The 2027 Medicare Part B premium projection: $218.60
The 2025 Medicare Trustees Report projects the 2027 standard Part B premium at $218.60 per month — a 7.7% jump over the confirmed 2026 standard of $202.90, and an 18.2% cumulative increase over two years. CMS won’t make it official until November, but federal retirees planning 2027 budgets should treat this as the working assumption, not a guess.
1. What the projection says
The 2025 Medicare Trustees Report — the annual financial report from Medicare’s six-member trustees board — projects the 2027 standard Medicare Part B premium at $218.60 per month under the intermediate assumption set. That’s the projection federal retirees should be planning around as of mid-2026.
For context: the confirmed 2026 standard Part B premium is $202.90/month (CMS announced this on November 14, 2025, in the Federal Register). The projection from $202.90 to $218.60 represents a year-over-year increase of about 7.7%. Layered on top of the prior year’s 9.7% jump from $185 to $202.90, the cumulative 2025-to-2027 increase comes to 18.2% — one of the largest two-year Part B premium spikes in recent memory.
The trustees attribute the projected jump primarily to faster-than-expected growth in two categories:
- Outpatient hospital and physician-administered drug spending — the largest single driver in their analysis
- Higher-than-projected utilization across the Medicare population as the program continues to grow
The 2025 Trustees Report also projects Part B cost growth averaging 8.8% per year over the next five years, which is faster than the projected GDP growth rate. That cost-growth assumption is what produces the steep premium curve through the late 2020s.
These projections are not guarantees. CMS will publish the actual 2027 Part B premium in November 2026, following its standard cycle. The Trustees Report is a planning document — sometimes its projections come in high, sometimes low. (The 2025 Trustees Report had projected the 2026 premium at $206.50; CMS came in $3.60 below at $202.90.) But for budget purposes between now and November, $218.60 is the working number.
Federal retirees on FEHB plus Medicare — particularly those evaluating Open Season decisions, suspending FEHB for TFL, or considering EGWP enrollment — make planning decisions on Part B costs months before CMS announces them. The Trustees projection is the best available 2027 figure as of mid-2026, and treating it as a planning assumption (with the understanding that the November announcement may shift it) is more useful than assuming Part B stays flat from 2026.
2. The nine-year curve
The 2025 Trustees Report doesn’t stop at 2027. It projects Part B premiums all the way through 2034 — and the picture isn’t reassuring for retirees making long-term planning assumptions.
| Year | Projected standard Part B | Year-over-year change |
|---|---|---|
| 2026 (confirmed) | $202.90 | +9.7% (vs $185.00 in 2025) |
| 2027 (projected) | $218.60 | +7.7% |
| 2028 (projected) | $231.30 | +5.8% |
| 2029 (projected) | $247.40 | +7.0% |
| 2030 (projected) | $264.70 | +7.0% |
| 2031 (projected) | $281.60 | +6.4% |
| 2032 (projected) | $300.80 | +6.8% |
| 2033 (projected) | $325.90 | +8.3% |
| 2034 (projected) | $347.50 | +6.6% |
If those projections held, the standard Part B premium would rise 71% from 2026 to 2034 — from $202.90 to $347.50. The largest single jump was the 2025-to-2026 step (+$17.90). After 2027, the projected annual increases settle into a roughly 6-8% range, which is still well above general inflation.
A point of comparison: the 2024 Trustees Report had projected the 2033 premium at $299.80. The 2025 Trustees Report raised that estimate to $325.90 — meaning the trustees themselves revised the nine-year curve significantly upward in just one year. This isn’t a stable projection. Cost-growth assumptions are being revised faster than originally modeled.
3. IRMAA — the 2027 picture
For higher-income federal retirees, the Part B story isn’t just the standard premium — it’s the Income-Related Monthly Adjustment Amount (IRMAA) that stacks on top.
The lookback rule: 2027 IRMAA is determined by your 2025 modified adjusted gross income (MAGI). The 2-year lag means your 2025 tax return controls your 2027 Medicare cost. For most retirees this is too late to change — 2025 income is already filed or being filed. But for retirees planning 2026 income (which controls 2028 IRMAA), the planning window is right now.
Projected 2027 IRMAA brackets — these are estimates based on the historical inflation indexing of the brackets applied to the 2026 multipliers. CMS will publish official figures in November:
| 2025 MAGI (single) | 2025 MAGI (MFJ) | 2027 projected total Part B (monthly) |
|---|---|---|
| $111,000 or less | $222,000 or less | $218.60 (standard) |
| $111,001–$139,000 | $222,001–$278,000 | ~$306 (+$87) |
| $139,001–$173,000 | $278,001–$346,000 | ~$437 (+$219) |
| $173,001–$207,000 | $346,001–$414,000 | ~$568 (+$350) |
| $207,001–$501,000 | $414,001–$751,000 | ~$700 (+$481) |
| $501,001 or more | $751,001 or more | ~$743 (+$525) |
The highest IRMAA tier in 2027 is projected to pay roughly $743/month — nearly $8,920/year per person — for Part B alone. For a high-income married couple, that’s almost $18,000/year in Part B premiums before any other healthcare spending.
The bracket thresholds themselves shift slightly year to year with inflation, but the structure is stable: five surcharge tiers above the standard premium, each defined by income ranges that haven’t moved much in recent years.
For the broader IRMAA framework — including strategies that can shift income across tax years to avoid bracket creep — see IRMAA explained.
A common trap: a retiree sells a property, takes a large IRA distribution, or recognizes a Roth conversion in one year, then is surprised when their Medicare premiums jump two years later. By the time the IRMAA tier hits, the income event is long past — and the surcharge is on the full year of premiums, not prorated. Major income events should be evaluated for their IRMAA impact two years out, not just for their immediate tax impact. The 2025 income decisions that hit you in 2027 are already made or being made; the 2026 ones can still be managed.
4. The hold-harmless provision
One protection in Social Security law shields some retirees from the full Part B increase: the hold-harmless provision.
How it works: If a retiree’s Social Security COLA in dollar terms is smaller than the Part B premium increase, the Part B premium is capped at the COLA dollar amount. The retiree’s net Social Security check cannot decrease from one year to the next due to a Part B increase alone.
Who is protected:
- Existing Medicare beneficiaries whose Part B premium is deducted from their Social Security check
- Retirees with low or zero COLA dollar amounts (typically those with smaller benefit checks)
Who is NOT protected:
- New Medicare enrollees (their first year on Medicare)
- Retirees subject to IRMAA (any tier above standard)
- Retirees who pay Part B directly rather than through Social Security deduction
- Retirees in their first year of Social Security collection
For 2027, the hold-harmless provision matters most if the eventual 2027 COLA comes in low. The 2026 COLA was 2.5%, producing roughly $55/month average increase per retiree — comfortably more than the $17.90 Part B increase from 2025 to 2026, so hold-harmless didn’t activate. If 2027’s COLA comes in at the same level or higher (current projections point to 3.5-4%), the $15.70 projected Part B increase is well within the typical COLA dollar range, and hold-harmless again does not bind for most retirees.
But for retirees in IRMAA tiers, hold-harmless never applies. The full projected increase — and the full IRMAA stack on top of it — hits regardless of COLA size.
The 2027 Part B premium projection isn’t just a Medicare story — it’s a federal retirement-budget story. For a couple in the standard bracket, the projected increase represents about $377 more in annual Part B costs than 2026. For a couple in the top IRMAA tier, the year-over-year jump exceeds $1,300 — and the cumulative annual cost approaches $18,000.
5. What federal retirees should do now
A few practical moves while the projection is still provisional:
Build the working budget around $218.60/month. For Medicare-eligible federal retirees, planning 2027 healthcare spending against the projection — rather than against 2026 — gives a safer baseline. If the November announcement comes in lower, that’s a positive surprise. If it comes in higher, you’ve already absorbed the harder number.
Manage 2026 income carefully. The 2026 income controls 2028 IRMAA. The same logic applies a year out — major income events (property sales, Roth conversions, large IRA distributions, business sales) deserve to be planned with explicit attention to their two-year-out IRMAA impact. The window to manage 2026 income is now and the rest of the calendar year.
Verify your 2025 income tier. Since 2027 IRMAA is set by 2025 income, you can pull your 2025 tax data and forecast which IRMAA tier you’ll land in. If you’re close to a bracket threshold, an amended return (when legitimately appropriate) could shift you down a tier.
Consider TFL if eligible. For dual-status retirees (military + federal civilian), the rising Part B trajectory doesn’t change the math against FEHB — TFL still pairs with Part B at $0 additional premium. The case for TRICARE for Life over FEHB gets stronger when both FEHB premiums and Part B premiums are rising together.
Watch the November CMS announcement. The actual 2027 figures land in early-to-mid November. Update plans then, not before. Until then, the Trustees Report is the best estimate available.
We’ll publish a follow-up dispatch the week CMS announces the official 2027 numbers.
This dispatch reflects the 2025 Medicare Trustees Report released in June 2025 and the confirmed 2026 Part B figure announced by CMS on November 14, 2025 (Federal Register, 90 FR 47XXX). The 2026 Trustees Report is expected in June 2026 and may revise the 2027 projection further. CMS will publish the actual 2027 Part B premium in November 2026. Numbers in this dispatch are accurate as of publication; the working assumption may shift with each release.
Frequently asked questions
When will the official 2027 Medicare Part B premium be announced?
CMS typically announces the next year’s Part B premium in November, following its standard administrative cycle. The 2027 announcement is expected in November 2026, with new premiums taking effect January 1, 2027. Until that announcement, the 2025 Medicare Trustees Report’s projection of $218.60/month is the best available estimate, but it’s not binding — actual figures can come in higher or lower than the Trustees Report intermediate assumptions.
Why is the 2027 Part B increase projected to be large?
The trustees attribute the projected jump primarily to faster-than-expected growth in outpatient hospital spending, physician-administered drug costs, and overall Medicare utilization as the program enrolls more beneficiaries. The 2025 Trustees Report projects Part B cost growth averaging 8.8% per year over the next five years — substantially faster than GDP growth or general inflation. The single biggest year-over-year jump was projected from 2025 to 2026; the 2026-to-2027 increase is also significant but proportionally smaller.
What income year determines my 2027 Medicare premium?
Your 2025 modified adjusted gross income (MAGI) determines your 2027 Medicare Part B and Part D premiums, due to the standard 2-year IRMAA lookback. This means 2025 income decisions — Roth conversions, capital gains, business sales, large IRA distributions — directly affect your 2027 Medicare costs. If you’re close to an IRMAA bracket threshold, your 2025 tax return is the document that locks in your 2027 surcharge tier.
Does the hold-harmless provision protect me from the 2027 Part B increase?
It depends on your situation. Hold-harmless protects existing Medicare beneficiaries (with Part B deducted from Social Security) from a net Social Security check decrease — but only if the COLA dollar amount is smaller than the Part B increase. Hold-harmless does not apply to new Medicare enrollees, IRMAA-tier payers, or those paying Part B directly. For 2027, the projected $15.70 monthly Part B increase is unlikely to trigger hold-harmless protection unless the COLA is unusually low, since typical COLA dollar amounts exceed that increase.
- CMS, “2025 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds”
- Federal Register, “Medicare Part B Monthly Actuarial Rates, Premium Rates, and Annual Deductible Beginning January 1, 2026” (CMS, Nov 19, 2025)
- MOAA, “Medicare Trustees Report Estimates Next 9 Years of Part B Premiums” (June 2025)
- Kiplinger, “Your Medicare Costs Are Set to Soar: What to Expect Over the Next Decade” (October 2025)
- The Finance Buff, “2026 2027 2028 Medicare IRMAA Premium MAGI Brackets”
- Medicare Rights Center, “2026 Medicare Premiums Announced” (November 2025)
- SSA, “Medicare Part B Premiums and the Hold-Harmless Provision”