Medicare Costs in 2026: Premiums, IRMAA, Deductibles & What You'll Pay
Complete breakdown of 2026 Medicare costs. Part A, Part B, Part D premiums, IRMAA surcharges by income, deductibles, coinsurance, Medigap, and late enrollment penalties.
1. Medicare Cost Overview
Here's what most people pay for Medicare in 2026:
| Part | Covers | Monthly Cost |
|---|---|---|
| Part A | Hospital, skilled nursing, hospice | $0 (most people) |
| Part B | Doctors, outpatient, preventive | $202.90 |
| Part D | Prescription drugs | ~$39.00 |
| Medigap (optional) | Covers gaps in Original Medicare | $100-$250 |
| Total | $242 - $492+ |
2. Part A (Hospital Insurance)
Premiums
- 40+ quarters (10+ years worked): $0
- 30-39 quarters: $311/month
- Under 30 quarters: $565/month
Deductible & Coinsurance
- Deductible: $1,736 per benefit period
- Days 1-60: $0 (after deductible)
- Days 61-90: $434/day
- Days 91+ (lifetime reserve): $868/day
3. Part B (Medical Insurance)
- Standard premium: $202.90/month
- Annual deductible: $283
- After deductible: you pay 20% coinsurance (no annual cap)
- The lack of an out-of-pocket cap is why many people buy Medigap
4. IRMAA Surcharges by Income
Higher earners pay more for Part B and Part D. IRMAA is based on your 2024 MAGI (Modified Adjusted Gross Income from 2 years prior).
Part B IRMAA (2026)
| Single MAGI | Joint MAGI | Part B/mo | Part D Surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| $109,001-$137,000 | $218,001-$274,000 | $284.10 | $14.50 |
| $137,001-$171,000 | $274,001-$342,000 | $405.80 | $37.50 |
| $171,001-$205,000 | $342,001-$410,000 | $527.50 | $60.40 |
| $205,001-$499,999 | $410,001-$749,999 | $649.20 | $83.30 |
| $500,000+ | $750,000+ | $689.90 | $91.00 |
IRMAA Cost Impact
At the highest bracket, you pay $689.90/month for Part B + $91/month Part D surcharge = $780.90/month total. That's $9,371/year just in premiums vs. $2,903/year at the standard rate. The difference: $6,468/year in IRMAA surcharges.
5. Part D (Prescription Drugs)
- Base premium: $38.99/month (actual plan premiums vary)
- Maximum deductible: $615 (some plans have lower or $0)
- Annual out-of-pocket cap: $2,100 (new under Inflation Reduction Act)
- After hitting cap: $0 for covered drugs rest of year
- IRMAA surcharges: up to $91/month for high earners
The $2,100 annual cap (up from $2,000 in 2025) is the biggest recent change to Medicare. Before 2025, there was no cap, and some beneficiaries faced $10,000+ in annual drug costs.
6. Medigap Supplement Plans
Original Medicare (Parts A + B) has no annual out-of-pocket maximum. The 20% Part B coinsurance is unlimited. Medigap plans cover these gaps:
Plan G (Most Popular)
- Covers: Part A deductible, Part B coinsurance (20%), skilled nursing coinsurance, Part A hospice coinsurance, foreign travel emergency
- Does NOT cover: Part B deductible ($283/year)
- Cost: $100-$250/month depending on age, location, insurer
- Best value for most people since Plan F is closed to new enrollees
Medigap only works with Original Medicare. If you choose Medicare Advantage (Part C), you cannot use Medigap. Medicare Advantage plans have their own cost structures and out-of-pocket maximums.
7. Late Enrollment Penalties
Missing your enrollment window has permanent consequences:
Part B Penalty
+10% per year of the standard premium for each full 12 months you delayed. Permanent. Example: delay 3 years = 30% surcharge = $202.90 + $60.87 = $263.77/month for life.
Part D Penalty
+1% per month of the base premium for each uncovered month (63+ consecutive days without creditable coverage). Permanent. Example: 24 months uncovered = 24% x $38.99 = +$9.36/month for life.
The Bottom Line
Medicare is not free. Most people pay at least $242/month in premiums, plus deductibles and coinsurance. Higher earners can pay $780+/month due to IRMAA surcharges. The biggest cost variables are your income (IRMAA), whether you buy Medigap, and your prescription drug needs.
Use our Medicare Cost Calculator to estimate your total costs based on your specific income and coverage choices.
Disclaimer: 2026 costs from CMS.gov. Part D premiums vary by plan. Medigap costs vary by insurer, age, and location. This is informational only, not insurance advice.
Frequently Asked Questions
How much will I pay for Medicare in 2026?
Baseline: $0 for Part A + $202.90/month for Part B + ~$39/month for Part D = about $242/month. Higher earners pay IRMAA surcharges up to $781/month total. Add $100-250/month for Medigap if you want supplement coverage. Total range: $242 to $1,000+/month depending on income and coverage choices.
What income triggers IRMAA surcharges in 2026?
IRMAA kicks in at $109,001 (single) or $218,001 (married filing jointly) based on your 2024 MAGI. At the first bracket, Part B goes from $202.90 to $284.10/month. At the highest bracket ($500K+ single / $750K+ joint), Part B is $689.90/month plus $91/month Part D surcharge.
How much is the Part A deductible in 2026?
The Part A deductible is $1,736 per benefit period (up from $1,676 in 2025). This applies each time you're admitted to a hospital. If you're discharged and readmitted within 60 days, it's the same benefit period. After 60 days out, a new benefit period (and new deductible) begins.
What is the Part D $2,100 out-of-pocket cap?
Starting in 2025 under the Inflation Reduction Act, Part D has an annual out-of-pocket cap ($2,100 in 2026, up from $2,000 in 2025). Once you hit this cap, you pay $0 for covered drugs for the rest of the year. This was a major change — previously there was no annual cap.