Every fall, the Centers for Medicare & Medicaid Services (CMS) announces updates to Medicare premiums, deductibles, and cost-sharing amounts for the coming year. These adjustments reflect rising healthcare expenses and inflation and they affect how much you’ll pay for your coverage in 2026.
If you’re enrolled in Medicare or planning to join soon, here’s what you need to know about the new costs for Parts A, B, C, and D in 2026, along with tips from Carolina Senior Benefits on managing your healthcare expenses wisely.
Part A: Hospital Coverage in 2026
Medicare Part A helps pay for inpatient hospital stays, care in a skilled nursing facility, hospice services, and limited home health care. Most people receive premium-free Part A, but certain costs still apply when you use these services.
Here are the updated figures for 2026:
- Part A Premium: Most people (approximately 99% of all medicare beneficiaries) enjoy premium-free Part A. As long as you’ve worked for at least 40 quarters, you won’t pay a premium. However, those who have worked less than 40 quarters will have a monthly amount due.
- At least 30 quarters: $311
- Less than 30 quarters: $565
- Hospital Deductible: $1,736 per benefit period (up from $1,676)
- Daily Coinsurance for Hospital Stays:
- Days 61–90: $434 per day
- Lifetime Reserve Days: $868 per day
- Skilled Nursing Facility Coinsurance: $217 per day for days 21–100
These amounts are what you’ll owe before your Medigap or Medicare Advantage plan coverage kicks in, so it’s important to understand how they may impact your out-of-pocket costs.
Part B: Doctor Visits and Outpatient Services
Part B covers medical services such as doctor visits, preventive care, lab work, outpatient surgeries, and durable medical equipment. Unlike Part A, nearly all beneficiaries pay a monthly premium for Part B.
For 2026, CMS announced the following changes:
- Standard Monthly Premium: $202.90 (up from $185 in 2025)
- Annual Deductible: $283 (up from $257)
Once you’ve met your deductible, Medicare generally pays 80% of approved costs, and you pay the remaining 20%.
Additional Costs for Higher-Income Beneficiaries
Those with higher incomes pay more for Part B through an Income-Related Monthly Adjustment Amount (IRMAA). These surcharges apply to individuals earning over $109,000 or couples earning over $218,000, based on your most recent tax return. IRMAA ranges from $81.20 to $487 per person, per month.
Part D: Prescription Drug Coverage Updates
Medicare Part D plans are offered by private insurance companies and help cover the cost of prescription drugs. Plan premiums, formularies, and pharmacy networks vary, but CMS provides standard benchmarks each year.
Here’s what to expect in 2026:
- National Average Base Premium: $38.99 (slightly higher than $36.78 in 2025).
- Maximum Deductible: $615 (up from $590).
- Out-of-Pocket Cap: Increases to $2,100 per year, following the 2025 redesign that eliminated the catastrophic coverage phase.
High-Income Adjustment for Part D
As with Part B, those with higher incomes may pay an additional monthly amount for Part D coverage. The exact amount varies depending on income level and is billed directly by Medicare. IRMAA for Part D ranges from $14.50 to $91 per person, per month.
Because plans differ significantly, it’s always a good idea to review your Annual Notice of Change and compare plan options each fall during the Open Enrollment Period (October 15–December 7).
Part C: Medicare Advantage Plan Trends
Medicare Advantage, or Part C, bundles your hospital and medical coverage—and often prescription drug coverage—into one plan offered by private insurers.
For 2026, the national average Medicare Advantage premium is expected to hover around $11.50 per month, with many $0 premium options still available. However, keep in mind that these plans differ widely in:
- Provider networks
- Drug formularies
- Copayments and coinsurance
- Out-of-pocket maximums (MOOP)
CMS allows Medicare Advantage plans to set a MOOP up to $9,250 for 2026, though many plans set lower limits. Reviewing your plan each year ensures you’re still getting the best value and provider access for your area.
Preparing for 2026 and Beyond
Even modest adjustments in premiums or deductibles can add up over time. For those on fixed incomes, a $15 or $20 increase per month may mean adjusting budgets or evaluating supplemental coverage options.
If you’re enrolled in a Medigap plan, these updates determine how much your plan will pay after Medicare pays its share. If you have a Medicare Advantage plan, your costs may differ since private insurers set their own rates, but understanding the national trends helps you know what to expect overall.
Reviewing your plan annually can help you:
- Avoid unexpected rate increases or coverage gaps.
- Ensure your prescription drugs are still covered affordably.
- Explore new benefits or cost-saving opportunities.
Medicare changes every year—but staying informed is the key to avoiding surprises. The 2026 updates bring moderate increases to most premiums and deductibles, but also maintain important protections for prescription drug spending.
To make sure your coverage is ready for 2026, reach out to Carolina Senior Benefits today. Our services are always free, and we’re here to help you make confident, informed choices about your Medicare plan.
