Medicare costs change every year, and 2026 brings several significant shifts. The Part B premium climbs to $202.90, the Part A hospital deductible rises to $1,736, and the Part D out-of-pocket cap settles at a firm $2,100. Here is every number in one place, plus three strategies that can lower what you actually pay.
The complete 2026 cost table
| Cost item | 2026 amount | Note |
|---|---|---|
| Part A hospital premium | $0 (most people) | Free if you or spouse worked 10+ years |
| Part A hospital deductible | $1,736 | Per benefit period (60 days) |
| Part B medical premium | $202.90/month | Standard; higher with IRMAA |
| Part B medical deductible | $257/year | Before Medicare pays 80% |
| Part B coinsurance | 20% | You pay 20% of approved amount |
| Part B IRMAA surcharge | $70 to $419+/month | Based on income from 2 years ago |
| Part D base premium | ~$34.50/month | Varies by plan |
| Part D deductible | $615/year | Max; some plans waive for generics |
| Part D out-of-pocket cap | $2,100/year | Firm cap on drug spending |
| Skilled nursing daily copay | $0 / $0 / $204 / $204 / $204 / $0 | Days 1-20 / 21-40 / 41-60 / 61-90 / 91-100 / 100+ |
Why the Part B premium keeps climbing
The Part B premium is not arbitrary. It is calculated to cover approximately 25% of the total cost of the Part B program, with the federal government covering the remaining 75%. As healthcare costs rise, the premium follows. The $202.90 figure represents a meaningful increase from previous years, and it is the number most beneficiaries feel directly in their Social Security check.
IRMAA adds another layer. If your modified adjusted gross income from two years ago exceeds $106,000 (single) or $212,000 (married filing jointly), you pay a surcharge on top of the standard premium. The highest IRMAA bracket adds over $400 per month. If your income has dropped due to retirement, you can appeal.
The $2,100 drug cap: what it really changes
The Part D out-of-pocket cap at $2,100 is the most consequential change in Medicare drug coverage in two decades. Before 2024, there was no cap. People with serious conditions — cancer drugs, specialty medications, insulin — could face $10,000 or more in annual drug costs. Now, once you hit $2,100, you pay nothing for covered drugs for the rest of the year.
This cap applies across all Part D plans and Medicare Advantage drug plans. It is uniform and non-negotiable. The impact is dramatic for anyone taking expensive medications.
Three ways to pay less
1. Medicare Savings Programs. If your income is limited, your state Medicaid program may pay your Part B premium, your Part A deductible, or both. QMB, SLMB, and QI are three tiers of assistance. Eligibility varies by state, but the income thresholds are higher than most people expect.
2. Extra Help for prescriptions. The federal Extra Help program can eliminate your Part D premium, deductible, and copays. In 2026, most single people with income below approximately $22,000 qualify. The application takes about 20 minutes and can save over $5,000 per year.
3. IRMAA appeals. If your income dropped recently — retirement, death of a spouse, divorce — you can file an appeal to reduce or eliminate your IRMAA surcharge. The key is filing within 60 days of receiving your IRMAA notice. We help clients with this every year.