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2027 COLA vs. Medicare Part B: Who the Hold-Harmless Rule Protects (and Who It Doesn’t)

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Updated August 24, 2026. Quick answer. The “hold harmless” rule protects most Social Security recipients from having their check shrink because Medicare Part B’s premium rose faster than their COLA — but it does not protect everyone, and it does not mean your net increase equals the full COLA percentage. Three groups are excluded entirely: people newly enrolling in Part B, anyone who pays Part B directly rather than having it deducted from a Social Security check, and anyone who pays the income-related IRMAA surcharge.

What the rule actually protects

Hold harmless (Social Security Act §1839(f)) guarantees that your Social Security check cannot go down in dollar terms because of a Part B premium increase — if the dollar increase in your Part B premium would exceed your dollar increase from the COLA, the premium increase is capped at whatever leaves your check unchanged. It says nothing about your check going up less than the full COLA; it only stops it from going down.

Who is not covered

  • New Medicare enrollees. If you first enroll in Part B during 2026, you are not protected by hold harmless for the 2027 premium change — you pay the full increase.
  • Anyone billed directly by CMS. If your Part B premium isn’t deducted from a Social Security check (because you haven’t claimed benefits yet, or you pay Medicare directly), hold harmless doesn’t apply — there’s no check for it to protect.
  • IRMAA payers. If your income triggers the income-related surcharge (roughly $109,000+ single / $218,000+ joint on the 2025-income basis that sets 2027 premiums — see the 2027 IRMAA brackets), the surcharge portion of your premium is not protected by hold harmless.
The three tests 42 U.S.C. section 1395r(f) applies, drawn on a September 2026 to February 2027 calendarA six-month calendar. Test 1, entitlement to monthly benefits, spans November and December 2026. Test 2, the Part B premium being deducted from those benefit payments, spans December 2026 and January 2027. Test 3, that January premium not being adjusted for income under subsection (i), falls on January 2027. Below them, the two benefit payments the cap rule compares: the November benefit, which arrives in December with December’s premium deducted, and the December benefit, which arrives in January with January’s premium deducted. The second, after its premium, cannot fall below the first.The two months that decide itwhat 42 U.S.C. §1395r(f) — Social Security Act§1839(f) — actually testsand the group each test leaves outSepOctNovDecJanFeb20262027Test 1 · entitled to benefits“entitled to monthly benefits … forNovember and December of the preceding year”left out: anyone not yet claiming SocialSecurityTest 2 · premium deducted from those benefits“the monthly premium … for December andfor January is deducted from those benefits”left out: anyone billed directly by CMS — andanyone with no December premium to deductTest 3 · that January’s premium notincome-adjusted“the amount of the individual’s premium is notadjusted for such January under subsection (i)”left out: anyone paying the IRMAA surchargeIf all three hold, the cap applies to these twochecksthe November benefit · arrives in December ·December’s premium deductedthe December benefit · arrives in January ·January’s premium deductedThe rule: the second of these, after theJanuary premium, cannot come out below thefirst, after the December premium.Clear Money Guide · 42 U.S.C. §1395r(f) (Social Security Act§1839(f)), and CMS, Federal Register 2025-20251 · CC BY 4.0
Hold harmless is decided in a two-month window, and the calendar is the part that trips people up. The statute is one sentence with three tests in it, all of them dated. What it compares is not two premiums but two checks — and as CMS puts it in the notice that set the 2026 premium, “a benefit check for November is not received until December, but December’s Part B premium has been deducted from it.” So the comparison runs between the payment that arrives in December and the one that arrives in January, each net of its own premium. When the tests are met, CMS applies the protection for that January “and for each of the succeeding 11 months” — it holds for the whole year, not one payment. The three groups this page names as excluded each fail one of these tests, which is where the exclusions come from. CC BY 4.0.

The net-check math, worked through

Say your 2026 benefit is $2,200/month and the COLA lands at 3.6% — a $79.20 increase. If your Part B premium rises from $202.90 to a projected $209.50–219, that’s a $6.60 to $16.10 increase. For a hold-harmless-protected recipient, the premium increase can never exceed the COLA dollar increase, so the check still rises — just by less than the full 3.6% once the premium is netted out. An IRMAA payer or new enrollee sees the full premium increase land on top, with no such floor.

The monthly Social Security benefit below which the hold-harmless cap bound, every payment year from 2010 through 2026, with 2027 drawn as an empty row17 horizontal rows, one per payment year: 2010, every protected beneficiary; 2011, every protected beneficiary; 2012, no premium increase; 2013, $294; 2014, no premium increase; 2015, no premium increase; 2016, every protected beneficiary; 2017, $4,067; 2018, no premium increase; 2019, $54; 2020, $569; 2021, $300; 2022, $366; 2023, no premium increase; 2024, $306; 2025, $412; 2026, $639. In 3 years the COLA was 0.0%, so there was no dollar increase to cap against and the provision bound for every protected beneficiary. In 5 years the standard premium did not rise, so there was nothing to cap. The 2027 row is drawn as an open dashed outline with a question mark: neither the 2027 premium nor the 2027 COLA has been announced.How small a check has to be before thecap actually bitesthe monthly Social Security benefit below which§1395r(f) held the Part B increase downannounced premium increase ÷ announcedCOLA, every payment year 2010–20262010allCOLA 0.0% — no dollar increase to capagainst, so the premium could not rise atall for anyone protected2011allCOLA 0.0% — no dollar increase to capagainst, so the premium could not rise atall for anyone protected2012the standard premium fell (−$15.50) —nothing to cap2013$2942014the standard premium did not rise2015the standard premium did not rise2016allCOLA 0.0% — no dollar increase to capagainst, so the premium could not rise atall for anyone protected2017$4,067COLA 0.3% against a $12.20 premium rise —above almost every benefit. CMS:“approximately 70 percent of Part Benrollees will be held harmless”2018the standard premium did not rise2019$542020$5692021$3002022$3662023the standard premium fell (−$5.20) —nothing to cap2024$3062025$4122026$6392027?neither input is announced — no bar isdrawn$0$200$400$600monthly Social Security benefitClear Money Guide · Part B standard premiums from the 18Federal Register notices that announced them (2008–2025);COLAs from SSA’s published series · CC BY 4.0
The protection matters enormously in some years and almost not at all in others — and which kind of year it is turns on the COLA. Each row is the announced Part B standard-premium increase divided by the announced COLA: the monthly benefit at which a dollar of premium increase exactly eats a dollar of raise, and so the level below which §1395r(f) held the increase down. In 8 of these 17 years that level sat between $54 and $639 a month, well under most benefits, and in 5 more the standard premium did not rise at all, so there was nothing to cap. But in the 3 years drawn full width the COLA was 0.0% and there was no dollar increase to cap against at all, and in 2017 a 0.3% COLA against a $12.20 premium rise put the level at $4,067 — above almost every benefit in the country. CMS’s own notices confirm both: approximately 70% of Part B enrollees were held harmless for 2017, and for 2016 “the majority of Part B enrollees were held harmless and paid a premium of $104.90” instead of the $121.80 standard. Two honest limits. This is arithmetic on the standard premium, so someone already held harmless from an earlier year faces a different increase of their own. And nothing is plotted for 2027: on the projections this site publishes — a 3.5–3.6% COLA, and a premium of $209.50 (Medicare Trustees) to $219 (private forecasters) against 2026’s $202.90 — the level would land near $183–$460, but not one of those inputs is announced, so the row stays open. CC BY 4.0.

Sources

Social Security Act §1839(f) (the statutory hold-harmless provision). Premium figures: see the 2027 Part B premium projections and the 2027 COLA projection, both attributed and not yet official.

Every projected figure above is attributed to the organization that published it and is explicitly not yet announced by the government body that sets it. This page will be updated with the official figure the day it is announced, and the projection will be struck through rather than deleted, so the record of what was projected vs. what actually happened stays visible. See the full current-numbers register for every figure this site tracks, dated and sourced. General information, not tax or legal advice.

Whether hold-harmless bites in 2027 turns on two figures that do not exist yet: the COLA and the Part B premium. Your 2027 numbers tracks what is already settled for 2027 and when each of these two is published.

More Medicare & IRMAA guides: see the full 44-page index.

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