Why Did Your Medicare Part B Premium Go Up? What North Carolina Retirees Should Check First

The standard Medicare Part B premium rose to $202.90 a month for 2026, up $17.90 from last year, according to the Centers for Medicare & Medicaid Services.

This year’s Social Security raise added about $56 a month.

So, the premium ate roughly a third of it before anything else did.

For some retirees the gap runs wider, because an income surcharge set by a two-year-old tax return lands on top.

Note: This is general information, not insurance or tax advice. Premiums, surcharge thresholds, and program rules are subject to change, so confirm your current numbers with Medicare.gov or the Social Security Administration.

The Standard Premium Rose to $202.90

The Centers for Medicare & Medicaid Services (CMS) set the standard Part B premium at $202.90 a month for 2026.

That’s a $17.90 jump from 2025’s $185.00.

That works out to almost a 9.7% increase.

The annual Part B deductible rose too, from $257 to $283.

CMS points to projected price changes and rising use of Part B-covered care as the main drivers, the same forces that push many years’ premium a little higher.

That’s routine, not rare.

Retirees nationwide often get caught off guard by other Medicare costs beyond the premium and deductible.

Even North Carolinians who chose a Medicare Advantage plan instead of Original Medicare still owe this.

More than 2.2 million North Carolinians carried Medicare as of 2024, the most recent year on record.

About 55% of them picked Medicare Advantage, per KFF, a nonprofit health policy research organization.

Every one of them still pays the Part B premium underneath their plan.

Your Social Security Raise May Not Cover the Difference

Why the premium rose is only half the equation; what shows up in a retiree’s check depends on their Social Security raise.

Social Security automatically deducts many beneficiaries’ Part B premium from their monthly check.

A federal rule called hold harmless limits how much that deduction can grow in a single year.

Under hold harmless, many beneficiaries’ Part B increase can’t be larger than the dollar amount of their Social Security cost-of-living adjustment (COLA) for that year.

For 2026, the COLA is 2.8%, an average add of about $56 a month, while the standard Part B premium jumped by $17.90.

Do the math, and the premium increase alone can eat close to a third of an average retiree’s raise.

Little room is left.

Hold harmless doesn’t protect everyone, though.

It skips anyone new to Part B this year, anyone who pays an income-related surcharge, and anyone whose premium is paid directly by Medicaid.

IRMAA Adds a Surcharge on Top of the Standard Premium

Medicare adds an income-related monthly adjustment amount (IRMAA) on top of the standard Part B premium once a beneficiary’s income crosses a set line.

For 2026, CMS sets that line at $109,000 in income for a single filer or $218,000 for a married couple filing jointly.

Cross it, and the total monthly premium rises to $284.10 instead of $202.90, a jump of $81.20 tacked straight onto the standard rate.

The surcharge increases in steps from there, all the way up to $689.90 a month for the highest earners, $500,000 or more in individual income, or $750,000 or more for a couple.

Not everyone pays it.

Roughly 8% of Part B enrollees pay some level of IRMAA, per CMS, so most people still pay the standard rate alone.

The Income Behind an IRMAA Surcharge Is Two Years Old

A Medicare Part B surcharge in 2026 doesn’t look at a retiree’s income from this year.

It looks two years back, at the tax return already on file.

That means a 2026 premium is set using a 2024 tax return, income that might not reflect where a retiree stands today.

Sell a house, take a large IRA withdrawal, or convert a big chunk of a 401(k) to a Roth account two years ago.

The bill can show up now, long after the money is spent.

Retirees rarely see it coming.

You Can Ask Social Security to Recalculate It

That two-year lag behind the surcharge isn’t set in stone.

The Social Security Administration (SSA) will lower an IRMAA surcharge for a retiree whose income has dropped since that old tax return.

A qualifying life event has to be behind the drop.

Qualifying events include marriage, divorce, the death of a spouse, a work stoppage or reduction, and a lost pension or income-producing property.

The request goes through Form SSA-44, and a retiree doesn’t have to wait for an official IRMAA notice to file it.

File as soon as the life event happens.

An approved request gets the surcharge recalculated using current income instead of the two-year-old figure, and SSA can refund any extra IRMAA already withheld that year.

Late Sign-Up Carries a Separate Penalty

Medicare charges a separate penalty for anyone who delays signing up for Part B without a qualifying reason, apart from IRMAA and apart from the standard yearly increase.

The penalty adds 10% to the premium for every full 12-month period a retiree could have signed up but didn't.

It never goes away.

Wait two full years past eligibility without qualifying coverage, and a retiree owes a permanent 20% penalty stacked on top of the standard rate.

That penalty pushes the bill to roughly $243.50 a month in 2026.

Working past 65 with employer coverage usually avoids this, but the paperwork proving that coverage existed matters when a retiree finally signs up.

What North Carolina Retirees Should Check First

North Carolina retirees who want a straight answer about their Part B bill have a free place to start.

The state's Seniors' Health Insurance Information Program (SHIIP) is run by the North Carolina Department of Insurance.

Trained volunteer counselors staff every one of the state's 100 counties.

A call to 855-408-1212 connects a retiree with a SHIIP counselor who doesn't sell insurance and doesn't work on commission.

North Carolina also runs Medicare Savings Programs that can pay a qualifying retiree's Part B premium outright.

The state calls its version Medicare-Aid, and it comes in three tiers.

Full help covers the lowest incomes, and Part-B-premium-only help covers a middle tier and the tier above that.

Income limits for a single applicant run from around $1,330 a month up to roughly $1,800 a month, depending on the tier, in 2026.

North Carolina updates these figures every spring.

Even a retiree who earns too much for full Medicaid can still qualify for one of the lower tiers and get relief on the Part B bill.

While a retiree is checking Part B costs, it's worth checking whether North Carolina taxes Social Security too.

FAQ

Quick answers to what North Carolina retirees ask most about their Medicare Part B bill.

No sales pitch here.

Why did my Medicare Part B premium go up in 2026?

Mainly because CMS raised the standard premium to $202.90 a month, a $17.90 increase from 2025. Some retirees pay more on top of that because of IRMAA, a late-enrollment penalty, or both.

What income triggers IRMAA in 2026?

IRMAA starts once a 2024 tax return shows more than $109,000 in income for a single filer or $218,000 for a married couple filing jointly, according to CMS.

Can I appeal an IRMAA surcharge?

Yes. Social Security will recalculate an IRMAA surcharge using current income after a qualifying life event, like a work stoppage or the death of a spouse, through Form SSA-44.

Does North Carolina help pay Medicare premiums for retirees with lower incomes?

Yes. North Carolina's Medicare Savings Programs can pay a qualifying retiree's Part B premium in full or in part, depending on income. SHIIP counselors help retirees check their eligibility for free.