Will the Part B deductible apply to me if I have a Medicare Advantage plan?

Typically, no. Medicare Advantage plans have their own structures. You usually pay copays for services rather than satisfying the specific annual Part B deductible of $283.

Why did the Part B premium go up so much in 2026?

The 9.7% increase is driven by projected price changes in the healthcare market and an expectation that beneficiaries will use more services.

What is the maximum I will pay for drugs in 2026?

Your maximum out-of-pocket cost for covered Part D drugs is capped at $2,100. After you pay this amount, you pay nothing for covered drugs for the rest of the year.

Medicare Costs in 2026: How Much You’ll Pay for Coverage

For millions of retirees, the announcement of new Medicare premiums is a pivotal moment in annual financial planning. In 2026, the news brings a mix of relief and financial tightening. While the Social Security Cost-of-Living Adjustment (COLA) has risen by 2.8%, a significant portion of that raise will go directly toward higher Medicare Part B premiums, which have increased by nearly 10%.

Understanding these changes is critical for your budget. The standard monthly premium for Part B has jumped to $202.90, and the maximum out-of-pocket cap for Part D prescription drugs has adjusted to $2,100. These aren’t just abstract numbers; they are line items that directly affect your monthly cash flow.

This guide breaks down every cost change for Medicare in 2026—from premiums and deductibles to the “hidden” surcharges for high earners—so you can adjust your retirement budget with confidence.

A senior man discusses his outpatient care with a doctor in a sunlit, modern medical office. — A senior patient smiles during a consultation with his doctor, representing the outpatient services covered by Medicare Part B.

Part B: Premiums and Deductibles (Doctor & Outpatient Services)

Medicare Part B covers medically necessary services like doctor visits, outpatient care, and durable medical equipment. For 2026, costs have risen notably due to projected price changes and increased utilization of healthcare services.

The New Standard Premium

Most beneficiaries will pay the standard monthly premium. If you are collecting Social Security, this amount is automatically deducted from your monthly benefit check.

2026 Standard Premium: $202.90 per month
Increase from 2025: $17.90 per month (up from $185.00)

This increase of roughly 9.7% is higher than the general inflation rate. According to CMS, this hike would have been even higher (approximately $11 more) if not for policy changes regarding “skin substitute” products that curbed projected spending.

The Annual Deductible

Before Medicare pays its share (typically 80% of the approved amount), you must meet your annual deductible. You pay the full negotiated rate for doctor visits until this amount is reached.

2026 Annual Deductible: $283
Increase from 2025: $26 (up from $257)

Action Step: If you have a Medigap Plan G, remember that you are responsible for this $283 deductible out-of-pocket at the start of the year. Once paid, your plan covers the remaining 20% coinsurance for covered services.

A senior woman walks through a modern, bright hospital hallway during discharge. — A smiling senior walks through a sunlit, modern hospital hallway, highlighting the supportive environment provided during inpatient care stays.

Part A: Hospital Costs (Inpatient Care)

Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. The vast majority of retirees (about 99%) do not pay a monthly premium for Part A because they or their spouse paid Medicare taxes while working.

However, the costs you pay when you actually use hospital services—specifically the deductibles and coinsurance—have increased.

Hospital Inpatient Deductible

This deductible is not annual; it applies per benefit period. A benefit period begins the day you’re admitted as an inpatient and ends when you haven’t received any inpatient care for 60 consecutive days. This means you could potentially pay this deductible more than once in a single year.

2026 Deductible: $1,736 per benefit period
Increase from 2025: $60 (up from $1,676)

Coinsurance for Long Stays

If your hospital stay exceeds 60 days, you are responsible for a daily coinsurance amount:

Days 1–60: $0 coinsurance (after deductible)
Days 61–90: $434 per day (up from $419)
Lifetime Reserve Days (after day 90): $868 per day (up from $838)

Skilled Nursing Facility (SNF) Coinsurance

Medicare covers the first 20 days of a qualified SNF stay in full. Starting on day 21, you pay a daily rate.

Days 21–100: $217 per day (up from $209.50)

Close-up of a senior organizing their prescriptions on a clean marble kitchen counter. — Carefully organizing daily medications helps you stay on track as you navigate important updates to prescription drug coverage.

Part D: Prescription Drug Changes

The landscape of prescription drug coverage has shifted dramatically due to the Inflation Reduction Act. While 2025 introduced a hard cap on out-of-pocket costs, 2026 adjusts that cap for inflation.

The New Out-of-Pocket Cap

In 2026, the maximum amount you will pay out-of-pocket for covered Part D drugs is $2,100. This is an increase from the $2,000 cap introduced in 2025.

What this means: Once your qualified out-of-pocket spending reaches $2,100, you pay $0 for covered prescriptions for the rest of the calendar year. This “catastrophic coverage” phase now eliminates copays entirely.

Part D Deductible

Plans are allowed to charge a deductible before coverage kicks in. Not all plans charge the maximum, but many do.

Maximum Annual Deductible for 2026: $615
Increase from 2025: $25 (up from $590)

“The $2,100 cap is a game-changer for retirees on expensive medications like cancer drugs or insulin. However, for those with lower drug costs, the rising premiums and deductibles may be the more noticeable change.” — Medicare Rights Center Analysis

A sophisticated retiree reviews her financial portfolio in a sunlit home library. — A woman reviews financial documents in her home library, carefully planning for the impact of IRMAA surcharges on retirement.

IRMAA: Surcharges for High Earners

If your income is above a certain threshold, you will pay more for both Part B and Part D. This surcharge is known as the Income-Related Monthly Adjustment Amount (IRMAA). For 2026, these determinations are based on your 2024 tax return (filed in 2025).

The income brackets have been adjusted for inflation. The table below outlines the total monthly costs for high-income beneficiaries.

Individual Income (2024 Tax Return)	Joint Income (2024 Tax Return)	Part B Total Monthly Premium	Part D Extra Surcharge
$109,000 or less	$218,000 or less	$202.90 (Standard)	$0.00
$109,001 – $137,000	$218,001 – $274,000	$284.10	+$14.50
$137,001 – $171,000	$274,001 – $342,000	$405.80	+$37.50
$171,001 – $205,000	$342,001 – $410,000	$527.50	+$60.40
$205,001 – $500,000	$410,001 – $750,000	$649.20	+$83.30
$500,001 and above	$750,001 and above	$689.90	+$91.00

Note: The Part D surcharge is added to whatever premium you already pay for your specific drug plan.

Comparison brochures for Medicare Advantage and Medigap on a wooden table. — Reviewing financial booklets and comparison charts helps clarify the shifting trends between Medicare Advantage and Medigap insurance options.

Medicare Advantage vs. Medigap Trends

Your experience with these cost increases depends heavily on whether you have Original Medicare with a Medigap supplement or a private Medicare Advantage plan.

Medicare Advantage (Part C)

Medicare Advantage plans continue to be a popular low-premium option. For 2026, the average premium has actually decreased slightly to approximately $11.50–$14.00 per month (on top of the Part B premium). However, trade-offs exist:

Maximum Out-of-Pocket (MOOP) Limit: For 2026, the mandatory limit for in-network services has decreased slightly to $9,250. This is the absolute most you would pay for Part A and B services in a year, though many plans voluntarily set lower limits.
Benefit Changes: Due to funding pressures, some insurers are trimming ancillary benefits like dental allowances or over-the-counter credits. Check your plan’s “Annual Notice of Change” letter carefully.

Medigap (Medicare Supplement)

Medigap plans cover the gaps in Original Medicare, such as the 20% coinsurance. Because they pay the bills that Medicare doesn’t, their premiums are directly tied to healthcare inflation.

Premium Outlook: Industry projections suggest Medigap premiums (like Plan G and Plan N) may rise by 8% to 12% in 2026. This is driven by the 9.7% increase in Part B costs and higher utilization of medical services.
Stability: Despite rising premiums, Medigap offers predictable costs—you won’t face copays for every doctor visit like you might in an Advantage plan.

A retiree checks his Social Security deposit on his phone while sitting outside. — A smiling retiree checks his phone for Social Security COLA updates while enjoying a peaceful, sunny morning in the garden.

The Social Security COLA Connection

A common frustration for retirees is the “give and take” between Social Security and Medicare. For 2026, the Social Security Cost-of-Living Adjustment (COLA) is 2.8%.

Here is how the math works for the average retiree:

Average Social Security Benefit (2025): ~$1,900 per month
2.8% COLA Increase: +$53 per month
Part B Premium Increase: -$17.90 per month
Net Monthly Increase: ~$35.10 per month

While the COLA does cover the Medicare hike for most people, the rising cost of Part B consumes about one-third of the entire raise. If you have a lower Social Security benefit, the Medicare increase will eat up a larger percentage of your COLA.

Are You Protected by the “Hold Harmless” Rule?

The “Hold Harmless” provision prevents your Social Security check from decreasing from one year to the next due to Medicare premium hikes. Because the 2026 COLA (2.8%) is substantial enough to cover the $17.90 Part B increase for nearly all beneficiaries, very few people will need to rely on this protection this year. You will likely see a net increase in your check, even if it is modest.

A senior woman carefully reviews her calendar and Medicare deadlines. — Carefully cross-referencing digital spreadsheets with a physical planner helps you identify and avoid common mistakes before they become problems.

Common Mistakes to Avoid

Navigating these changes can be tricky. Avoid these common pitfalls to keep your costs down.

Ignoring the Annual Notice of Change (ANOC): Medicare Advantage and Part D plans send this letter in September. It details changes for the coming year. Assuming your plan costs will stay the same is a risky gamble—insurers often change drug formularies and copays annually.
Auto-Renewing Without Comparison: With the Part D cap moving to $2,100 and deductibles rising, your current drug plan might no longer be the most cost-effective. Use the Medicare.gov Plan Finder tool every year during Open Enrollment (Oct 15 – Dec 7).
Forgetting About IRMAA Appeals: If your income dropped in 2025 due to a life-changing event (like retirement, divorce, or death of a spouse), you can appeal the 2026 IRMAA surcharge. You don’t have to accept the higher premium if your current reality doesn’t match your 2024 tax return. Use form SSA-44 to file an appeal.

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Professional vs. Self-Guided Planning

Should you navigate these changes alone or seek help? Here is a quick guide.

Go Self-Guided If: You have Original Medicare with a Medigap plan and are happy with it. You are comfortable using online tools to compare Part D drug plans and your income is stable and below the IRMAA thresholds.
Consult a Broker/Expert If: You are on a Medicare Advantage plan and your doctors have changed, or if your plan is cutting benefits. A licensed broker can help you check network viability which is hard to do accurately on your own.
Consult a Financial Planner If: You are subject to IRMAA surcharges. A planner can help you manage withdrawals from retirement accounts (like Roth conversions or QCDs) to lower your reported income and potentially avoid these surcharges in future years.

Frequently Asked Questions

Will the Part B deductible apply to me if I have a Medicare Advantage plan?: Typically, no. Medicare Advantage plans have their own structures. You usually pay copays for services rather than satisfying the specific annual Part B deductible of $283. Check your plan’s “Summary of Benefits.”
Why did the Part B premium go up so much in 2026?: The 9.7% increase is driven by projected price changes in the healthcare market and an expectation that beneficiaries will use more services. It corrects for previous estimates that were too low.
What is the maximum I will pay for drugs in 2026?: Your maximum out-of-pocket cost for covered Part D drugs is capped at $2,100. After you pay this amount (including your deductible and copays), you pay nothing for covered drugs for the rest of the year.

Next Steps for Your Budget

The 2026 Medicare cost increases are significant, but manageable with the right information. Your immediate next step should be to check your specific benefit status. Log in to your my Social Security account to see your exact net benefit amount for 2026 once the COLA notice is posted in December.

If you are concerned about the rising costs of prescriptions or premiums, verify if you qualify for programs like “Extra Help” (for Part D) or Medicare Savings Programs (for Part B premiums), which have income limits that adjust annually. Taking an hour to review your coverage options during Open Enrollment can often save you hundreds of dollars over the course of the year.

The information in this guide is meant for educational purposes. Your specific circumstances—including income, savings, health coverage, and goals—may require different approaches. When in doubt, consult a licensed professional.