2027 Medicare Part B Premium: $209.50 Projected, What to Budget

Last Updated: June 28, 2026 Reading Time: 8 min

The 2026 Medicare Trustees Report projects the 2027 Medicare Part B premium at $209.50 a month, up from the confirmed $202.90 in 2026. That is a projection, not a final number, and CMS won't confirm the official 2027 rate until November 2026. But after two straight years of steep increases, 2027 looks like a gentler year, and it's the right time for federal retirees to plan around it. The catch: a FERS retiree and a CSRS retiree will feel this increase very differently.

Key Takeaways

  • Projected 2027 Part B premium: $209.50/month, up $6.60 (3.25%) from 2026's $202.90. Source: 2026 Medicare Trustees Report (June 9, 2026).
  • This is the smallest projected percentage increase since 2023, when premiums actually fell.
  • The 2027 COLA estimate is 3.6% (CSRS/Social Security) but only about 2.6% for most FERS retirees because of the diet-COLA rule.
  • CSRS retirees without Social Security get no hold-harmless protection and absorb the full increase.
  • Your 2027 IRMAA surcharge is based on your 2025 income, a trap for anyone who retired with a big final-year payout.

Every 2027 figure here is a projection from the Trustees Report. CMS announces the official 2027 premium, deductible, and IRMAA brackets in November 2026.

Where $209.50 Fits in the Premium Trend

Part B premiums have climbed steadily, with two notable jumps. The table below shows confirmed history and the 2027 projection.

Year Monthly premium Change Driver
2023 $164.90 -3.1% Aduhelm reserve released (only recent decrease)
2024 $174.70 +5.9% Return to baseline trend
2025 $185.00 +5.9% GLP-1 drug costs
2026 $202.90 +9.7% GLP-1 expansion, procedure costs
2027 $209.50 (projected) +3.25% Moderation from the 2026 spike

The Trustees Report projects premiums resume climbing after 2027: about $224.50 in 2028 and $238.50 in 2029. So 2027's pause is real, but it's a pause, not a reversal.

Why 3.25% Still Pinches FERS Retirees

On paper, a 3.6% COLA beats a 3.25% premium increase. For federal retirees, the math is not that simple.

Under 5 U.S.C. 8462(b), FERS retirees do not get the full COLA when inflation runs high. They receive:

  • The full CPI-W increase when inflation is under 2%
  • A flat 2.0% when inflation is 2% to 3%
  • CPI-W minus 1 percentage point when inflation is 3% or higher

If the final 2027 COLA lands at 3.6%, most eligible FERS retirees get about 2.6%, which trails the projected 3.25% Part B increase. CSRS retirees and Social Security recipients get the full 3.6%, so they stay slightly ahead.

Here is the net picture for a $3,000/month FERS annuity, showing how Part B eats into the raise.

Year Part B monthly FERS COLA Net effect on a $3K/mo FERS annuity
2025 $185.00 2.0% +$60 COLA, Part B +$10.30, net +$49.70/mo
2026 $202.90 2.0% +$60 COLA, Part B +$17.90, net +$42.10/mo
2027 $209.50 (proj) ~2.6% (est) ~+$78 COLA, Part B +$6.60, net ~+$71.40/mo

In 2026, the $17.90 premium jump swallowed a big chunk of the FERS raise. In 2027, the smaller $6.60 increase leaves more of the COLA intact. That's the silver lining of a moderate year.

The Hold-Harmless Gap Federal Retirees Miss

The hold-harmless provision keeps a Social Security check from shrinking because of a Part B increase. It sounds universal. It is not.

You are protected if your Part B premium is deducted from a Social Security or Railroad Retirement check.

You are NOT protected if you fall into any of these groups, several of which are common for feds:

  • CSRS retirees without Social Security. Hired before 1984 and never paid into Social Security? You are billed directly by CMS and absorb 100% of every increase.
  • FERS retirees who retired before claiming Social Security and pay Part B by direct quarterly billing.
  • Anyone enrolling in Part B for the first time, who has no prior-year premium to protect.
  • IRMAA payers at any income tier.

NARFE supports H.R. 3696, the Medicare Premium Fairness Act, which would extend hold-harmless protection to CSRS retirees. As of June 2026, it has not passed.

The 2025 Income Look-Back That Catches New Retirees

Your 2027 IRMAA surcharge is based on your 2025 MAGI. For 2026, IRMAA starts at $109,000 for single filers and $218,000 for joint. The Finance Buff projects the 2027 first threshold near $112,000 single and $224,000 joint, but CMS won't confirm until November 2026.

The trap: a high-income final working year can push you over a threshold two years later. Watch for these 2025 events:

  • A lump-sum annual leave payout at retirement (can be 400+ hours of pay in one check)
  • TSP withdrawals or Roth conversions
  • Social Security Fairness Act retroactive back-pay (signed January 2025)

If any of those inflated your 2025 income, check it against the projected 2027 brackets now, while you still have planning options.

Model Your FEHB and Medicare Costs

Deciding how Part B fits with your FEHB plan is the bigger question behind the premium number. Use our free FEHB Premium Calculator to compare your plan options, then the FERS Retirement Calculator to estimate your gross annuity before netting out Part B. Compare your FEHB costs.

Frequently Asked Questions

What is the projected Medicare Part B premium for 2027?

The 2026 Medicare Trustees Report, published June 9, 2026, projects the standard monthly Part B premium at $209.50 in 2027, up from the confirmed $202.90 in 2026. That's a $6.60/month increase (3.25%). It's a projection. CMS announces the official 2027 rate in November 2026.

Will the 2027 COLA offset the Part B increase for federal retirees?

It depends on your system. The 2027 COLA estimate is 3.6% (CSRS and Social Security), which beats the 3.25% Part B projection. But FERS retirees get COLA minus 1 point when inflation tops 3%, so roughly 2.6% projected, slightly behind the Part B increase. CSRS retirees come out a bit ahead in 2027.

Are CSRS retirees protected from Medicare Part B increases?

Often not. The hold-harmless rule protects Social Security beneficiaries whose Part B is deducted from their SS check. CSRS retirees without Social Security are billed directly by CMS and get no hold-harmless protection, so they absorb 100% of any increase. NARFE backs H.R. 3696 to fix this, but it has not passed as of June 2026.

What 2025 income determines my 2027 IRMAA surcharge?

2027 IRMAA is based on your 2025 MAGI, a two-year look-back. Federal employees who retired in 2025 with a lump-sum annual leave payout, took TSP withdrawals or Roth conversions, or received Social Security Fairness Act back-pay may have crossed a threshold without realizing it. Check your 2025 MAGI against the projected 2027 brackets.