COLA Ledger

An independent reference — not affiliated with the Social Security Administration. Every figure traced to the government publication that produced it.

When Medicare takes the whole raise — and sometimes the whole check

The Part B premium is a flat $202.90 a month regardless of the size of the benefit it comes out of. At the top of the benefit distribution that is a nuisance. At the bottom it is most of the payment.

2026 Part B standard premium

$202.90

Deducted whole from every benefit it is withheld from. On a $500 monthly payment that is 40.6% of the check.

Hold-harmless break-even
$639.29in 2026
Beneficiaries below the premium
0retired workers, at the published bands
Premium as share of a $500 check
40.6%
Premium increase this year
+$18

What actually happens at the bottom

Three different things happen depending on where the benefit sits, and they are genuinely different calculations rather than smaller versions of the same one.

Small monthly benefits through the 2026 adjustment and premium
Benefit beforeAfter the adjustmentPremium chargedNet paymentBilled separately
$200$205$190.00$15
$300$308$193.00$115
$400$411$196.00$215
$500$514$199.00$315
$600$616$201.00$415
$700$719$202.90$516

The premium never drives the payment negative. Where it exceeds the benefit, the excess is billed rather than withheld — the payment simply stops at zero. Any calculator that returns a negative figure here is not modelling the programme.

What hold harmless does, and does not, do

Below about $639.29 a month, the 2.8% adjustment produces a smaller dollar increase than the +$18 premium increase. Section 1839(f) caps the premium so the net payment cannot fall.

With and without the hold-harmless cap, at the bottom of the ladder
Benefit beforePremium without the capPremium with the capNet with the capNet without it
$200$202.90$190.00$15$2
$300$202.90$193.00$115$105
$400$202.90$196.00$215$208
$500$202.90$199.00$315$311
$600$202.90$201.00$415$413
$700$202.90$202.90$516$516

The protection is real and it is narrow: it stops the net payment falling, and it does nothing about the fact that the raise has been fully consumed. Someone protected by hold harmless in a given year receives the same amount as last year — not less, and not more. The provision in full, with its four exclusions.

How many people are down here

SSA publishes the retired-worker population by monthly benefit amount. The bottom of that distribution is not a rounding error.

Retired-worker beneficiaries at the bottom of the distribution, December 2024
Monthly benefitBeneficiariesSharePremium as a share of the benefit
Less than 300.00559,3601.1%67.6%
300.00-399.90538,3251.0%50.7%
400.00-499.90602,2511.2%40.6%
500.00-599.90631,7951.2%33.8%
600.00-699.90656,5111.3%29.0%
3,300.00 or more4,090,6737.9%

Below $600 a month, the standard premium is more than a third of the entire payment. About 3.3% of retired workers receive less than $500 a month.

SSI is a different case entirely, and getting this wrong is the classic error

None of the above applies to a Supplemental Security Income payment. SSI recipients are categorically Medicaid eligible in most states, and their Part B premium is paid by the state under a Medicare Savings Program buy-in — not deducted from the payment. Subtracting $202.90 from the 2026 SSI federal rate is simply wrong, and the engine behind this site refuses to do it rather than returning a plausible wrong number. The SSI figures.

Common questions

What happens if the premium is larger than my benefit?

Nothing is paid out and the balance is billed separately rather than withheld. The payment does not go negative, and the calculators on this site show that case explicitly rather than returning a negative number.

Does hold harmless protect a very small benefit?

It protects it from falling, which is not the same as protecting it from being small. Below about $639.29 a month the Part B increase is capped at the beneficiary's own dollar adjustment, so the net payment holds — but it barely rises either.

Why would someone have a Social Security benefit that small?

A short earnings record, low lifetime earnings, an early claim, or a benefit on someone else’s record. SSA publishes the distribution and the bottom of it is not a rounding error: hundreds of thousands of retired workers sit there.

Is SSI the same situation?

No, and this is the most important distinction on the page. SSI recipients are categorically Medicaid eligible in most states and their Part B premium is paid by the state under a Medicare Savings Program buy-in. No premium should ever be deducted from an SSI payment.

Related

Sources and freshness

Figures effective January 2026. Page figures last verified against the sources above on 10 August 2026. Corrections: the correction log · support@inventum.com.au