Every year, Medicare premiums, deductibles, and out-of-pocket costs change. Knowing what you will pay in 2026 is an important part of planning your retirement healthcare budget. This guide covers every major Medicare cost for 2026 — Parts A, B, D, IRMAA surcharges, and Medicare Advantage out-of-pocket limits — all in one place.
If you are turning 65 and want help comparing plans in your area, visit our Turning 65 in New York Medicare Guide or schedule a free consultation with Craig Smith.
Medicare Part A Costs 2026
Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. For most people, Part A is premium-free — but there are costs to know about when you actually use it.
Part A Premium
Most people pay $0 per month for Part A because they or their spouse paid Medicare taxes for at least 40 quarters (10 years) while working. However, if you do not have 40 quarters of work history, a premium applies:
- 30–39 work quarters: $311 per month
- Fewer than 30 work quarters: $565 per month
Part A Deductible
The Part A deductible applies per benefit period — not per year. In 2026, that deductible is $1,736, which is an increase of $60 from the 2025 amount of $1,676.
Importantly, if you have a Medicare Supplement (Medigap) plan, it will likely cover this deductible for you.
Part A Coinsurance
- Days 1–60: $0 coinsurance per benefit period
- Days 61–90: $433 per day
- Days 91+: $866 per day (lifetime reserve days)
- Skilled Nursing Facility Days 21–100: $216.50 per day
Medicare Part B Costs 2026
Medicare Part B covers doctor visits, outpatient services, preventive care, and durable medical equipment. Unlike Part A, Part B always comes with a monthly premium.
Part B Premium
The standard Part B premium in 2026 is $202.90 per month. Higher-income beneficiaries pay more due to IRMAA surcharges — see the IRMAA section below for full details.
If you are already receiving Social Security benefits, your Part B premium is automatically deducted from your monthly check. Otherwise, you will be billed quarterly by Medicare.
Part B Deductible
The annual Part B deductible in 2026 is $283. After meeting this deductible, Medicare pays 80% of covered outpatient services and you are responsible for the remaining 20% — unless you have a Medigap plan that covers your coinsurance.
Part B Coinsurance
After meeting the deductible, you pay 20% of the Medicare-approved amount for most covered services. Because there is no out-of-pocket maximum with Original Medicare, many beneficiaries choose to add a Medicare Supplement plan for protection against large medical bills.
Medicare Part D Costs 2026
Medicare Part D covers prescription drugs through private insurance companies approved by Medicare. Premiums and costs vary by plan and location, so comparing options in your ZIP code is essential.
Part D Premium
Part D premiums vary by plan. In New York, plans typically start around $10–$15 per month for basic coverage, with more comprehensive plans costing more. Additionally, higher-income beneficiaries pay an IRMAA surcharge on top of their plan premium.
Part D Deductible
The maximum Part D deductible in 2026 is $615. Some plans offer a reduced deductible or no deductible at all, but no plan can exceed this federal limit.
Part D Out-of-Pocket Cap — $2,100
One of the most significant changes for 2026 is the $2,100 annual out-of-pocket cap on prescription drug spending. Once you reach $2,100 in out-of-pocket drug costs, you pay nothing for covered drugs for the rest of the year. As a result, this cap provides meaningful relief for beneficiaries with high-cost medications. It applies to both standalone Part D plans and Medicare Advantage plans with drug coverage.
IRMAA Surcharges 2026
IRMAA — the Income-Related Monthly Adjustment Amount — is an additional surcharge added to your Part B and Part D premiums if your income exceeds certain thresholds. Specifically, IRMAA is based on your Modified Adjusted Gross Income (MAGI) from two years prior, meaning your 2026 premiums are based on your 2024 tax return.
2026 Part B IRMAA Surcharges
| Individual MAGI (2024) | Joint MAGI (2024) | Monthly Part B Premium |
|---|---|---|
| Up to $106,000 | Up to $212,000 | $202.90 |
| $106,001 – $133,000 | $212,001 – $266,000 | $285.00 |
| $133,001 – $167,000 | $266,001 – $334,000 | $357.00 |
| $167,001 – $200,000 | $334,001 – $400,000 | $429.00 |
| $200,001 – $500,000 | $400,001 – $750,000 | $594.00 |
| Above $500,000 | Above $750,000 | $628.90 |
To find out exactly what you will pay, use our Medicare IRMAA Calculator.
Medicare Advantage Out-of-Pocket Costs 2026
If you choose a Medicare Advantage plan instead of Original Medicare, your costs work differently. In contrast to Original Medicare, Advantage plans include a built-in annual out-of-pocket maximum that limits your total exposure for covered services.
- Maximum in-network out-of-pocket limit 2026: $9,250
- Once you reach this limit, your plan covers 100% of covered services for the rest of the year
- Many plans offer lower out-of-pocket maximums than the federal limit
- Premiums vary — some plans in New York offer $0 monthly premiums
However, network restrictions mean you may be limited to specific doctors and hospitals — an important consideration in New York City where many top specialists do not participate in HMO networks.
Medicare Supplement (Medigap) Costs 2026
A Medicare Supplement plan helps cover the gaps in Original Medicare — including the Part A deductible, Part B coinsurance, and excess charges. Medigap premiums vary by plan, carrier, age, and location.
In New York, Plan G is the most popular Medigap plan for new Medicare enrollees. It covers everything except the annual Part B deductible of $283. Furthermore, New York has year-round guaranteed issue rights, meaning you can apply for or switch Medigap plans at any time without medical underwriting — a significant advantage over most other states.
For a side-by-side comparison of all Medigap plans, visit our Medicare Supplement Plans page.
2026 Medicare Costs Quick Reference
| Cost Item | 2026 Amount |
|---|---|
| Part A Premium (40+ quarters) | $0/month |
| Part A Premium (30–39 quarters) | $311/month |
| Part A Premium (under 30 quarters) | $565/month |
| Part A Deductible | $1,736 per benefit period |
| Part B Standard Premium | $202.90/month |
| Part B Annual Deductible | $283 |
| Part B Coinsurance | 20% after deductible |
| Part D Maximum Deductible | $615 |
| Part D Out-of-Pocket Cap | $2,100 |
| Medicare Advantage Max Out-of-Pocket | $9,250 in-network |
| Part B Deductible (Medigap Plan G) | $283 (not covered by Plan G) |
Get Help Understanding Your 2026 Medicare Costs
Understanding what Medicare costs is only half the equation. The other half is knowing which plan structure gives you the best value for your specific health needs and budget.
As an independent Medicare broker serving New York City, Long Island, Westchester, and clients nationwide, I compare every plan available in your ZIP code at no cost to you. Whether you are turning 65 or reviewing your current coverage, I am here to help you make the most informed decision possible.
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Craig Smith Insurance Group
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Craig Smith
Independent Medicare Insurance Broker | AHIP Certified
Craig Smith is the founder of Craig Smith Insurance Group, an independent Medicare brokerage serving seniors across New York, New Jersey, and nationwide since 2013. With over 25 years of financial services experience and 317+ five-star Google reviews, Craig helps clients compare Medicare Advantage, Medicare Supplement, and Part D plans — always free of charge.
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