Medicare Part B Premium Projected at $209.50 for 2027 — What to Do Before AEP Opens Oct. 15 (IRMAA Brackets, Deductible & Checklist)

Medicare's Annual Enrollment Period (AEP) opens Wednesday, October 15, 2026, and runs through December 7. Changes you make during that window take effect January 1, 2027. Two days before the door opens, one number is already dominating retiree budgeting conversations: the Medicare Board of Trustees projects the standard Part B premium will rise to $209.50 a month in 2027 — up $6.60 from the confirmed 2026 premium of $202.90. The Part B deductible is projected to move from $283 to $292. Those figures come from the 2026 Trustees Report and were summarized by AARP on October 5, 2026. They are projections, not the final CMS rates. CMS typically announces the official premium, deductible, and IRMAA brackets in November. This guide walks through what is already locked for 2026, what the Trustees expect for 2027, how IRMAA works off your 2025 MAGI, and a practical checklist for the AEP window that starts tomorrow.

Educational disclaimer: This article is general information for U.S. consumers and Medicare beneficiaries, not personalized medical, tax, insurance, or legal advice. Official 2027 Part B premiums, deductibles, and IRMAA brackets will be set by CMS; until that announcement, treat $209.50 / $292 as Trustees projections. Plan benefits, networks, and drug formularies change every year — verify details on Medicare.gov, your plan's Evidence of Coverage, and your Annual Notice of Change (ANOC). Dollar Lane is not affiliated with CMS, SSA, or any Medicare Advantage or Part D insurer.

The numbers that matter right now (October 2026)

Start with what is confirmed versus what is still a forecast. CMS published the 2026 Parts A and B figures on November 14, 2025. The Trustees' 2027 path is the best public estimate available ahead of the November CMS release — and AARP notes that over the past decade the Trustees' Part B premium projection has been exact three times and within 30 cents in other years. Still, label every 2027 dollar figure below as projected until CMS speaks.

Item	2026 (CMS final)	2027 (Trustees projection)	Change
Part B standard monthly premium	$202.90	$209.50	+$6.60 (~3.25%)
Part B annual deductible	$283	$292	+$9
Extra annual Part B premium cost (standard)	—	~$79.20	12 × $6.60
Part A inpatient hospital deductible	$1,736	Not yet announced	—
AEP window for 2027 coverage	—	Oct. 15 – Dec. 7, 2026	Effective Jan. 1, 2027

Sources: CMS fact sheet, "2026 Medicare Parts A & B Premiums and Deductibles" (Nov. 14, 2025); AARP summary of the 2026 Medicare Trustees Report (Oct. 5, 2026); Medicare.gov Open Enrollment page.

Context helps. Last year's jump from $185.00 (2025) to $202.90 (2026) was $17.90 — about 9.7%. A ~3.25% move for 2027 would be far milder. AARP also cites the Trustees' longer path: an average ~6% annual rise from 2026 through 2031, when the standard premium could reach $272.10. That longer path is why October's AEP decisions matter even if next year's bump looks small on a monthly statement.

What Medicare Part B actually pays for

Part B is the outpatient half of Original Medicare. CMS describes it as covering physicians' services, outpatient hospital services, certain home health services, durable medical equipment, and other medical and health services not covered by Part A. In plain English for most households, that means:

• Doctor and specialist visits
• Outpatient surgery and clinic care
• Lab work, X-rays, and many diagnostic tests
• Preventive screenings (many with $0 cost-sharing when Medicare-approved)
• Some injectable or infusion drugs given in a doctor's office or clinic
• Durable medical equipment (wheelchairs, oxygen, etc.)

You pay the monthly Part B premium whether you use Original Medicare alone, pair it with a Medigap (Medicare Supplement) policy, or enroll in a Medicare Advantage (Part C) plan that still requires you to keep Part B. That is why a $6.60 monthly bump shows up for nearly every beneficiary — Advantage enrollees included — even when the plan advertises a $0 plan premium.

How the Part B premium is set (and why it rose so hard in 2026)

By statute, the standard Part B premium is designed to cover about 25% of projected Part B spending per beneficiary age 65 and older. The other ~75% is financed by general revenues paid into the Supplementary Medical Insurance (SMI) Trust Fund. When CMS actuaries expect higher utilization, higher prices, or both, the premium climbs.

CMS said the 2026 increase was driven mainly by projected price changes and utilization consistent with historical experience. The agency also noted that without actions in the 2026 Physician Fee Schedule Final Rule targeting spending on skin substitutes, the Part B premium increase would have been about $11 more per month. Put differently: program spending on specific high-cost items can move the premium that every enrollee pays.

For 2027, the Trustees' milder ~3.25% projection assumes a calmer spending path than 2026. Final CMS numbers can still land higher or lower once autumn utilization and fee-schedule assumptions are locked. Independent analysts quoted in secondary coverage have speculated about a final range in the mid-$210s, but those are not official. Until CMS publishes the 2027 fact sheet (historically mid-November), budget with $209.50 as the planning number and leave a cushion.

IRMAA: when your income pushes Part B above $202.90

About 8% of Part B enrollees pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard premium, according to CMS. IRMAA is based on your modified adjusted gross income (MAGI) from two years earlier. For 2026 premiums, that means your 2024 tax return. For 2027 premiums, Social Security and CMS will look at your 2025 MAGI.

Here are the official 2026 Part B IRMAA brackets from the CMS November 14, 2025 fact sheet. These are the brackets in force today. 2027 IRMAA thresholds and surcharge dollars will be announced with the 2027 premium.

Individual MAGI (2024)	Joint MAGI (2024)	IRMAA	Total monthly Part B
≤ $109,000	≤ $218,000	$0.00	$202.90
$109,001 – $137,000	$218,001 – $274,000	$81.20	$284.10
$137,001 – $171,000	$274,001 – $342,000	$202.90	$405.80
$171,001 – $205,000	$342,001 – $410,000	$324.60	$527.50
$205,001 – $499,999	$410,001 – $749,999	$446.30	$649.20
≥ $500,000	≥ $750,000	$487.00	$689.90

Source: CMS, "2026 Medicare Parts A & B Premiums and Deductibles," Nov. 14, 2025. Married filing separately while living with a spouse has a compressed two-tier table (≤ $109,000 → $202.90; $109,001–$390,999 → $649.20; ≥ $391,000 → $689.90).

Part D also carries IRMAA. For 2026, the Part D IRMAA add-ons (paid to Medicare/SSA on top of your plan premium) are $14.50, $37.50, $60.40, $83.30, and $91.00 across the same income bands. If you are in an IRMAA tier, your total Medicare cost is standard Part B + Part B IRMAA + Part D plan premium + Part D IRMAA.

What to do if your income dropped: Form SSA-44

IRMAA uses a two-year lookback, which is rough if you retired, lost a spouse, divorced, or saw a pension stop between the tax year being measured and today. Social Security lets you request a new initial determination using Form SSA-44 when a qualifying life-changing event reduced your income. Qualifying events generally include:

• Work stoppage or work reduction
• Marriage, divorce, or annulment
• Death of a spouse
• Loss of income-producing property
• Loss of pension income
• Employer settlement payment

You will need proof of the event and evidence of the lower income (recent tax return, W-2 estimates, or pay stubs). File with Social Security — not with your Medicare Advantage insurer. If SSA accepts the request, your IRMAA can be recalculated based on the more recent income. This is one of the highest-ROI paperwork tasks for newly retired households still stuck in a high IRMAA tier based on peak earning years.

Hold-harmless: why some Social Security checks barely move

The Social Security Act's hold-harmless provision prevents a Part B premium increase from reducing certain beneficiaries' net Social Security payment below the prior year's amount. Roughly 70% of Part B enrollees are eligible in a typical year; AARP notes that about 30% are not — including people who do not receive Social Security and people who pay IRMAA.

Whether hold-harmless bites in 2027 depends on the size of the Social Security COLA relative to the Part B increase. AARP, writing on October 5, expected a roughly 3.6% COLA based on then-available inflation data, with the official COLA announcement due October 14, 2026. A ~3.6% COLA would outpace the Trustees' ~3.25% Part B projection, which would leave most hold-harmless beneficiaries absorbing the premium rise because their COLA is large enough. (If the COLA lands smaller than the premium hike, hold-harmless would shelter some of the increase for eligible beneficiaries.) Either way, IRMAA payers and people without Social Security checks do not get that shield.

The $90 Part B rebate (October 2026) — who gets it and who doesn't

Separately from the 2027 premium projection, CMS and the Social Security Administration began issuing a one-time ~$90 rebate in October 2026 to help Original Medicare beneficiaries with Part B costs. AARP reported that about 20.8 million people are eligible. Key eligibility points from CMS coverage of the payment:

• You must be enrolled in Original Medicare (Parts A and/or B)
• You must live in the United States
• You cannot be receiving premium assistance from Medicaid
• Medicare Advantage enrollees (about 36.1 million people) are not eligible
• People paying IRMAA are also ineligible for the rebate

Most eligible recipients receive the money by direct deposit from SSA; others get a check at their Medicare mailing address. Call 1-800-MEDICARE to check eligibility, or SSA at 1-800-772-1213 for payment status. The $90 covers less than half of one month's $202.90 premium — useful, but not a substitute for AEP shopping or IRMAA planning.

AEP starts October 15: what you can change

Medicare.gov's Open Enrollment page is unambiguous: Open Enrollment / AEP runs October 15 through December 7. Changes are effective January 1 of the following year if the plan receives your enrollment request by December 7. During AEP you can:

• Join, switch, or drop a Medicare Advantage plan (with or without drug coverage)
• Join, switch, or drop a stand-alone Part D prescription drug plan
• Switch from Medicare Advantage back to Original Medicare (and, if needed, add a Part D plan)
• Switch from Original Medicare to a Medicare Advantage plan

Medigap (Medicare Supplement) has its own guaranteed-issue and open-enrollment rules that are separate from AEP. If you leave Advantage for Original Medicare, check whether you can buy Medigap in your state without medical underwriting — especially if you are outside your Medigap Open Enrollment Period (the six-month window that starts when you are 65 or older and enrolled in Part B).

Coverage path	You still pay Part B?	Typical extra pieces	AEP action
Original Medicare only	Yes	Optional Medigap + Part D	Review Part D formulary; check Medigap rules separately
Original Medicare + Medigap + Part D	Yes	Medigap premium + Part D premium (+ IRMAA if any)	Compare Part D plans; Medigap switches vary by state
Medicare Advantage (with or without drugs)	Yes (almost always)	Plan premium (often $0) + cost-sharing + network rules	Compare plans on Medicare.gov; read ANOC

Seven-item AEP checklist before December 7

1. Open your ANOC. Your current plan's Annual Notice of Change lists 2027 premium, deductible, copays, formulary, and network changes. If you throw this envelope away unread, you are shopping blind.
2. List every prescription and pharmacy. Run them through Medicare.gov's Plan Finder. A plan that was cheapest in 2026 can jump if a drug moves tiers or a preferred pharmacy drops out.
3. Confirm doctors and hospitals. Advantage plans are network-based. Call the office and ask whether they will accept your specific 2027 plan — not just "Medicare."
4. Estimate total out-of-pocket, not just the premium. A $0-premium Advantage plan with high specialist copays can cost more than a modest-premium plan if you see several specialists a year.
5. Check prior authorization and referral rules. Advantage plans often require referrals for specialists and prior auth for imaging or specialty drugs. Original Medicare + Medigap usually does not.
6. Look at IRMAA on your latest SSA notice. If your 2025 income dropped after retirement, gather SSA-44 documents now so a correction can land before 2027 premiums bill.
7. Budget the projected Part B bump. At $209.50, a couple on standard Part B both would pay about $419 a month — $50.40 more per year per person than 2026, or ~$100.80 more for two. Add IRMAA if you are in a surcharge tier.

Side-by-side: Annual Part B cost at standard vs. first IRMAA tier

Scenario (monthly × 12)	2026 annual	2027 projected annual*	YoY difference
Standard Part B ($202.90 → $209.50)	$2,434.80	$2,514.00	+$79.20
Couple, both standard	$4,869.60	$5,028.00	+$158.40
First IRMAA tier 2026 ($284.10) — illustrative	$3,409.20	TBD by CMS	Await Nov. announcement
Part B deductible alone	$283	$292 projected	+$9

*2027 standard premium and deductible are Trustees projections summarized by AARP (Oct. 5, 2026). IRMAA surcharges for 2027 are not yet published. Dollar Lane calculations from CMS 2026 figures × 12.

Part A costs you should not ignore while shopping Part B

Even though this article focuses on Part B, AEP and Original Medicare budgeting also include Part A hospital cost-sharing. For 2026, CMS set:

• Inpatient hospital deductible: $1,736 per benefit period
• Days 61–90 coinsurance: $434 per day
• Lifetime reserve days: $868 per day
• Skilled nursing facility coinsurance (days 21–100): $217.00 per day

About 99% of beneficiaries pay no Part A premium because they (or a spouse) have 40+ quarters of Medicare-covered employment. If you buy into Part A, the 2026 reduced premium is $311 and the full premium is $565. 2027 Part A figures will arrive with the CMS fall announcement.

Common mistakes that get expensive after January 1

• Assuming "my plan auto-renews, so I'm fine." Auto-renewal is normal — but formulary, network, and cost-sharing changes are also normal. Read the ANOC.
• Shopping only on monthly premium. The Medicare Plan Finder's estimated annual drug + medical cost is a better ranking key than the sticker premium.
• Ignoring the two-year IRMAA lag. A Roth conversion or large capital gain in 2025 can raise 2027 IRMAA. Coordinate with a tax professional before year-end moves.
• Dropping Advantage without a Medigap plan. Outside guaranteed-issue windows, Medigap can underwrite for health conditions. Know your state's rules before you leave Advantage.
• Missing the Dec. 7 deadline. Late changes generally wait for another enrollment period (for example, the Medicare Advantage Open Enrollment Period from Jan. 1 to March 31, which has narrower options).
• Treating the $90 rebate as ongoing relief. It is one-time and excludes Advantage and IRMAA households.

FAQ

Is $209.50 the official 2027 Part B premium?
No. It is the Medicare Trustees' projection from the 2026 Trustees Report, as reported by AARP on October 5, 2026. CMS will announce the official 2027 premium, deductible, and IRMAA brackets later this fall (historically November).

When does AEP start and end?
October 15 through December 7, 2026. Changes take effect January 1, 2027 if your enrollment request is received by December 7 (Medicare.gov).

Do Medicare Advantage members pay the Part B premium?
Almost always yes. You must keep Part A and Part B to stay in an Advantage plan. A "$0 premium" Advantage plan usually means $0 plan premium on top of the Part B premium you already pay.

Whose tax return sets my 2027 IRMAA?
Generally your 2025 MAGI (two-year lookback). If a qualifying life-changing event lowered your income, ask Social Security about Form SSA-44.

Will the Social Security COLA cover the Part B increase?
It depends on the final COLA (due around October 14, 2026) and the final Part B premium (due around November). AARP's early October estimate of ~3.6% COLA would outpace the Trustees' ~3.25% Part B projection — but both numbers can still move, and IRMAA payers do not get hold-harmless protection.

Where should I compare plans?
Start at Medicare.gov Plan Compare, then confirm network and formulary details with the plan and your providers. SHIP (State Health Insurance Assistance Program) counselors offer free, unbiased help.

Does this article recommend a specific Advantage or Part D plan?
No. Plan fit depends on your doctors, drugs, county, and risk tolerance for networks vs. Medigap premiums. Use official comparison tools and, if needed, a licensed advisor who Fiduciary-discloses commissions.

Bottom line for the October 15 open

Treat $209.50 as the working Part B number for 2027 household budgets until CMS finalizes it. Expect a much smaller percentage increase than 2026's 9.7% jump — but do not let a "mild" premium story distract you from formulary, network, and IRMAA checks during AEP. Open your ANOC this week, run Plan Finder with every prescription, confirm your doctors, and if your income fell after 2025, start the SSA-44 packet before January bills arrive. AEP is open for 54 days starting October 15. The households that use those days on total cost — not just the Part B line item — are the ones who avoid January surprises.

Sources linked inline and listed in the Dollar Lane research notes for this post: CMS 2026 Parts A & B fact sheet; Medicare.gov Open Enrollment; AARP Part B 2027 premium coverage (Oct. 5, 2026); Medicare Trustees Report projections as cited by AARP/KFF commentary. Figures current as of October 13, 2026 research; always re-check official pages before enrolling.