Medicare Costs: What You'll Actually Pay

The four kinds of cost

Almost every Medicare bill is one of these four. Knowing which is which makes the rest of this page, and your plan documents, much easier to read, because the same four behave differently in each part of Medicare.

• Premium: A monthly amount you pay to have the coverage at all.
• Deductible: What you pay yourself before the coverage starts paying.
• Coinsurance: A percentage of the cost, paid after the deductible.
• Copayment: A set dollar amount for a particular service or prescription.

Part A costs (2026)

Most people get premium-free Part A, having 40 or more quarters of Medicare taxes behind them. With fewer quarters you buy in: $311 a month at 30 to 39 quarters, $565 below that. A $0 premium is not the same as free, though, because the deductible and coinsurance still apply.

• Inpatient deductible: $1,736 per benefit period, not per year. A new benefit period begins once you have been out of hospital for 60 days in a row, so it is possible to pay this more than once in a calendar year.
• Days 1 to 60: No coinsurance once the deductible is met.
• Days 61 to 90: $434 a day.
• Lifetime reserve days: $868 a day, and you only get 60 of these in your lifetime. They do not renew.
• Skilled nursing, days 21 to 100: $217 a day, after a qualifying hospital stay. Days 1 to 20 cost nothing.

Part B costs (2026)

The standard Part B premium is $202.90 a month, usually taken straight out of your Social Security payment. There is a $283 annual deductible, and after that Medicare pays 80% of the approved amount for most services while you pay the remaining 20%. Many preventive services cost nothing at all if your provider accepts assignment.

IRMAA, if your income is above the threshold

Higher earners pay an income-related monthly adjustment amount on top of the standard Part B and Part D premiums. It is based on your tax return from two years earlier, so 2026 IRMAA looks at your 2024 income. In 2026 it adds between $81.20 and $487.00 a month to Part B. If your income has fallen since that tax year because you retired, divorced or lost a spouse, you can appeal using form SSA-44 rather than simply paying it.

Part D drug costs (2026)

Part D premiums vary by plan, and higher earners pay an IRMAA surcharge on those too. Two limits apply whichever plan you pick: no plan's drug deductible can exceed $615, and once your out-of-pocket spending on covered drugs reaches $2,100 you pay nothing more for them for the rest of the year. That annual cap comes from the Inflation Reduction Act and is indexed each year. Our page on Medicare Part D Costs walks through each stage, and if you delay drug coverage without other creditable coverage, a late enrollment penalty is added to your premium for as long as you have it.

Medicare Advantage costs work differently

Medicare Advantage (Part C) Costs are set by the plan itself, inside federal rules. You keep paying your Part B premium, plus whatever the plan charges on top, which is often nothing. Instead of the standard Part A and Part B cost-sharing you pay the plan's own copays. The important structural difference is that every Medicare Advantage plan must cap your annual out-of-pocket costs for covered medical care. Once you hit that cap, the plan pays everything else for the year.

The cost with no limit at all

Here is the fact most people do not know until it matters. Original Medicare on its own has no annual out-of-pocket maximum. There is no ceiling. A long illness means your 20% share of Part B services simply keeps accumulating, and a serious hospitalization can run to tens of thousands in cost-sharing. This single gap is why most people add something: Medigap policies, which cover most of the cost-sharing, or a Medicare Advantage plan, which brings the statutory cap described above.

What a year actually looks like

Picture two versions of the same year. With Parts A and B alone, you first pay the $283 Part B deductible, then 20% of the approved amount for every visit, test and treatment after it, and if you are admitted to hospital you pay the $1,736 deductible for that benefit period. None of it has a ceiling. In a Medicare Advantage plan you pay set copays per visit instead, and your total is capped by the plan's annual maximum, though you may need to stay in network to get it. Which is better depends on your health, your doctors and how much risk you are comfortable carrying.

Ways to pay less

Most of these cost nothing to act on, and the first two are the ones people skip. Check first whether you qualify for help: our cost assistance page covers Medicaid, Extra Help and the Medicare Savings Program that can pay your Part B premium outright. Compare plans every fall as well, because drug lists and costs change annually.

• Check whether you qualify for help: Medicaid, a Medicare Savings Program or Extra Help can cut your costs sharply. Extra Help reduces Part D premiums, deductibles and copays; a Medicare Savings Program can pay your Part B premium outright. Extra Help income limits are $23,475 for an individual and $31,725 for a couple.
• Compare plans every fall: Costs and drug lists change annually, and the plan that was right last year often is not this year.
• Appeal an IRMAA you should not owe: Form SSA-44 exists precisely for income that has dropped since the tax year CMS used.
• Stay in network: If you are in a Medicare Advantage plan, out-of-network care usually costs considerably more.
• Use the free preventive care: Many screenings and the annual wellness visit cost nothing.
• Enroll on time: Late penalties on Part B and Part D are usually permanent.

What changes in 2027

CMS publishes next year's figures on different schedules, so some 2027 numbers are already final and others are not. The Part D limits are confirmed: the maximum drug deductible rises to $700 and the out-of-pocket cap to $2,400. Social Security benefits rise by 3.6%. The Part A and Part B amounts are normally announced in mid-November, and until they are, the figures below are this year's. Whichever way you put your Medicare coverage together, the figures move on this same schedule.

• Part B premium: $202.90 (2026 figure, 2027 not yet announced)
• Part B deductible: $283 (2026 figure, 2027 not yet announced)
• Part A inpatient deductible: $1,736 (2026 figure, 2027 not yet announced)
• Hospital days 61 to 90: $434 (2026 figure, 2027 not yet announced)
• Skilled nursing days 21 to 100: $217 (2026 figure, 2027 not yet announced)

Common questions

More in Medicare 101

• Turning 65: Your complete guide to starting Medicare
• Medicare Eligibility: Who Qualifies, and When
• How to Enroll in Medicare, Step by Step
• Medicare and Working Past 65: When to Enroll and What to Keep
• The Parts of Medicare, Explained: A, B, C and D
• Medicare Enrollment Periods: Every Window Explained
• Medicare Late Enrollment Penalties, and How to Avoid Them
• Medicare Advantage vs. Medicare Supplement: How to Choose
• Medicare Prescription Drug Coverage: Where It Comes From and How It Works