One of the biggest surprises people face when they turn 65 is discovering that Medicare is not free. As a Medicare insurance broker serving clients across New York, New Jersey, and beyond, I field questions about Medicare costs every single day. To help you plan, here is a clear, up-to-date breakdown of what you can expect to pay for Medicare in 2026.

Overview: Do You Have to Pay for Medicare?

Yes, most people do pay some Medicare premiums. How much you pay depends on which parts of Medicare you have, your work history, and your income. Here are the key points to keep in mind:

• Most people qualify for premium-free Part A if they have worked at least 40 quarters (10 years) in the U.S. and paid Medicare taxes during that time
• Part B and Part D premiums are income-based; higher earners pay more through a surcharge called IRMAA
• The standard Medicare Part B premium in 2026 is $202.90/month
• Supplemental coverage (Medicare Supplement or Medicare Advantage) adds additional costs but can significantly reduce your out-of-pocket exposure

The good news: once you understand the structure, it’s straightforward to estimate your costs and plan accordingly.

Medicare Part A Costs in 2026

For most Medicare beneficiaries, Part A is premium-free. If you worked at least 10 years (40 quarters) in the United States and paid Medicare payroll taxes during that time, you have already prepaid for your Part A coverage. Approximately 99% of Medicare beneficiaries qualify for premium-free Part A.

Part A Premiums If You Have to Buy In

If you do not have enough work history to qualify for free Part A, you can still purchase coverage:

• Fewer than 30 quarters of work: $565/month
• 30–39 quarters of work: $311/month (pro-rated premium)

To be eligible to purchase Part A, you must have been a legal U.S. resident or green card holder for at least five years.

Part A Deductible for 2026

Part A covers your inpatient hospital stays, skilled nursing facility care, and some home health services. Should you have a hospital stay, you will be responsible for the Part A deductible of $1,736 in 2026, an increase of $60 from the 2025 deductible of $1,676. If you have a Medicare Supplement (Medigap) plan, it will likely cover this deductible for you, which is one of the key reasons many beneficiaries choose supplemental coverage.

Medicare Part B Costs in 2026

Part B is your outpatient medical insurance — covering doctor visits, preventive services, lab work, and outpatient procedures. Unlike Part A, Part B always comes with a monthly premium, and that premium is based on your income.

How Is the Part B Premium Calculated?

The Social Security Administration (SSA) determines your Part B premium using your Modified Adjusted Gross Income (MAGI) from your IRS tax return two years prior. This is known as the two-year look-back period. So your 2026 Part B premium is based on your 2024 tax return. Income sources that count toward your MAGI include:

• Wages and self-employment income
• Interest and dividends from investments
• Capital gains
• Social Security benefits
• Tax-deferred pension distributions

Income sources that do not count toward MAGI include:

• Roth IRA and Roth 401(k) withdrawals
• Life insurance proceeds
• Reverse mortgage proceeds
• Health savings account (HSA) distributions

2026 Part B Standard Premium

The standard Part B premium for 2026 is $202.90/month. This is what most beneficiaries pay. Only about 5% of Medicare beneficiaries pay higher premiums due to income.

Part B IRMAA Surcharges for 2026

If your income exceeds certain thresholds, you will pay an additional surcharge on top of the standard premium. This is called the Income-Related Monthly Adjustment Amount (IRMAA). If you are married and filed jointly, Social Security uses your combined household income to determine your bracket — but you and your spouse each pay your own individual Part B premium. Note: The SSA typically notifies beneficiaries of their next year’s premium in December or early January by mail. If you believe your premium is based on income that no longer reflects your current situation — for example, if you recently retired, you may be able to appeal using Form SSA-44.

Medicare Part D Costs in 2026

Part D provides prescription drug coverage and is offered through private insurance carriers approved by Medicare. Like Part B, your Part D costs in 2026 depend on both your plan choice and your income.

Part D Base Premiums

Part D plan premiums vary by carrier and state. In most states, you can find plans starting around $10–$15/month, though premiums vary widely based on the plan’s formulary and benefit design. Whatever premium your chosen plan charges is called the base premium.

Part D IRMAA Surcharges for 2026

Higher-income beneficiaries pay an additional IRMAA surcharge on top of their plan’s base premium. This surcharge is separate from and in addition to the Part B IRMAA surcharge. When comparing Part D costs to employer-sponsored drug coverage, be sure to factor in any applicable IRMAA surcharge, as well as copays and coinsurance for your specific medications. If your income has dropped since retirement and you find yourself in a higher IRMAA bracket based on older tax returns, you may qualify to appeal for a reduced premium. Contact the Social Security Administration or speak with a licensed Medicare broker for guidance.

Frequently Asked Questions About Medicare Costs

How much does Medicare cost per month?

Your total monthly Medicare cost depends on which parts and plans you have. At a minimum, most people pay the standard Part B premium of $202.90/month. Add your Part D plan premium, any IRMAA surcharges, and any supplemental coverage premiums (Medigap or Medicare Advantage), and your total monthly cost will vary based on your income and plan selections.

Why do some people pay less for Medicare Part B?

Beneficiaries who receive both Medicare and Medicaid (dual-eligible) may have their Part B premium covered by their state Medicaid program. Others who enrolled in Medicare when premiums were lower may be protected by the “hold harmless” provision, which in certain years prevents Social Security recipients from seeing their net benefit reduced by premium increases.

Is Medicare deducted from your Social Security check?

Yes, if you are receiving Social Security benefits, your Medicare Part B premium (and Part D premium, if applicable) is typically deducted directly from your monthly Social Security payment.

Are Medicare premiums tax-deductible?

Medicare premiums may be tax-deductible if you itemize deductions and your total medical expenses exceed 7.5% of your adjusted gross income. Self-employed individuals may be able to deduct Medicare premiums directly. Consult a tax professional for guidance specific to your situation.

We Can Help You Plan for Medicare Costs

Understanding your Medicare costs before you retire allows you to budget accurately and avoid surprises. Many of my clients are pleasantly surprised to find that Medicare — combined with a Medicare Supplement or Medicare Advantage plan — costs less than the private insurance they had while working. As an independent Medicare broker licensed in New York, New Jersey, and nationwide, I can help you:

• Estimate your specific Part B and Part D premiums based on your income
• Understand whether IRMAA will apply to you — and how to reduce it potentially
• Compare Medicare Supplement and Medicare Advantage plans side by side
• Make sure you enroll at the right time to avoid late enrollment penalties

📞 Contact Craig Smith Insurance Group today for a free Medicare cost review. We serve clients across Queens, Long Island, the Bronx, Westchester, Rockland County, and throughout New York and New Jersey — and we’re available by phone, video, or in person.

Key Takeaways: Medicare Costs for 2026

• Most beneficiaries qualify for premium-free Part A with 40+ quarters of U.S. work history
• The standard Part B premium in 2026 is $202.90/month — higher earners pay more via IRMAA
• The Part A deductible in 2026 is $1,736 per benefit period
• Part D premiums vary by plan and are also subject to IRMAA surcharges for higher-income beneficiaries
• IRMAA is calculated using your tax return from two years before retirement, which can trigger an appeal
• A Medicare Supplement plan can cover many of the out-of-pocket costs that Original Medicare leaves behind