Medicare 2026 premiums: what Part A, B, and D cost this year

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Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health. Most people pay no Part A premium at all: if you or your spouse worked and paid Medicare taxes for at least 40 quarters (roughly 10 years), Part A is premium-free.

If you have 30 to 39 quarters of Medicare-taxed work, the 2026 buy-in premium is $311 per month. With fewer than 30 quarters, the full buy-in is $565 per month.

Even with premium-free Part A, hospital stays carry cost-sharing:

One detail worth understanding: the Part A deductible applies per benefit period, not per calendar year. If you are hospitalized, discharged, and then re-admitted after 60 days, a second $1,736 deductible can apply. Days 1 to 20 of a covered SNF stay have no coinsurance; after day 100, you pay all costs.

To qualify for SNF coverage, you must have a formal 3-day inpatient hospital admission. Observation status is billed under Part B and does not count toward those 3 days.

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Part B covers physician services, outpatient care, preventive services, and durable medical equipment. In 2026, the standard Part B premium is $202.90 per month and the annual Part B deductible is $283.

After the deductible, Medicare pays 80% of the approved amount and you pay 20%, with no annual cap on that 20% in Original Medicare alone. That uncapped coinsurance is the main reason many people add a Medigap (Medicare Supplement) policy or enroll in Medicare Advantage, both of which provide some ceiling on out-of-pocket spending.

Non-participating providers and excess charges

Providers who accept Medicare assignment bill only the Medicare-approved amount. Non-participating providers may charge up to 15% above the approved amount. Some states ban excess charges entirely, which effectively eliminates that exposure for beneficiaries in those states.

IRMAA: higher earners pay more

Higher-income beneficiaries pay more through IRMAA (Income-Related Monthly Adjustment Amount), a surcharge added on top of the standard premium. In 2026, IRMAA begins above $109,000 in modified adjusted gross income (MAGI) for single filers and $218,000 for joint filers. The surcharge rises through several tiers above those thresholds. IRMAA also applies to Part D. CMS determines your 2026 IRMAA using your 2024 tax return, a two-year lookback. If your income has dropped significantly since then because of retirement or another life-changing event, you can request a new determination using SSA Form SSA-44. You have 60 days from the date you receive the IRMAA notice to file a reconsideration.

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Part D (prescription drug coverage) is provided through private plans that contract with Medicare. The 2026 figures to know:

• Maximum deductible: No Part D plan may set a deductible above $615. Many plans set lower or $0 deductibles.
• Out-of-pocket cap: In 2026, out-of-pocket spending on covered Part D drugs is capped at $2,100 for the year. Once you reach that cap, you pay $0 for covered drugs for the rest of the year. The coverage gap (donut hole) that existed in prior years is gone.
• National base beneficiary premium: $38.99. This figure is used to calculate the late-enrollment penalty, not what most people pay for a plan.

Part D late-enrollment penalty

If you go 63 or more days without creditable drug coverage after your Initial Enrollment Period (IEP), a late-enrollment penalty applies. The penalty adds 1% of the $38.99 national base beneficiary premium for each full month you went without coverage. It is permanent and added to your monthly premium for as long as you have Part D. Creditable coverage includes most employer and union drug plans; your plan administrator is required to tell you each year whether your coverage is creditable.

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Medicare Advantage (MA) plans bundle Part A, Part B, and usually Part D coverage. Federal rules set maximum limits on how much you can spend out of pocket in a year on in-network services.

In 2026, the federal in-network MOOP (maximum out-of-pocket) cap is $9,250. Plans may set lower limits, and many do: according to KFF, the 2026 enrollment-weighted average in-network MOOP is $5,421. The combined in-network plus out-of-network MOOP cap is $13,900.

Once you hit the MOOP, the plan pays 100% of covered in-network costs for the rest of the year. Note that the standard Part B premium still applies even in an MA plan.

Prior authorization timelines under the 2026 rule

Under CMS rule CMS-0057-F, which took effect January 1, 2026, MA plans must issue standard prior-authorization decisions within 7 calendar days. Expedited decisions must come within 72 hours, and any denial must include a specific reason so you can appeal.

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The figures above are a starting point for estimating your 2026 Medicare costs. Your actual spending depends on the specific plan you choose, the providers you see, and the prescriptions you take. To find out more about coverage, please contact us to discuss plan options.

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