment penalty that many people do not know about until it appears on their bill. If you do not enroll in Part B when you are first eligible and you have no other credible coverage, your premium can go up by 10% for each full 12-month period you were eligible but not enrolled. That penalty is permanent — it stays on your premium for as long as you have Part B. The standard math: several years of delay can mean a premium 20% to 40% or more above base, payable for life.

The most common loophole is employer coverage. If you are still working past 65 and have group health coverage from your employer or your spouse's employer, you can delay Part B without penalty, in most cases for as long as that credible coverage continues. You must file within your Special Enrollment Period after the coverage ends or you stop working — generally the eight months that follow — and delay past that window resets the penalty clock. The penalty is exactly why advisers urge people to enroll at 65 even if they feel healthy: the annual cost is a small price for keeping your future premium at the base rate.

Part B vs. Medicare Advantage: Which Fits Your 2027 Plan

In Original Medicare, Part B is paired with Part A (hospital insurance) and, if you want drug coverage, a standalone Part D plan. That combination is called Original Medicare. The alternative is Medicare Advantage, a private plan sold by insurers that replaces Original Medicare with a network-based plan that must provide the same Part A and Part B benefits but usually adds extras like dental, vision and hearing, and rolls prescription coverage into one plan.

The choice has real trade-offs. Original Medicare offers nationwide access to any Medicare-participating provider and no network approval for most Part B services, but it requires separate Part D coverage and exposes you to 20% coinsurance you may need a Medigap plan to fill. Medicare Advantage often has lower monthly premiums and caps your annual out-of-pocket spending, but it limits you to the plan's network and usually requires referrals or prior authorization for major care. During the Annual Enrollment Period from October 15 to December 7, you can switch between Original Medicare and Medicare Advantage for the following year — one of the few times each year you can make that move without a special circumstance.

How Employer Coverage Lets You Delay Part B Without Penalty

Nobody should pay the penalty described above if they have qualifying coverage, and the rules spell out exactly when delay is safe. If you are 65 or older and you or your spouse have coverage through current employment — not COBRA, not retiree coverage — you can postpone Part B and Part A enrollment risk-free in most cases. Your credit for that coverage typically extends through the end of the month after the employment ends or the coverage ends, whichever comes first, and your Special Enrollment Period for Part B generally runs for eight months after that month.

The key trap is misunderstanding what counts as "creditable." Coverage from a former employer, retiree plans, and COBRA generally do not count for delaying Part B without penalty, no matter how good they are. There are exceptions for some Federal Employees Health Benefits participants and for people who receive premium-free Part A through a spouse's work record, so the right move is to confirm your specific situation with Medicare before your initial enrollment window closes. Filing the paperwork correctly the first time prevents a permanently higher premium.

Budgeting for 2027: The Numbers That Matter

For planning purposes, the responsible approach is to separate confirmed numbers from projections. Confirmed for 2027 already: the Part D out-of-pocket cap rises to $2,400 (from $2,100 in 2026) and the Part D standard deductible rises to $700 (from $615). Projected, not final: the Part B standard premium around $209.50 and the Part B deductible around $292 to $310, both to be confirmed in November 2026. The trustees also project the Part A inpatient deductible rising from $1,736 to about $1,788, but that figure is not official yet either.

If you want a conservative 2027 budget, plan around the higher end of the range: assume a Part B premium near $215 to $219 rather than the trustees' $209.50 floor, and build in at least a $5 to $10 monthly buffer. Watch for the CMS announcement in November, typically mid-month, which finalizes the premium, the deductible and the new IRMAA brackets together. Between now and then, keep your income on file accurate — because the 2027 surcharges are based on your 2025 tax return — and if your income dropped due to a life-changing event, you can already prepare a Form SSA-44 to request a lower IRMAA tier when the announcement lands.

Turning 65 in 2027: Your Initial Enrollment Window

If you turn 65 in 2027, your Initial Enrollment Period is a seven-month window that begins three months before the month you turn 65 and ends three months after it. Unlike the Annual Enrollment Period, this window is your one guaranteed chance to sign up for Part B exactly on time, with no late penalty risk. Signing up at the start of your window — three months before your birthday month — generally means your coverage starts the first day of your birthday month. Signing up in your birthday month pushes coverage to the next month, and signing up in the last three months of the window delays it further.

There is a planning subtlety that catches people every year: if you are 65 but already covered by a group health plan from current work, your IEP is not the only chance you will have — the Special Enrollment Period described earlier in this guide still protects you. But if you have any doubt about whether your coverage qualifies as creditable, the safe play is to enroll anyway, drop it later if you must, and never expose yourself to a 10%-per-year penalty that lasts for life. Medicare automatically enrolls you in premium-free Part A, but Part B is optional — which means refusing it quietly is a decision you should make deliberately, with the penalty rules in front of you.

What the Part A Costs Mean for Your 2027 Budget

The Part B premium is only half of the Medicare cost picture. Part A, hospital insurance, is premium-free for most people who worked 40 quarters or more, and for many spouses and dependents through a work record. But premium-free does not mean cost-free: Part A carries a deductible per benefit period and coinsurance for extended hospital stays. The inpatient hospital deductible for 2026 is $1,736 (the trustees project roughly $1,788 for 2027), and you pay coinsurance for days beyond the 60th day in a benefit period, with much higher rates after day 90 when lifetime reserve days kick in.

A benefit period — also called a spell of illness — starts when you are admitted and ends once you have been out of the hospital or skilled nursing facility for 60 consecutive days. You can pay the Part A deductible more than once per year if you have separate benefit periods, which is a detail many beneficiaries discover only when they read a second Explanation of Benefits. Skilled nursing facility care also has a daily coinsurance amount from day 21 through day 100. All of this is why comparing a total Medicare budget — Part B premium plus Part A cost sharing plus Part D plus a possible Medigap premium — gives a much truer picture than quoting the Part B premium alone.

Common Part B Mistakes in a Premium-Rise Year

Years with a headline premium increase bring predictable mistakes, and most of them are avoidable. The first is ignoring the IRMAA notice: if your income two years earlier was above the threshold, the surcharge appears on a Medicare letter, and many people assume it is a bill error. It is not — but you can appeal it with Form SSA-44 if your income dropped because of retirement, divorce, a spouse's death, or other life-changing events. The second mistake is confusing the premium announcement with an enrollment deadline: the November announcement sets the rate, but the deadline that counts for choosing coverage is December 7, the last day of the Annual Enrollment Period.

The third mistake shows up in January: assuming the new premium only means a slightly smaller Social Security check. If you are directly billed because you have deferred Social Security, the full increase lands on your quarterly bill in one step, with no hold-harmless cushion. Budgeting for that bill, rather than only for the check deduction case, is the difference between a smooth start to 2027 and a scramble. The final mistake is doing nothing at all: for most people the right answer is simply to stay put, but the AEP exists precisely so you can re-check that your current plan combination is still the cheapest for your prescriptions and doctors.

Your November 2026 Action Plan

The confirmed 2027 numbers will arrive together in the mid-November CMS announcement: the standard Part B premium, the Part A and Part B deductibles, and the IRMAA tiers. A few days later, before December 7, your plan choices for 2027 must be finalized. That sequence means your action plan is simple and timeboxed. First, read the announcement when it comes out and compare the final premium to the $209.50 projection — a difference of only a few dollars changes your annual budget by a small but real amount. Second, use the month between the announcement and December 7 to review your Part D plan's drug list, because premiums and formulary tiers change every year, and a different plan is often the cheapest single fix available to you.

Third, check your 2025 tax return against the new IRMAA brackets: 2027 surcharges are based on 2025 income, so you already know your tier before the announcement. If your income was unusually high in 2025 for a reason that has since changed, prepare the SSA-44 paperwork now rather than scrolling for forms in December. Finally, whether you are newly eligible or a long-time beneficiary, set one reminder for December 7 — the annual deadline after which most changes become impossible until next fall. Medicare math rewards the prepared: the same facts that produce a scare headline every October are, for most people, a two-hour task with a clear deadline.

How the 2027 Premium Fits the Longer Trend

Putting the 2027 projection in context makes the numbers easier to trust and to plan around. The standard Part B premium has climbed steadily: $148.50 in 2021, $164.90 in 2022, $170.10 in 2023, $174.70 in 2024, $185.00 in 2025, and $202.90 in 2026. That is a compound increase of roughly 37% over six years, driven mainly by physician-administered drug spending and outpatient utilization as the Medicare population grows. The 2027 trustees projection of about $209.50 would be the smallest percentage increase since the current cycle began, and the trustees further project $224.50 in 2028 before steeper climbs later in the decade, reaching about $338.50 by 2034.

That trajectory has two practical implications. First, the one-year jump between 2025 and 2026 (nearly 10%) was unusually large, and assuming that becomes the new normal will overstate next year's bill; the trustees' current estimates point to more moderate annual steps for the next few years. Second, whatever the exact 2027 number, the longer arc is clearly upward — which strengthens the case for locking in plan stability this December and for checking each year that your Part D plan is still the cheapest option for your specific prescriptions. Medicare cost planning is a yearly habit, and 2027 is simply the next checkpoint in that cycle.

Verified Official Sources

• Source: CMS — Medicare Part B premiums and deductibles
• Source: Social Security Administration — COLA
• Source: SSA — COLA methodology and latest amount
• Source: Medicare.gov — Annual Enrollment Period

Frequently Asked Questions

How much will the Part B premium be in 2027?

Projected at $209.50 per month, up from $202.90 in 2026. The official amount is announced by CMS in November 2026.

When is the 2027 Part B premium announced?

CMS announces the official premium in November 2026, after the Medicare Trustees report and CMS fact sheets.

What was the Part B premium in 2026?

$202.90 per month, up $17.90 (9.7%) from $185 in 2025 — the second-largest Part B increase in program history.

Will the Part B increase reduce my COLA?

For most people the premium is deducted from the Social Security check, so a premium increase absorbs part of the COLA. Hold-harmless caps the net reduction for most.

What is hold-harmless?

It prevents most beneficiaries' benefit from dropping when the Part B increase exceeds the COLA dollar gain. It does not apply to new enrollees or IRMAA payers.

What does Medicare Part B cover exactly?

Doctor visits, outpatient care, preventive services, durable medical equipment, ambulance services and some home health care. It does not cover most dental, vision, hearing or at-home prescription drugs.

Can I delay Medicare Part B if I am still working?

Yes, in most cases you can delay Part B without penalty while you have group coverage from current employment, then sign up during the eight-month Special Enrollment Period after that coverage ends.

What is the penalty for late Part B enrollment?

Your premium can increase by 10% for each full 12-month period you were eligible without enrolling, and the penalty is permanent for as long as you have Part B.

How is the Part B premium paid?

If you get Social Security, the premium is deducted automatically from your check. If not, Medicare bills you directly, usually quarterly, or you can use Medicare Easy Pay.

What is the difference between Original Medicare Part B and Medicare Advantage?

Original Medicare lets you see any participating provider with no network, plus a separate Part D plan. Medicare Advantage is a private network plan that bundles coverage and usually adds extras like dental and vision.

Why did the Part B premium jump from $185 to $202.90 in 2026?

The 2026 premium reflected a near-10% rise driven by projected program spending; a 2025 reduction that did not carry over was reversed, and cost pressures returned to a normal trend.

When does my Part B coverage start if I turn 65 in 2027?

If you sign up in the three months before your birthday month, coverage starts the first day of your birthday month; signing up later in your seven-month window delays the start.

Is Part A really free?

For most people who worked at least 40 quarters it is premium-free, but you still pay a hospital deductible per benefit period and coinsurance for long stays.

What is the deadline to change Medicare coverage for 2027?

December 7, 2026 — the last day of the Annual Enrollment Period. After that, most changes for 2027 are off the table.

How do I appeal an IRMAA surcharge for 2027?

File Form SSA-44 with documentation if your income dropped due to a life-changing event like retirement, divorce or a spouse's death.

When is the official 2027 Part B premium announced?

CMS typically releases the confirmed premium, deductibles and IRMAA brackets in mid-November 2026, before the December 7 deadline.