Medicare Costs

What Medicare costs in 2026 — the overview

Medicare isn’t one bill — it’s a stack of premiums, deductibles, and coinsurance across Parts A, B, and D, plus whatever plan you add on top. Here’s the whole picture for 2026; the detailed breakdowns follow further down this page.

• Part A (hospital): premium-free for most people — if you or your spouse paid Medicare taxes for at least 40 quarters (about 10 years of work). If you don’t have enough quarters, a monthly premium applies. The 2026 hospital deductible is $1,736 per benefit period.
• Part B (doctors & outpatient): the standard premium is $202.90 a month in 2026, with a $283 annual deductible. After that you pay 20% of the Medicare-approved amount for most services — and under Original Medicare alone, that 20% has no annual cap.
• IRMAA (higher-income surcharge): if your income is above the annual threshold, you pay an income-related monthly adjustment amount on top of your Part B and Part D premiums. It’s based on your tax return from two years earlier.
• Part D (prescriptions): a separate premium that varies by plan, plus cost-sharing — but in 2026 your out-of-pocket on covered drugs is capped at $2,100 for the year. Full details are in the Part D section below.
• Medicare Advantage (Part C): bundles A, B, and usually D into one plan, often at a low or $0 premium — though you still pay your Part B premium. Each plan sets its own copays and an annual in-network out-of-pocket maximum (as high as $9,250 in 2026, though most plans set theirs lower).
• Medicare Supplement (Medigap): an extra monthly premium that covers most or all of the gaps Original Medicare leaves — trading a predictable monthly cost for far fewer surprise bills.
• What changes every year: premiums, deductibles, the Part D out-of-pocket cap, and plan copays all reset annually. Every figure on this page is a 2026 number.

Medicare Part D (prescription drugs)

• Medicare Part D is administered by private insurance companies.
• Each company determines its monthly premium, along with what drugs are on formulary, on which tier, and copay amounts.
• What you pay for prescriptions depends on:
  • the drug
  • whether the plan has a deductible
  • what tier each drug is on
  • what phase you are in (deductible, initial coverage, catastrophic)
  • what pharmacy you use
  • whether you qualify for Extra Help
• How costs are structured in 2026 (the old “donut hole” coverage gap was eliminated in 2025):
  • Deductible phase: you pay 100% of your drug costs until you meet the plan’s deductible (no more than $615 in 2026)
  • Initial coverage phase: you pay copays/coinsurance until your out-of-pocket spending reaches the annual cap
  • Annual out-of-pocket cap: once you have spent $2,100 out of pocket on covered drugs (2026), you pay $0 for covered drugs for the rest of the year (the catastrophic phase)
  • There is no longer a coverage gap (“donut hole”) where your costs jump in the middle of the year
• Late enrollment penalty:
  • Calculated by multiplying 1% of the “national base beneficiary premium” ($38.99 in 2026) times the number of full, uncovered months you didn’t have Part D or other creditable coverage
  • The result is rounded to the nearest $0.10 and added to your monthly Part D premium
  • The national base beneficiary premium may increase each year, so your penalty amount may also increase each year
  • It is added for as long as you have Medicare drug coverage, even if you switch plans
  • You may owe the penalty if you go 63 or more continuous days without Part D, without a Medicare Advantage plan (or other Medicare health plan) that offers drug coverage, or without other creditable prescription drug coverage — after your Initial Enrollment Period is over
• Medicare Part D information (medicare.gov)
• How much Medicare drug coverage costs (medicare.gov)
• Help with drug costs (medicare.gov)
• GoodRx — find prescription savings

Extra Help (prescription cost assistance)

• Anyone who has Medicare can get Medicare prescription drug coverage.
• Some people with limited resources and income may be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan.
• Income limit (2026 figures):
  • Annual income generally must be at or below $23,475 for an individual, or $31,725 for a married couple living together (about 150% of the federal poverty level)
  • Higher limits apply in Alaska ($29,925 single / $40,575 married) and Hawaii ($27,540 single / $37,335 married)
  • As of 2024, partial Extra Help was eliminated — everyone who qualifies now receives the full benefit
• Resources limit (2026 figures):
  • Must be at or below $18,090 for an individual or $36,100 for a married couple living together (these include a $1,500-per-person burial set-aside; without it, the limits are $16,590 and $33,100)
  • Countable resources include: bank accounts (checking, savings, CDs); stocks; bonds, including U.S. Savings Bonds; mutual funds; IRAs; cash at home or anywhere else
  • Excludes your home, car, and life insurance
• If in doubt, apply.
• How to apply:
  • Apply online at secure.ssa.gov/i1020/start (English or Español)
  • Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply by phone or request a paper application
  • Or apply at your local Social Security office
• Apply for Extra Help online (Social Security)