Every fall, the Centers for Medicare & Medicaid Services (CMS) releases the official premium and deductible figures that will govern Original Medicare costs for the coming year. For 2026, those numbers are now final — and if you're among the roughly 67 million Americans enrolled in Medicare, understanding exactly what you'll owe before you ever see a doctor is one of the most practical things you can do for your financial health.
The standard monthly premium for Medicare Part B in 2026 is $185.00. That's the amount most beneficiaries pay, automatically deducted from their Social Security check each month. Part B covers outpatient services: doctor visits, lab work, preventive screenings, durable medical equipment, and most services you receive outside a hospital. The Part B annual deductible for 2026 is $257. Once you've met that deductible, Medicare pays 80% of approved costs for covered services, and you're responsible for the remaining 20% — with no out-of-pocket cap under Original Medicare alone. That 20% coinsurance is one of the most important numbers to keep in mind, because for a major illness or surgery, it can add up to thousands of dollars quickly.
If your income is above certain thresholds, you pay more than the standard $185.00 premium through what's called the Income-Related Monthly Adjustment Amount, or IRMAA. For 2026, IRMAA surcharges kick in for individuals with a modified adjusted gross income above $106,000 (or $212,000 for married couples filing jointly, based on 2024 tax returns). At the highest income tier — individuals earning above $500,000 or couples above $750,000 — the total Part B premium reaches $628.90 per month. There are six income tiers in total, and CMS uses your tax return from two years prior to determine which tier applies to you. If your income has dropped significantly since then — due to retirement, the death of a spouse, or another life-changing event — you can appeal your IRMAA determination by filing Form SSA-44 with the Social Security Administration and providing documentation of the change.
On the hospital side, Medicare Part A covers inpatient stays, skilled nursing facility care, hospice, and some home health services. Most people don't pay a monthly premium for Part A if they or their spouse worked and paid Medicare taxes for at least 40 quarters (10 years). But Part A does come with its own cost-sharing structure, and it works differently than most insurance. The Part A deductible for 2026 is $1,676 per benefit period. A benefit period begins the day you're admitted to a hospital or skilled nursing facility and ends when you've been out of inpatient care for 60 consecutive days. This means if you're hospitalized twice in the same year with more than 60 days between stays, you pay the $1,676 deductible twice. There is no annual cap on how many benefit periods you can have.
For longer hospital stays, Part A coinsurance kicks in after the first 60 days. Days 61 through 90 of a single hospital stay cost $419 per day in 2026. Beyond 90 days, you can draw on your 60 lifetime reserve days, which cost $838 per day. Once those lifetime reserve days are exhausted, Medicare pays nothing for inpatient care. For skilled nursing facility stays — which require a qualifying three-day hospital admission first — the first 20 days are fully covered by Part A. Days 21 through 100 carry a daily coinsurance of $209.50 in 2026. After day 100, Medicare coverage ends entirely, and you're responsible for the full cost.
These cost-sharing figures are exactly why Medigap (Medicare Supplement) plans exist. A Medigap Plan G, for example, covers the Part A deductible, Part A coinsurance, Part B coinsurance (the 20%), and the skilled nursing facility coinsurance — leaving you with only the Part B deductible to pay out of pocket each year. Plan N covers similar benefits but requires small copays for some office visits and emergency room visits. The trade-off is a monthly premium for the Medigap policy itself, which varies significantly by insurer, your age, your gender, and where you live. In many markets, a Plan G premium for a 65-year-old runs between $100 and $200 per month, though it can be higher in certain states or for older enrollees. Comparing that cost against the potential exposure from the 20% coinsurance and the Part A deductible is a straightforward calculation worth doing every year.
If you're enrolled in a Medicare Advantage plan (Part C) rather than Original Medicare, these specific deductibles and coinsurance amounts don't apply directly to you — your plan sets its own cost-sharing structure within CMS guidelines. However, the Part B premium still applies; you pay it regardless of whether you're in Original Medicare or a Medicare Advantage plan. Some Medicare Advantage plans offer a Part B premium reduction benefit, which can offset some or all of that $185.00 monthly cost, though those benefits vary by plan and county and are not guaranteed to continue year to year.
For beneficiaries who are approaching Medicare eligibility or considering switching between coverage types, the timing of your decisions matters. The Annual Enrollment Period runs October 15 through December 7 each year, during which you can switch from Original Medicare to Medicare Advantage, return to Original Medicare from Medicare Advantage, or change Medicare Advantage plans. Changes made during AEP take effect January 1. If you want to switch back to Original Medicare and pick up a Medigap plan, be aware that in most states, insurers can use medical underwriting outside of your initial enrollment window — meaning they can charge you more or deny coverage based on health conditions. The exceptions are the 13 states with birthday rule protections: California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, and Oregon. In those states, you have a 30-day window around your birthday each year to switch Medigap plans without medical underwriting.
Low-income beneficiaries have additional options worth knowing. The Medicare Savings Programs, administered through state Medicaid offices, can help pay Part B premiums, deductibles, and coinsurance for those who qualify. The Qualified Medicare Beneficiary (QMB) program, for instance, covers both Part A and Part B premiums and cost-sharing for individuals with incomes at or below 100% of the federal poverty level. The income and asset limits vary by state, so checking with your State Health Insurance Assistance Program (SHIP) counselor — a free, unbiased resource available in every state — is a practical first step. You can find your local SHIP contact at shiphelp.org.
The bottom line for 2026 is this: Original Medicare's cost-sharing structure places real financial risk on beneficiaries, particularly for hospitalizations and extended illness. The $257 Part B deductible is manageable, but the uncapped 20% coinsurance and the per-benefit-period Part A deductible can create significant exposure. Reviewing your current coverage against these updated figures — and comparing what a Medigap or Medicare Advantage plan would cost versus what you'd pay out of pocket under Original Medicare alone — is the most concrete action you can take right now to protect your budget in 2026.