2026 Medicare Costs Guide
Introduction: Making Sense of Medicare Expenses
Welcome to your straightforward guide to Medicare costs. If you're new to the system, understanding the expenses can feel overwhelming. This guide is designed to make it simple by clearly explaining the primary costs associated with Original Medicare for the year 2026.
Original Medicare is the foundational health coverage provided by the federal government and is composed of two main parts:
• Part A (Hospital Insurance): Helps cover your costs if you are admitted to a hospital.
• Part B (Medical Insurance): Helps cover doctor visits and other outpatient services.
Throughout this guide, we'll break down key terms like premium, deductible, and co-pay in simple, easy-to-understand language so you can feel confident about how your healthcare costs are structured.
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1. Understanding Medicare Part A (Hospital Insurance) Costs for 2026
1.1. What Part A Covers
Part A is often called "Hospital Insurance" because its main job is to cover the costs of inpatient care. Key services covered by Part A include:
• Inpatient hospital care
• Skilled nursing facility care (for intensive rehabilitation after a hospital stay)
• Hospice care
1.2. Your Part A Costs: A Detailed Breakdown
Here is a look at the specific costs you can expect with Medicare Part A in 2026.
Monthly Premium For about 99% of people, the monthly premium for Part A is $0. This is because you or your spouse pre-paid for it through FICA or self-employment taxes during your working years. As long as you have at least 40 quarters (the equivalent of 10 years) of work history, you will not have a monthly Part A premium. This work history can be your own, or it can be based on the record of a current spouse, ex-spouse, or even a deceased spouse.
Hospital Deductible The Part A hospital deductible for 2026 is $1,736.
It's crucial to understand that this is not an annual deductible. Instead, it's tied to what Medicare calls a "benefit period."
Imagine you are hospitalized on March 1st. You pay the $1,736 deductible. You are discharged on March 8th. Your "benefit period" clock starts now. If you are re-admitted for any reason before May 7th (60 days after discharge), you pay nothing more for your hospital stay. But if you are re-admitted on May 8th or later, a new benefit period begins, and you must pay the $1,736 deductible again.
Key Insight: This single $1,736 deductible covers all of your hospital costs for the first 60 continuous days of an inpatient stay within a single benefit period.
Extended Stay Co-payments These costs only apply if you have a continuous hospital stay that lasts longer than 60 days, which is quite rare.
• Days 61-90: You pay a co-payment of $434 per day.
• Days 91 and beyond: You pay $868 per day. For these days, you start using your 60 "lifetime reserve days."
Once you use your 60 lifetime reserve days, they are gone forever and cannot be renewed.
Skilled Nursing Facility Co-payment To qualify for this benefit, you must first have been admitted as an inpatient to a hospital for at least three full days (72 hours), an event sometimes called "three midnights." Following that qualifying hospital stay, your costs are:
• Days 1-20: You pay $0.
• Days 21-100: You pay a co-payment of $217 per day.
Now that you understand the costs for hospital stays, let's look at the expenses for doctor visits and other outpatient services under Part B.
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2. Understanding Medicare Part B (Medical Insurance) Costs for 2026
2.1. What Part B Covers
Part B is your "Medical Insurance." It covers a wide range of outpatient services and supplies that are medically necessary. The primary services covered by Part B include:
• Doctor services, including visits to primary care doctors, specialists, surgeons, and hospitalists.
• Outpatient services, such as lab work, MRIs, and CAT scans.
• Durable medical equipment (DME), like walkers, wheelchairs, and CPAP machines.
2.2. Your Part B Costs: A Detailed Breakdown
Here are the standard costs you can expect with Medicare Part B in 2026.
Monthly Premium The standard monthly premium for Part B in 2026 will be $202.90. This is the amount most people pay. If you are receiving Social Security benefits, this premium is typically deducted directly from your check. If not, you can pay it via an automatic bank draft or a quarterly bill. Some people with higher incomes pay a higher premium, which we'll cover in the next section.
Annual Deductible The Part B annual deductible for 2026 is $283.
Unlike the Part A deductible, the Part B deductible is a straightforward calendar-year deductible. This means you are responsible for the first $283 of your Part B covered medical expenses for the entire year. After you have paid this amount, your Medicare coverage kicks in. This amount is not pro-rated, meaning you pay the full $283 even if you start Medicare in the middle of the year.
Co-insurance After you have met your $283 annual deductible, you are responsible for 20% co-insurance on most Medicare-approved services. This means Medicare pays 80% of the cost, and you pay the remaining 20%.
Key Insight: This 20% co-insurance represents one of the greatest financial risks in Original Medicare because there is no maximum out-of-pocket limit. You are responsible for 20% of the cost, no matter how high the total bill goes.
Excess Charges An "excess charge" is an additional 15% that some doctors are legally permitted to add to your bill on top of the Medicare-approved amount. These charges are rare, as about 95% of doctors are "participating providers" who agree to accept the Medicare-approved amount as full payment. Only physicians and surgeons can add excess charges; hospitals and medical equipment suppliers cannot.
While most people pay the standard Part B premium, your income can significantly change your monthly costs. Let's explore how that works.
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3. How High Income Can Affect Your Medicare Premiums (IRMAA)
3.1. What is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge that individuals with higher incomes must pay in addition to the standard premium for their Medicare Part B and Part D (prescription drug) plans.
To determine if you owe an IRMAA surcharge, Medicare looks at the Modified Adjusted Gross Income (MAGI) you reported on your IRS tax return from two years prior. This means your 2026 premiums will be based on your 2024 tax return. For most people, your MAGI is easy to find: it is simply line 11 plus line 2a on your IRS Form 1040.
3.2. 2026 Income Thresholds and Surcharges
The table below shows the income thresholds that determine your total monthly Part B premium for 2026. Find your 2024 income in the left column to see your corresponding monthly premium on the right.
2024 Modified Adjusted Gross Income (MAGI)
Total 2026 Monthly Part B Premium
Individuals: ≤ $109,000. Married Couples: ≤ $218,000
$202.90 (Standard Premium)
Individuals: > $109,000 up to $138,000. Married Couples: > $218,000 up to $276,000
**284.10∗∗(202.90 + $81.20 surcharge)
Individuals: > $138,000 up to $172,000. Married Couples: > $276,000 up to $344,000
**405.80∗∗(202.90 + $202.90 surcharge)
Individuals: > $172,000 up to $206,000. Married Couples: > $344,000 up to $412,000
**527.50∗∗(202.90 + $324.60 surcharge)
Individuals: > $206,000 and < $500,000. Married Couples: > $412,000 and < $750,000
**649.30∗∗(202.90 + $446.40 surcharge)
Individuals: ≥ $500,000. Married Couples: ≥ $750,000
**689.90∗∗(202.90 + $487.00 surcharge)
It's important to note that these same income levels are also used to determine surcharges for the Medicare Part D prescription drug plan.
If your income has decreased since 2024 due to a "life-changing event"—such as work stoppage/reduction, divorce, or the death of a spouse—you can file an appeal to have your IRMAA determination reconsidered based on your more current income.
Understanding these potential costs is the first step, and the next is knowing how you can manage them with additional insurance.
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4. A Brief Note on Covering the Gaps: Medigap Plans
To cover the costs that Original Medicare doesn't—like the Part A and B deductibles and the 20% co-insurance—many people purchase a Medicare Supplement Insurance plan, also known as a Medigap policy. These plans are sold by private insurance companies and work alongside Original Medicare to pay for the remaining "gaps."
Here is a look at the two most popular Medigap plans, framed as a choice between predictability and a lower monthly premium:
• Plan G (Maximum Predictability): Best for those who want to nearly eliminate unpredictable medical bills. After you pay the single annual Part B deductible ($283 in 2026), your Medicare-covered costs are covered 100% for the rest of the year. This provides peace of mind for a higher monthly premium.
• Plan N (Lower Premium with Co-pays): A budget-friendlier option for those comfortable with small, predictable co-pays for doctor and emergency room visits (up to $20 and $50, respectively). You save on the monthly premium in exchange for sharing a minor portion of costs as you use services. Plan N also does not cover Part B excess charges, which are rare.
