Medicare Costs 2026: What You'll Actually Pay
The official 2026 Medicare premiums, deductibles, and coinsurance — with IRMAA surcharges at every income tier. For retirees with incomes above $109,000 (single) or $218,000 (married), IRMAA adds up to $6,936 per person per year on top of the base Part B premium.
Part A Costs 2026 (Hospital Insurance)
Most retirees pay $0 for Part A premiums if they or their spouse worked 40+ quarters (10 years) paying Medicare taxes. If you didn't meet that threshold:
| Medicare-covered work quarters | Monthly Part A premium 2026 |
|---|---|
| 40 or more quarters | $0 |
| 30–39 quarters | $311/month |
| Fewer than 30 quarters | $565/month |
Part A Hospital Deductible and Coinsurance 2026
Part A uses a benefit period structure — not a calendar-year deductible. Each new hospital admission can trigger a new benefit period and a new $1,736 deductible if you've been out of inpatient care for 60+ consecutive days.
| Inpatient stay length | Your cost in 2026 |
|---|---|
| Days 1–60 (per benefit period) | $1,736 deductible |
| Days 61–90 | $434/day coinsurance |
| Days 91–150 (lifetime reserve days) | $868/day coinsurance |
| Beyond 150 days | All costs — no Part A coverage |
| Skilled nursing facility, days 1–20 | $0 |
| Skilled nursing facility, days 21–100 | $217/day coinsurance |
| Skilled nursing facility, beyond day 100 | All costs |
Medigap Plan G and Plan N each cover the Part A deductible and hospital coinsurance, which is why most retirees choosing Original Medicare pair it with a supplement. See Medigap Plan G vs. Plan N comparison.
Part B Costs 2026 (Medical Insurance)
Part B covers outpatient care, physician visits, preventive services, and durable medical equipment. After your $283 annual deductible, you pay 20% of covered costs with no out-of-pocket cap under Original Medicare (Medigap fills that gap).
Base Part B Premium: $202.90/month
That's the floor — $2,434.80 per year. Beneficiaries with 2024 MAGI above $109,000 (single) or $218,000 (married filing jointly) pay an IRMAA surcharge on top of this amount.
IRMAA Surcharges 2026: Part B and Part D by Income Tier
IRMAA uses the two-year look-back: your 2026 Medicare premiums are based on your 2024 MAGI, as reported on your 2024 tax return filed in spring 2025.
| 2024 MAGI — Single | 2024 MAGI — Married (MFJ) | Part B surcharge/mo | Total Part B/mo | Part D surcharge/mo | Annual IRMAA (both parts) |
|---|---|---|---|---|---|
| ≤$109,000 | ≤$218,000 | $0 | $202.90 | $0 | $0 |
| $109,001–$137,000 | $218,001–$274,000 | +$81.20 | $284.10 | +$14.50 | $1,148/yr |
| $137,001–$171,000 | $274,001–$342,000 | +$202.90 | $405.80 | +$37.50 | $2,886/yr |
| $171,001–$205,000 | $342,001–$410,000 | +$324.60 | $527.50 | +$60.40 | $4,620/yr |
| $205,001–$499,999 | $410,001–$749,999 | +$446.30 | $649.20 | +$83.30 | $6,355/yr |
| ≥$500,000 | ≥$750,000 | +$487.00 | $689.90 | +$91.00 | $6,936/yr |
IRMAA surcharges are per person. Married couples each pay individually based on their joint MAGI against the MFJ brackets above. If both spouses are on Medicare, multiply the annual figure by 2.
What a Married Couple Actually Pays in Medicare Premiums 2026
When both spouses are on Medicare, IRMAA hits both. The combined cost for a couple by income bracket:
| Joint 2024 MAGI | Annual Part B per person | Annual IRMAA per person | Combined annual IRMAA (couple) |
|---|---|---|---|
| ≤$218,000 | $2,435 | $0 | $0 |
| $218,001–$274,000 | $3,409 | $1,148 | $2,296 |
| $274,001–$342,000 | $4,870 | $2,886 | $5,772 |
| $342,001–$410,000 | $6,330 | $4,620 | $9,240 |
| $410,001–$749,999 | $7,790 | $6,355 | $12,710 |
| ≥$750,000 | $8,279 | $6,936 | $13,872 |
These figures cover Part B + Part D surcharges only. Add your Part D plan premium (typically $20–$80/month per plan), plus Medigap supplements if using Original Medicare.
The Two-Year Look-Back: Which Income Year Drives Your Premium
SSA sets premiums using the most recently completed tax return — typically two years prior.
| Premium year | MAGI year used | Tax return filed |
|---|---|---|
| 2026 | 2024 MAGI | Spring 2025 |
| 2027 | 2025 MAGI | Spring 2026 |
| 2028 | 2026 MAGI | Spring 2027 |
If you retired in 2024 or 2025 and your income dropped significantly from the year SSA is using, you can appeal using SSA Form SSA-44. A successful appeal lets SSA use your current-year income projection instead. See How to Appeal IRMAA Surcharges (SSA-44).
What Counts as MAGI for IRMAA
IRMAA MAGI includes virtually all income sources:
- Wages, self-employment income, pensions, and annuities
- Traditional IRA and 401(k) distributions (fully counts)
- Roth conversions (the conversion amount adds to MAGI in the conversion year)
- Required Minimum Distributions (RMDs)
- Social Security benefits (the taxable portion)
- Capital gains — including gains from selling a home above the $250K/$500K exclusion
- Rental income and other passive income
What does not count: Roth IRA distributions (after the 5-year rule), and Qualified Charitable Distributions (QCDs) from an IRA — QCDs are excluded from MAGI, making them one of the most effective IRMAA reduction tools available to retirees over 70½.1
A large Roth conversion in 2024 may have already lifted your 2026 premiums to a higher tier. Conversely, careful 2025 income management will determine your 2027 premiums. See Roth Conversion + IRMAA Strategy and 7 Ways to Reduce Your IRMAA Surcharges.
Part D Costs 2026 (Prescription Drug Coverage)
Part D has two cost layers:
- Plan premium: Varies by plan and geography — most stand-alone Part D plans run $20–$80/month. You choose a plan annually during the October 15–December 7 Annual Enrollment Period.
- IRMAA surcharge: Paid directly to Medicare on top of your plan premium (amounts in the table above).
For 2026, the Part D out-of-pocket maximum is $2,000 — a significant improvement from prior years' uncapped catastrophic exposure. See Medicare Part D 2026 Complete Guide for the full cost structure including late enrollment penalties.
Total Annual Medicare Cost Snapshot (Single Retiree, Base IRMAA Tier)
| Cost component | Annual cost (2026) |
|---|---|
| Part A premium (40+ quarters) | $0 |
| Part B premium (base) | $2,435 |
| Part B annual deductible | $283 |
| Part D plan premium (estimate) | $360–$960 |
| Medigap Plan G supplement (estimate, age 65) | $1,800–$3,600 |
| Estimated total (no IRMAA, with Medigap G) | ~$4,900–$7,300/yr |
If you're in Medicare Advantage instead of Original Medicare + Medigap, the structure differs: many MA plans have $0 or low monthly premiums but charge copays and coinsurance at time of service. See Medicare Advantage vs. Medigap: How to Decide.
Get your Medicare costs modeled
A specialist advisor runs your actual numbers: IRMAA exposure across each year of retirement, Roth conversion tradeoffs, Medigap vs. Medicare Advantage — for your specific income picture. Free match.
Related guides
- Medicare IRMAA Bracket Calculator — enter your 2024 MAGI and see your exact 2026 surcharge
- 7 Ways to Reduce Your IRMAA Surcharges
- How to Appeal IRMAA Surcharges (SSA-44)
- Roth Conversion Timing and IRMAA
- Medigap Plan G vs. Plan N vs. High-Deductible G
- Medicare Part D 2026: Costs, IRMAA, Penalties
- Medicare for Married Couples: Coordinating Coverage and IRMAA
- Medicare Planning Complete Guide
- QCD exclusion from MAGI: IRS Publication 590-B; QCDs reduce AGI directly and are excluded from IRMAA MAGI calculation. 2026 QCD limit: $111,000/person. IRS Publication 590-B
- 2026 Part A premiums: $0 (40+ qtrs), $311 (30–39 qtrs), $565 (<30 qtrs). Hospital deductible $1,736; SNF days 21–100 coinsurance $217/day. CMS 2026 Medicare Parts A & B Premiums and Deductibles Fact Sheet
- 2026 Part B standard premium $202.90/month; annual deductible $283. CMS fact sheet, November 2025.
- 2026 IRMAA thresholds (single: $109K/$137K/$171K/$205K/$500K; MFJ: $218K/$274K/$342K/$410K/$750K) and Part B/D surcharge amounts. SSA POMS HI 01101.020
- Part D 2026 $2,000 out-of-pocket cap per Inflation Reduction Act. CMS Part D benefit structure
All values verified April 2026 against CMS and SSA official sources. IRMAA brackets reflect 2024 MAGI look-back for 2026 coverage year. Medigap and Part D plan premiums are estimates; actual costs vary by plan, insurer, and geography.