Medicare isn't free — and the costs can be higher than many people expect, especially for those with higher incomes. Here's a full breakdown of what you'll actually pay in 2026. For context on what each part covers in exchange for these costs, see Medicare Parts A, B, C & D Explained.
Key Takeaways (2026 figures)
- Part A is premium-free for most people; the inpatient deductible is $1,736 per benefit period.
- Standard Part B premium is $202.90/month with a $283 annual deductible, plus 20% coinsurance.
- Part D premiums vary by plan. The defined-standard deductible and out-of-pocket threshold are $615 and $2,100 in 2026, and $700 and $2,400 in 2027.
- Higher earners pay an IRMAA surcharge on top of standard Part B and Part D premiums.
Part A Costs (2026)
| Item | 2026 Amount |
|---|---|
| Premium — 40+ work quarters | $0/month |
| Premium — 30–39 work quarters | $311/month |
| Premium — under 30 work quarters | $565/month |
| Inpatient deductible | $1,736 per benefit period |
| Coinsurance, days 1–60 | $0 |
| Coinsurance, days 61–90 | $434/day |
| Coinsurance, lifetime reserve days (up to 60 over your lifetime) | $868/day |
Part B Costs (2026)
| Item | 2026 Amount |
|---|---|
| Standard premium | $202.90/month |
| Annual deductible | $283 |
| Coinsurance after deductible | 20% of Medicare-approved amount |
Part D Costs (2026 and 2027)
CMS finalized the defined-standard Part D benefit amounts shown below. Individual plan premiums and cost sharing can differ; check current plan documents.
| Item | 2026 Amount | 2027 Amount |
|---|---|---|
| Monthly premium | Varies by plan | Varies by plan |
| Maximum defined-standard deductible | Up to $615 | Up to $700 |
| Annual out-of-pocket threshold | $2,100 | $2,400 |
After reaching the applicable threshold, you pay no cost sharing for covered Part D drugs for the rest of that calendar year. Monthly premiums and non-covered drugs are separate.
IRMAA: Income-Related Monthly Adjustment Amount
Higher-income beneficiaries pay more for Part B and Part D through a surcharge called IRMAA, based on your modified adjusted gross income (MAGI) from two years prior. Most people fall under the threshold and pay the standard premium — but if your income crosses these 2026 brackets (based on 2024 MAGI), expect an add-on:
| MAGI (Individual) | MAGI (Joint) | Extra Part B / month |
|---|---|---|
| $109,000 or less | $218,000 or less | $0 (standard premium) |
| Over $109,000 through $137,000 | Over $218,000 through $274,000 | +$81.20 |
| Over $137,000 through $171,000 | Over $274,000 through $342,000 | +$202.90 |
| Over $171,000 through $205,000 | Over $342,000 through $410,000 | +$324.60 |
| Over $205,000 and under $500,000 | Over $410,000 and under $750,000 | +$446.30 |
| $500,000 or more | $750,000 or more | +$487.00 |
These are CMS's published 2026 Part B IRMAA amounts for individual and joint filers with full Part B coverage. Separate rules apply to married beneficiaries filing separately who lived with their spouse during the tax year. Part D has its own additional monthly surcharge.
If your income has dropped since the tax year used to calculate your IRMAA — due to retirement, divorce, or the death of a spouse, among other qualifying events — you can appeal by filing Form SSA-44 with the Social Security Administration.
Total Cost Scenarios
A retiree on Original Medicare with no supplement could face $283 (Part B deductible) plus 20% coinsurance on every service with no annual cap — a single hospitalization or surgery could run into thousands of dollars in exposure. Adding a Medigap plan or choosing Medicare Advantage changes that math substantially; see our Medicare Advantage vs. Medigap comparison to weigh the tradeoffs for your own budget.
Kayla Price is licensed in NC, SC, GA, FL, VA, MD, KS, TX, OH, and MI — a free call gets you answers specific to your situation.