Medicare Costs and Premiums Explained for 2026

Medicare Part A Costs

Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. Most people do not pay a premium for Part A because they or their spouse paid Medicare taxes for at least 40 quarters (10 years) while working.

Even with premium-free Part A, you still pay cost-sharing when you use hospital services:

• Part A deductible: $1,676 per benefit period in 2026. A benefit period begins when you are admitted to a hospital and ends when you have been out for 60 consecutive days.
• Hospital coinsurance: Days 1-60: $0 per day (after deductible). Days 61-90: $419 per day. Lifetime reserve days (60 total): $838 per day.
• Skilled nursing facility: Days 1-20: $0 per day. Days 21-100: $209.50 per day. After 100 days: You pay all costs.

If you did not work enough quarters to qualify for premium-free Part A, the premium is up to $518 per month in 2026.

Medicare Part B Costs

Medicare Part B covers doctor visits, outpatient services, preventive care, medical equipment, and some home health services. Everyone enrolled in Part B pays a monthly premium.

The standard Part B premium for 2026 is $185 per month. Higher-income beneficiaries pay more through Income-Related Monthly Adjustment Amounts (IRMAA). If your modified adjusted gross income exceeds $106,000 (individual) or $212,000 (married filing jointly), your Part B premium will be higher.

IRMAA surcharges for Part B in 2026 range from an additional $74.00 to $395.60 per month depending on your income bracket. IRMAA is based on your tax return from two years prior.

The Part B annual deductible is $257 in 2026. After meeting the deductible, you typically pay 20% coinsurance for most Part B services. There is no annual out-of-pocket maximum with Original Medicare, which is why many people purchase Medigap insurance.

Medicare Part D Costs

Medicare Part D prescription drug plans have monthly premiums that vary by plan. The average Part D premium is approximately $40 per month in 2026, with plans ranging from about $7 to over $100.

High-income beneficiaries also pay IRMAA surcharges on Part D premiums, ranging from $13.70 to $81.00 per month depending on income.

The maximum Part D deductible for 2026 is $590, though many plans have lower or $0 deductibles. After the deductible, you pay copays or coinsurance for your prescriptions until reaching the annual out-of-pocket cap.

Thanks to the Inflation Reduction Act, total out-of-pocket spending on Part D drugs is capped at $2,000 per year starting in 2025. This is a significant cost protection that eliminates the old coverage gap (donut hole) and reduces catastrophic costs.

Medicare Advantage Costs

Medicare Advantage plan costs vary by plan but include several components:

You continue paying the Part B premium ($185/month) regardless of which MA plan you choose. Many MA plans charge an additional monthly premium, though a significant number offer $0 premium plans.

When you use services, you pay copayments (fixed dollar amounts) or coinsurance (percentage of costs) that vary by service type and plan. Common copays include $0-$20 for primary care visits, $20-$50 for specialist visits, and $250-$500 per hospital admission.

All Medicare Advantage plans must cap annual out-of-pocket spending. For 2026, the maximum allowed out-of-pocket limit is $8,850 for in-network services. Many plans set their limits lower, typically between $3,000 and $7,500.

MA plans with prescription drug coverage include Part D costs within the plan's cost-sharing structure.

Medigap (Medicare Supplement) Costs

Medigap premiums depend on the plan letter, insurance company, your age, location, gender, and tobacco use. Unlike Medicare Advantage, there is no standard pricing.

Typical monthly premium ranges by plan type: - Plan G: $100-$300+ per month - Plan N: $80-$220+ per month - Plan F (pre-2020 eligibles only): $120-$350+ per month

With Medigap, your out-of-pocket costs for Medicare-covered services are minimal or zero (depending on plan type) because the supplement covers most or all cost-sharing. This predictability is the primary advantage of Medigap over Medicare Advantage.

The total monthly cost for Original Medicare + Medigap + Part D typically ranges from $300 to $500+ per month (Part B + Medigap + Part D premiums combined), compared to $185-$250 per month for most Medicare Advantage plans. The trade-off is provider freedom and cost predictability.