Medicare Part B premiums are projected to increase by several hundred dollars per month in 2026 for beneficiaries who had significant capital gains in 2024 [1, 2, 3].
This surge affects retirees because the Social Security Administration uses a two-year look-back period to determine Modified Adjusted Gross Income. A large asset sale from 2024 can trigger an Income-Related Monthly Adjustment Amount, known as an IRMAA surcharge, which adds to the standard premium [1, 3].
For 2026, the standard Part B premium is $202.90 per month [3]. However, crossing the $109,000 MAGI threshold by one dollar for a single filer jumps that monthly premium to $284.10 [3].
Larger gains result in steeper costs. A $300,000 gain can push a single retiree's IRMAA surcharge to roughly $483 per month [1]. Some retirees could pay nearly $700 per month for Medicare in 2026 due to these surcharges [2].
These premium hikes may offset other financial gains. The Social Security cost-of-living adjustment for 2026 is 2.8% [5]. Some reports indicate the overall Medicare premium increase in 2026 will be close to 10% [6].
Beneficiaries who experience a significant drop in income after a one-time asset sale may be able to challenge the surcharge. The IRMAA process relies on tax data from two years prior, meaning 2024 financial activity directly dictates 2026 costs [1, 3].
“A $300,000 gain can push a single retiree's IRMAA surcharge to roughly $483/month”
The two-year look-back rule creates a financial lag that can penalize retirees for one-time liquidity events, such as selling a second home or a business. Because the IRMAA surcharge is based on past income rather than current cash flow, beneficiaries may face high monthly premiums even if their current annual income has returned to a lower level.
