If you're a Medicare beneficiary on a fixed income, 2026 brought another round of cost increases that deserve your full attention. The Centers for Medicare & Medicaid Services confirmed that the standard monthly Part B premium is now $185.00, up $10.30 from the $174.70 you paid in 2025. For most people enrolled in Original Medicare, this amount is deducted directly from your Social Security check, so the increase shows up quietly — but it adds up to $123.60 more per year coming out of your pocket before you've seen a single doctor.
The Part B annual deductible also increased, reaching $257 in 2026 compared to $240 in 2025. This is the amount you must pay out-of-pocket for covered outpatient services — doctor visits, lab work, outpatient procedures — before Medicare's 80% coverage kicks in. Once you meet that deductible, you're still responsible for the remaining 20% coinsurance on most Part B services, with no cap on that exposure unless you have a Medigap supplemental policy or Medicaid coverage.
On the hospital side, the Part A inpatient deductible — which applies each benefit period, not each calendar year — rose to $1,676 in 2026, up from $1,632 in 2025. This is a critical distinction that trips up many beneficiaries: if you're hospitalized, discharged, and then readmitted more than 60 days later, you owe that $1,676 deductible again. A beneficiary who has two separate hospital stays in a single year could face over $3,300 in Part A deductibles alone. Days 1 through 60 of a hospital stay are covered after that deductible; days 61 through 90 carry a daily coinsurance of $419 in 2026, up from $408 in 2025.
For skilled nursing facility care — the kind of post-hospital rehabilitation stay that many older adults need after a surgery or serious illness — the coinsurance structure also shifted upward. Days 1 through 20 of a qualifying SNF stay remain fully covered by Medicare Part A. But from day 21 through day 100, you now owe $209.50 per day in 2026, compared to $204.00 per day in 2025. That's a meaningful difference if you're recovering from a hip replacement or stroke and need several weeks of facility-based therapy. Beyond day 100, Medicare pays nothing, and you're entirely responsible for the cost.
Higher-income beneficiaries face an additional layer of cost through the Income-Related Monthly Adjustment Amount, known as IRMAA. In 2026, individuals with a modified adjusted gross income above $106,000 (or $212,000 for married couples filing jointly) pay more than the standard $185.00 Part B premium. The surcharges are tiered: at the highest income bracket — individuals earning above $500,000 or couples above $750,000 — the monthly Part B premium reaches $628.90 in 2026. IRMAA also applies to Part D drug coverage. Importantly, IRMAA is based on your tax return from two years prior, meaning your 2026 surcharge is calculated from your 2024 income. If your income dropped significantly due to retirement, divorce, or the death of a spouse, you can appeal your IRMAA determination by filing Form SSA-44 with the Social Security Administration.
So what can you actually do about these rising costs? The most powerful tool available to many beneficiaries is a Medicare Supplement (Medigap) policy. Medigap Plan G, the most comprehensive option available to people who became Medicare-eligible on or after January 1, 2020, covers the Part A deductible, Part A coinsurance, Part B coinsurance (the 20% you owe after the deductible), skilled nursing facility coinsurance, and foreign travel emergency care. You still pay the Part B deductible yourself under Plan G, but after that, your out-of-pocket exposure for covered services is essentially zero. Monthly premiums for Plan G vary widely by age, location, and insurer — typically ranging from roughly $100 to $250 per month for a 65-year-old — but the predictability it provides can be worth the cost for anyone with chronic conditions or frequent medical needs.
Medigap Plan N is a lower-premium alternative worth considering. It covers the Part A deductible and coinsurance but requires you to pay up to $20 per office visit and up to $50 for emergency room visits that don't result in inpatient admission. For beneficiaries who are relatively healthy and see their doctor only a few times per year, Plan N's lower monthly premium may result in lower total annual spending than Plan G. The right choice depends on your actual utilization patterns, not just the premium sticker price.
If you're considering switching Medigap plans or enrolling for the first time outside your initial open enrollment window, medical underwriting is a real obstacle in most states — insurers can reject you or charge higher premiums based on your health history. However, 13 states have enacted birthday rule protections that give you a 30-day window around your birthday each year to switch Medigap plans without underwriting: California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, and Oregon. If you live in one of these states and your current Medigap plan has become unaffordable, your birthday window may be your best opportunity to shop for a lower-premium plan with equivalent coverage.
For beneficiaries who can't afford Medigap premiums, Medicare Advantage plans — the private insurance alternative to Original Medicare — often carry $0 monthly premiums and include built-in out-of-pocket maximums that Original Medicare lacks entirely. In 2026, Medicare Advantage plans are required to cap your annual out-of-pocket costs for covered in-network services. However, Medicare Advantage plans use provider networks, require referrals in some cases, and can change their benefits, formularies, and premiums each year during the Annual Enrollment Period (October 15 through December 7). Switching to Medicare Advantage is not a decision to make lightly, particularly if you have established relationships with specialists or receive care at specific hospitals.
Low-income beneficiaries have additional options that are frequently underutilized. The Medicare Savings Programs — funded jointly by federal and state governments and administered through your state Medicaid office — can pay your Part B premium, deductible, and coinsurance depending on your income level. The four tiers are Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled and Working Individuals (QDWI). A single person with monthly income below roughly $1,275 (thresholds vary by state) may qualify for QMB, which covers the Part B premium entirely and eliminates most cost-sharing. Contact your State Health Insurance Assistance Program (SHIP) counselor — a free, unbiased resource available in every state — to find out whether you qualify and how to apply. You can find your local SHIP contact at shiphelp.org.
The Social Security cost-of-living adjustment (COLA) for 2026 was 2.5%, which added roughly $50 per month to the average Social Security benefit. The Part B premium increase of $10.30 per month consumes a portion of that COLA gain, but the net effect for most beneficiaries is still a modest increase in take-home Social Security income. That said, beneficiaries who pay significant out-of-pocket costs for Part A services, skilled nursing care, or Part D drugs may find that the COLA doesn't stretch as far as the headline number suggests. Reviewing your total Medicare cost exposure — not just your monthly premium — is the most accurate way to understand what 2026 actually costs you.