The standard Part B premium in 2026

In 2026, the standard Medicare Part B premium is $202.90 per month. That is the amount most people in Charlotte and across North Carolina pay, regardless of which county they live in — Part B is a federal program, so the premium is the same in Mecklenburg County as it is anywhere else in the country.

Alongside the premium, Part B has an annual deductible of $283 in 2026. After you meet that deductible, Original Medicare generally pays 80% of the Medicare-approved amount for covered services, and you pay the remaining 20% coinsurance. It is worth knowing that Original Medicare has no annual out-of-pocket cap on that 20% — which is one of the main reasons many people pair it with a Medicare Supplement (Medigap) policy or choose a Medicare Advantage plan instead.

What that monthly premium buys you

Part B is the "medical" side of Original Medicare. Your premium covers the outpatient half of your care:

  • Doctor visits and outpatient care — physician services, specialist visits, outpatient hospital care, and mental health services
  • Preventive services — many at no cost to you when you use a Medicare-approved provider who accepts assignment, including the annual Wellness visit, many vaccines, and a range of covered screenings
  • Durable medical equipment — wheelchairs, walkers, oxygen equipment, and blood-sugar monitors your doctor prescribes for home use
  • Lab tests, outpatient surgery, ambulance services, and outpatient therapy

Who pays more: the income-related adjustment (IRMAA)

Not everyone pays the standard $202.90 in 2026. If your income is above a certain level, Medicare adds a surcharge called IRMAA — the Income-Related Monthly Adjustment Amount.

  • In 2026, IRMAA begins when your modified adjusted gross income (MAGI) is above $109,000 for an individual or $218,000 for a married couple filing jointly.
  • The first bracket adds $284.10 per month to your Part B premium in 2026 (and $14.50 per month to Part D, if you have drug coverage). Higher incomes pay more in higher brackets.
  • Here is the detail that surprises many people: IRMAA is based on your tax return from two years prior. Your 2026 premium uses your 2024 income. So a strong final working year, a large IRA withdrawal, or the sale of a Charlotte-area home in 2024 can raise your Medicare premium in 2026 — even if you have since retired and your income has dropped.

If your income has fallen because of a life-changing event such as retirement, you may be able to ask Social Security to reconsider the surcharge. This is a common conversation for people retiring in the Charlotte area, and it is worth having before you simply accept the higher bill.

Who pays less: help for limited incomes

On the other end, North Carolina residents with limited income and resources may qualify for a Medicare Savings Program, administered through the state's Medicaid program:

  • QMB (Qualified Medicare Beneficiary) — the most generous; helps pay Part A and Part B premiums plus deductibles, coinsurance, and copayments
  • SLMB (Specified Low-Income Medicare Beneficiary) — helps pay the Part B premium only
  • QI (Qualifying Individual) — also helps pay the Part B premium only, for incomes just above the SLMB level; it is first-come, first-served each year

Income and resource limits are set at the state level and change yearly, so check with the North Carolina Medicaid office, your local SHIP counselor, or 1-800-MEDICARE for the current figures. A helpful bonus: qualifying for any of these programs also automatically qualifies you for Extra Help with Part D drug costs.

The late enrollment penalty — why timing matters

If you delay Part B without qualifying coverage, the premium goes up permanently. The Part B late enrollment penalty adds 10% for each full 12-month period you could have had Part B but didn't sign up — and it lasts for life. It is calculated on top of whatever the premium is each year.

That is why the enrollment windows matter so much. Your Initial Enrollment Period is the 7-month window around your 65th birthday: the 3 months before your birth month, your birth month, and the 3 months after. If you miss it and don't qualify for a special exception, the General Enrollment Period runs January 1 through March 31 each year. If you're still working past 65 with employer coverage — common in Charlotte's banking and healthcare workforce — the rules for delaying Part B without penalty depend on your specific situation, so it pays to confirm your timing before you turn 65 rather than after.

How you actually pay the bill

If you receive Social Security benefits, the Part B premium is deducted automatically from your monthly benefit — most people never write a check. If you are delaying Social Security, Medicare bills you directly instead. Either way, the premium amount is the same.

Does Medicare Advantage or Medigap change the Part B premium?

No — and this trips up a lot of people. Whether you stay on Original Medicare, add a Medicare Supplement (Medigap) policy, or enroll in a Medicare Advantage plan, you keep paying your Part B premium. A Medicare Advantage plan with a low or $0 plan premium does not replace the Part B premium; it sits on top of it. When you compare your total costs, always start with the Part B premium as the baseline and add plan premiums, deductibles, and copays from there.

How The Jordan Insurance Agency helps

The Jordan Insurance Agency is an independent, full-time, licensed insurance agency in Charlotte, North Carolina, serving clients across the state. Because we are independent, we represent multiple carriers rather than one company's products, and our agents complete annual AHIP and carrier certifications, carry errors-and-omissions coverage, and review your coverage every year at renewal — including checking whether an income change should trigger an IRMAA reconsideration or whether you might qualify for a Medicare Savings Program.

Here is the part people appreciate most: working with us costs you nothing extra. The insurance carrier pays the agent, and your premium is exactly the same whether you enroll on your own or with our help. If you're approaching 65 in Charlotte or anywhere in North Carolina and want to understand what Part B will actually cost you — standard premium, possible surcharges, and how to avoid the late penalty — reach out to The Jordan Insurance Agency and we'll walk through it in plain English.

Plan availability & disclaimer

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. The Jordan Insurance Agency is not connected with or endorsed by the United States government or the federal Medicare program.