That yearly bump can feel like a win—until you look at your January deposit and wonder why it barely moved. When Medicare premiums rise, it’s normal to worry that your raise got eaten before you ever touched it. The good news is the answer isn’t the same for everyone, and for many people, protections and planning can soften the hit. What matters most is your benefit amount, your premium situation, and whether any income-related adjustments apply. Let’s break down what’s happening in 2026 and how to keep more of your money in your pocket.
Start With the Simple Math
In 2026, Social Security benefits rise by 2.8%, and that change begins with checks paid in January 2026. The standard Part B premium is $202.90 per month in 2026, up from $185.00 in 2025. Whether your COLA increase gets “wiped out” depends on how much your benefit grows in dollars compared to how much more you pay in premiums. A quick estimate is: take your monthly benefit, multiply by 2.8%, and compare that result to the premium increase.
When Part B Premiums Rise Faster Than a COLA Increase
A key protection is the Medicare “hold harmless” provision, which can limit how much your Part B premium can rise if it would otherwise reduce your Social Security check. In plain terms, if the premium increase would take away more than your benefit increase, hold harmless may cap the premium so your net check doesn’t go down.
This is why some people don’t feel the full premium jump even when the standard premium rises. It doesn’t apply to everyone, and it doesn’t mean premiums can’t rise—just that your check may be protected from dropping due to the premium change. The bottom line is that a COLA increase can still help, but hold harmless often determines how “real” it feels in January.
Why Some People Feel the Hit More Than Others
If you’re subject to income-related monthly adjustment amounts (IRMAA), your Part B premium can be higher than the standard amount. New enrollees can also be more exposed, since hold harmless generally protects people who have the Part B premium deducted from Social Security and meet certain conditions.
And if you pay your premium directly (not deducted from a Social Security benefit), you may not get the same “net check” protection. This is where the COLA increase story splits into two experiences: one group sees a smaller-than-expected bump, while another group sees premiums jump more sharply. If you’ve had a life change that lowered your income, you may be able to appeal IRMAA to reduce the surcharge.
The Deductible Can Matter as Much as the Premium
Premiums get the headlines, but the Part B deductible also affects what you actually spend in a year. In 2026, the Part B deductible is $283, up from $257 in 2025. If you use outpatient services early in the year, that higher deductible can make January through March feel tighter even if your monthly check rose.
It’s another reason some people feel like their COLA increase “disappeared,” because the pressure shows up through cost-sharing, not just premiums. If you’re budgeting, plan for both the monthly premium and the annual deductible so the first quarter doesn’t become a surprise.
Budget Moves That Help the Increase Go Further
Start by reviewing your Medicare coverage costs now so you understand where your money is going, including any drug coverage premiums and copays. If your income is limited, check whether Medicare Savings Programs might help with premiums, because that can protect your monthly cash flow more than any small cut elsewhere. Consider using a simple “health sinking fund” in savings so doctor visits and pharmacy costs don’t spill into credit cards.
For higher-income retirees, managing taxable income can reduce the chance of IRMAA surcharges that make Part B much more expensive. If your premium is deducted from your Social Security check, track your net deposit in January so you can adjust your budget quickly instead of guessing.
A Fast Checklist to See If You’re at Risk
Write down your 2025 monthly Social Security amount and your new 2026 amount, then calculate the dollar difference. Next, confirm whether you’re paying the standard Part B premium or an income-adjusted amount based on your tax return from two years ago. Then check whether your Part B premium is deducted from your benefit or billed directly, because that can affect how protections show up for you.
Finally, estimate your expected outpatient care so you’re not caught off guard by the deductible and early-year spending. If anything looks off, start by calling Social Security for benefit questions and Medicare for coverage and billing questions, because guessing usually costs more.
The Real Win Is Keeping Your Raise in Your Life
Even if premiums rise, you can still make the year feel better by directing the COLA increase into the categories that create the most stress. The goal isn’t to obsess over every dollar—it’s to prevent a predictable premium change from turning into a budget shock. When you plan for premiums, the deductible, and any income adjustments, you keep more flexibility month to month. And if you find your net check barely changed, that’s your signal to review assistance programs, appeal surcharges if eligible, and tighten the budget in the easiest spots first. A COLA increase is still useful, but it works best when you give it a job instead of letting higher costs quietly claim it.
When you look at your January deposit, did it feel bigger, smaller, or about the same—and what expense is squeezing you most right now?
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