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Last reviewed: July 2026

The three kinds of Medicare costs

Almost every dollar you spend on Medicare falls into one of three buckets: premiums (what you pay monthly just to have coverage), deductibles (what you pay before coverage kicks in), and coinsurance or copayments (your share of each service after that). The amounts below are the standard 2026 figures set by the Centers for Medicare & Medicaid Services (CMS). If you are new to how the parts fit together, start with our guide to Medicare's parts, then come back for the numbers.

Part A: why "free" still has real costs

Most people pay no premium for Part A (hospital insurance) because they or a spouse paid Medicare taxes for at least 40 quarters, about 10 years of work. If you have 30 to 39 quarters, Part A costs $311 per month in 2026; with fewer than 30 quarters, it costs $565 per month.

But premium-free is not cost-free. When you actually use Part A, you pay:

Crucially, Original Medicare has no annual out-of-pocket maximum. That gap is a big part of why some people add a Medigap policy or choose a Medicare Advantage plan, which handles costs differently; see Medicare Advantage vs. Original Medicare for how those structures compare.

Part B: the premium most people actually pay

The standard Part B (medical insurance) premium is $202.90 per month in 2026, up $17.90 from $185.00 in 2025. Most people have it deducted from their Social Security payment. Higher-income beneficiaries pay more (see IRMAA below), and people with limited income may pay less or nothing through a Medicare Savings Program.

The annual Part B deductible is $283 in 2026, up from $257. After you meet it, you generally pay 20% coinsurance on the Medicare-approved amount for covered doctor visits, outpatient care, and durable medical equipment, again with no annual cap under Original Medicare. Many preventive services are covered at no cost to you; our preventive benefits guide lists them.

Part D: drug coverage costs in 2026

Part D premiums are set by private plans, so there is no single standard premium; what you pay depends on the plan you pick. Two national numbers matter anyway:

The biggest protection: once your out-of-pocket spending on covered drugs reaches $2,100 in 2026 (up from $2,000 in 2025), you enter catastrophic coverage and pay $0 for covered prescriptions the rest of the year. You can also opt into the Medicare Prescription Payment Plan, which spreads your drug costs across the year in monthly installments rather than lowering them. For how the phases and formularies work, see our Part D drug coverage guide.

IRMAA: the income surcharge, explained conceptually

If your income is above a set level, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of your Part B premium and, if you have drug coverage, your Part D premium. Key facts:

Late enrollment penalties: avoidable, but permanent

Signing up late can add permanent surcharges. The Part B penalty is generally 10% of the standard premium for each full 12-month period you could have had Part B but didn't, paid for as long as you have Part B. The Part D penalty is 1% of the national base beneficiary premium ($38.99 in 2026) for each month you went without creditable drug coverage. Whether you can safely delay depends on your situation, especially if you have employer coverage; see our guides to enrollment periods and working past 65.

If these numbers strain your budget

Help exists and is underused. Medicare Savings Programs can pay the Part B premium (and sometimes more) for people with limited income and resources, and Extra Help lowers Part D premiums and drug costs. Our guide to help paying for Medicare walks through the programs and how to apply.

Which coverage combination makes financial sense depends entirely on your health, budget, and existing coverage; no article can answer that for you. For personalized, unbiased help, use medicare.gov, call 1-800-MEDICARE, or contact your State Health Insurance Assistance Program (SHIP) for free one-on-one counseling.

Sources

This guide is for general education only and is not medical, legal, insurance, or financial advice. For decisions about your own coverage, use official sources or free help from your SHIP counselor.