2026 Medicare Costs at a Glance
Every year, Medicare adjusts its premiums, deductibles, and out-of-pocket limits. For 2026, most costs have gone up modestly — but there’s one major piece of good news: your out-of-pocket prescription drug costs are now capped at $2,100 per year. That’s a first for Medicare.
Here’s a quick breakdown of every key number you need to know for 2026, straight from the official CMS handbook.
Part A — Hospital Insurance
| Item | 2025 | 2026 |
|---|---|---|
| Monthly Premium (most people) | $0 | $0 |
| Monthly Premium (if buying) | Up to $518 | Up to $565 |
| Inpatient Deductible (per benefit period) | $1,676 | $1,736 |
| Hospital Days 61–90 | $419/day | $434/day |
| Lifetime Reserve Days (91–150) | $838/day | $868/day |
| Skilled Nursing Facility Days 21–100 | $209.50/day | $217/day |
Part B — Medical Insurance
| Item | 2025 | 2026 |
|---|---|---|
| Standard Monthly Premium | $185.00 | $202.90 |
| Annual Deductible | $257 | $283 |
| Coinsurance (after deductible) | 20% | 20% (unchanged) |
Part B IRMAA — Higher Premiums for Higher Earners
If your modified adjusted gross income (from your 2024 tax return) exceeds certain thresholds, you’ll pay more for Part B. Here are the 2026 brackets:
| Individual Income | Joint Income | Monthly Premium |
|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $202.90 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.20 |
| ≥ $500,000 | ≥ $750,000 | $689.90 |
Part D — Prescription Drug Coverage
This is where the biggest 2026 change lives:
| Item | 2025 | 2026 |
|---|---|---|
| National Base Premium | $36.78/month | $38.99/month |
| Out-of-Pocket Cap | No cap | $2,100/year 🎉 NEW! |
| Insulin Copay Cap | $35/month | $35/month (no deductible) |
The Big Win: $2,100 Out-of-Pocket Cap on Prescriptions
For the first time ever, Medicare is capping what you pay out of pocket for prescription drugs. In 2026, once your total out-of-pocket drug spending hits $2,100, you pay $0 for covered Part D drugs for the rest of the year.
This is a game-changer for anyone taking expensive medications. Previously, there was no annual limit — you could pay thousands of dollars in the “coverage gap” and “catastrophic” phases.
Plus, the new Medicare Prescription Payment Plan lets you spread your drug costs across monthly payments instead of paying large amounts upfront at the pharmacy. There’s no fee to participate.
Other Key 2026 Changes
- 10 negotiated drug prices take effect January 1, 2026 — the first-ever prices negotiated directly by Medicare with drug manufacturers
- Advanced Primary Care Management — a new monthly benefit where your doctor coordinates your care with 24/7 access to your care team
- CT colonography (virtual colonoscopy) is now covered for colorectal cancer screening
- Insulin remains capped at $35/month per insulin with no deductible
What Should You Do Now?
- Review your current plan. With the new $2,100 drug cap, your Part D plan costs may look very different in 2026.
- Check your IRMAA bracket. The income thresholds have shifted — you may pay less (or more) for Part B and Part D than last year.
- Consider a Medigap review. If you’re on Original Medicare, make sure your Medigap plan still makes sense with the new cost structure.
- Talk to an independent agent. An independent Medicare agent can compare plans across multiple carriers to find the best fit for your needs and budget — at no cost to you.
Need Help Understanding Your 2026 Medicare Costs?
As an independent licensed agent, I shop across multiple carriers to find the right coverage for your situation. Whether you’re turning 65, reviewing your current plan, or trying to understand IRMAA, I’m here to help — at no cost to you.
Schedule a free consultation or call (919) 689-6565.