Key Takeaways
- In 2026, CMS set $1,736 (Part A hospital deductible per stay period), $202.90/month (standard Part B premium), and $283 (Part B annual deductible)—figures Medicare.gov matches.
- Most people pay $0 for Part A; if you buy in, expect $311 or $565/month in 2026 depending on work history (Medicare.gov).
- Part C and Part D costs vary by plan and service area—there is no single national price; use Medicare Plan Compare for your ZIP code.
- IRMAA can raise Part B and Part D costs for higher earners; see CMS’s 2026 fact sheet.
- Original Medicare has no yearly out-of-pocket cap on its own; Medicare Advantage plans include an annual limit on covered Part A and B cost-sharing (Medicare.gov).
- What Changes for Medicare Costs in 2026
- Part A Costs in 2026
- Part B Costs in 2026
- How Medicare Advantage Fits Into Your Budget
- Part D Drug Coverage Costs in 2026
- Common Coverage Gaps
- Frequently Asked Questions
- Take the Next Step
Each fall, CMS announces updated premiums, deductibles, and coinsurance for Part A and Part B for the next calendar year. On November 14, 2025, CMS released the 2026 amounts used throughout this article, together with 2026 IRMAA tables for Part B, Part D, and related categories on its official fact sheet.
For Brooklyn and NYC readers, the practical split is simple: Original Medicare cost-sharing is national—your deductibles and standard Part B premium are the same whether you live in 11230 or another state. What varies locally is Medicare Advantage and Part D: monthly premiums, copays, networks, and drug formularies depend on the plans sold in your county. Always confirm plan-specific numbers in your Evidence of Coverage or Medicare Plan Compare.
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Use primary sources: Medicare.gov — Costs for consumer-facing summaries, CMS newsroom fact sheets for the same figures with technical context, and your plan documents for Part C/D. If you want free, unbiased counseling, contact your State Health Insurance Assistance Program (SHIP) via SHIP Help.
Part A (Hospital Insurance) helps cover inpatient hospital care, skilled nursing facility care after a hospital stay, hospice, and limited home health in defined situations. For cost-sharing, think in three layers: premium (often zero), deductible per benefit period, and daily coinsurance after certain day counts.
Usually no. If you or your spouse paid Medicare taxes for long enough while working (often described as about 10 years / 40 quarters), you get premium-free Part A. Medicare.gov states that roughly this group pays $0. If you are not premium-free, you may be able to buy Part A; in 2026, CMS set the reduced buy-in at $311/month (for people with 30–39 quarters of coverage) and the full premium at $565/month (fewer than 30 quarters), as summarized on Medicare.gov and detailed on the CMS fact sheet. You generally must also enroll in Part B to buy Part A.
For 2026, the Part A inpatient hospital deductible is $1,736 for each benefit period, before Original Medicare starts paying its share—up $60 from $1,676 in 2025, per CMS. A benefit period begins the day you are admitted as an inpatient and ends when you have been out of the hospital or SNF for 60 days in a row; you can have more than one benefit period in a year, so you could pay that deductible more than once in a year if you have separate qualifying stays (Medicare.gov).
Inpatient daily coinsurance (2026) after the deductible, per CMS:
| Situation | You pay (2026) |
|---|---|
| Days 1–60 | $0 after the deductible |
| Days 61–90 | $434 per day |
| Lifetime reserve days | $868 per day |
Skilled nursing facility: days 1–20 are $0 for covered care; days 21–100 are $217/day in 2026 (Medicare.gov, CMS).
Part B (Medical Insurance) covers doctors’ services, outpatient care, durable medical equipment, and many preventive services. Almost everyone who wants Part B pays a monthly premium and, for most services, cost-sharing after the annual deductible.
For 2026, the standard Part B premium is $202.90/month (up from $185.00 in 2025), and the annual Part B deductible is $283 (up from $257), according to CMS and Medicare.gov. After you meet the deductible, you often pay 20% of the Medicare-approved amount for many Part B services when the provider accepts assignment—but outpatient hospital visits can include additional copayments, so your bill may be higher in a hospital outpatient department than in a doctor’s office for a similar service (Medicare.gov).
If your income is above certain thresholds, you pay more than the standard Part B premium. IRMAA (income-related monthly adjustment) affects about 8% of people with Part B, per CMS. The 2026 income brackets and total monthly premiums appear in the tables on CMS’s 2026 premiums and deductibles fact sheet; Medicare uses tax return data from two years earlier to determine whether IRMAA applies, with a formal appeals process if your situation changes.
A smaller group who lost full Part B after a kidney transplant may elect Part B coverage limited to immunosuppressive drugs. For 2026, CMS lists a standard premium of $121.60 for that benefit, with separate IRMAA tables if income is high—see CMS.
Medicare Advantage (Part C) bundles Part A and Part B benefits through private plans that follow Medicare rules. Costs vary by plan: you may pay a plan premium on top of your Part B premium (some plans advertise $0 plan premiums but you still keep paying Part B unless Medicaid or another program helps). Medicare.gov emphasizes that you must stay enrolled in Part A and Part B and continue paying the Part B premium to stay in a Medicare Advantage plan.
The main structural difference from Original Medicare: Medicare Advantage plans include a yearly limit on your out-of-pocket costs for covered Part A and B services—the MOOP (maximum out-of-pocket). Original Medicare alone does not cap your annual spending—Medicare.gov states there is no yearly limit unless you add supplemental coverage or use Part C.
If you are comparing Original Medicare plus options with Medicare Advantage, our guides to Medicare Advantage vs Original Medicare and the Medicare Advantage overview walk through tradeoffs at a high level—always verify networks, referrals, and drug coverage for your plans.
Part D helps cover outpatient prescription drugs. Premiums, deductibles, copays, and coinsurance depend on which drug plan you choose and which tier your medications fall into; Medicare.gov states these amounts vary by plan and pharmacy. Many Medicare Advantage plans include drug coverage (MA-PD); if you stay in Original Medicare, you usually add a standalone Part D plan unless you have other creditable drug coverage.
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Similar to Part B, higher-income enrollees may pay an extra amount on top of their Part D premium. CMS publishes 2026 Part D IRMAA amounts on the same fact sheet as Part B IRMAA. Roughly 8% of Part D enrollees pay these adjustments, per CMS.
If you go 63 days or more in a row without creditable drug coverage after you are first eligible, you may owe a Part D late enrollment penalty that can last as long as you have Part D. Medicare.gov explains how to avoid penalties—including signing up when you are first eligible and keeping proof of creditable coverage from an employer or union plan.
If you have limited income and resources, you may qualify for Extra Help (the Low-Income Subsidy) to pay Part D premiums and costs, or for a Medicare Savings Program through your state for Part A/Part B help. Start with Medicare — Get help with costs and your local SHIP counselor.
Need help comparing plans in your ZIP code? Call (347) 696-6757 for a free, no-obligation conversation with a licensed Medicare advisor based in Brooklyn. We can explain how Part C and Part D options work among plans we offer in your area—then confirm details on Medicare Plan Compare or with SHIP for all available plans.
Medicare is strong hospital and medical insurance, but it does not cover everything. Common Original Medicare gaps include long-term custodial care (help with bathing, dressing, and eating in a nursing home), routine dental, routine vision exams for eyeglasses, routine hearing exams for hearing aids, and most care outside the United States. Medicare.gov — What’s not covered? lists additional examples.
How people fill gaps: Some use Medicare Advantage plans that may include extra benefits (which vary by plan and change yearly). Others stay on Original Medicare and add Medigap for help with deductibles and coinsurance on Part A/B services, plus Part D for drugs—subject to Medigap enrollment rules in your state. If you are dual eligible (Medicare and Medicaid), a D-SNP or other coordination pathway may apply; see our D-SNP overview and what is a D-SNP.
For enrollment timing that affects what you pay, review our posts on AEP, OEP, and SEP and the Medicare enrollment checklist.
The standard monthly Part B premium is $202.90 in 2026, per CMS and Medicare.gov. If IRMAA applies because of higher income, you pay more; CMS lists the exact total premiums by bracket on its 2026 fact sheet.
The Part A inpatient hospital deductible is $1,736 per benefit period in 2026 (CMS). Because benefit periods can repeat, you could owe that deductible more than once in a year if you have separate qualifying hospital stays.
Original Medicare alone has no yearly out-of-pocket maximum for Part A and B services. Medicare.gov notes you may get a cap if you add Medigap or enroll in Medicare Advantage, which must limit out-of-pocket spending for covered services each year.
You continue paying your Part B premium (and Part A premium if you have one). Medicare Advantage plans may charge an additional plan premium; some show $0. Standalone Part D plans charge a separate premium. If you have MA-PD, drug coverage is usually bundled into the same plan with one premium structure—verify your Summary of Benefits.
IRMAA is an income-related extra charge on Part B and sometimes Part D. Medicare uses IRS data from about two years ago to assign a bracket. If your income drops because of retirement, marriage status changes, or other life events, you can ask for a reconsideration using Social Security’s process—start with the notice you receive or Medicare.gov.
Yes, for many who qualify. Medicare Savings Programs and Extra Help can reduce premiums, deductibles, and drug costs based on income and resources. Use Medicare — Get help with costs and SHIP for free screening; NY also has Medicaid and Medicare–Medicaid coordination rules that may apply if you are dual eligible.
Medicare cost-sharing rules are national, but your best-value plan depends on drugs, doctors, and budget—and those are personal. If you want a licensed broker to review Medicare Advantage and related options available in your area, SJM Cares serves Brooklyn and the five NYC boroughs every week.
Call us at (347) 696-6757 or schedule an appointment online.
Written by Hamad Amir, licensed insurance agent and founder of SJM Insurance Services, LLC. Licensed in New York and New Jersey (License #LB-1024797). Specializing in Medicare Advantage and D-SNP plans for Brooklyn and NYC residents.
Image credits: Hero and inline photos from Unsplash (Unsplash License—free commercial use).
Disclaimer: This article is for educational and informational purposes only and does not constitute professional insurance, financial, or legal advice. For personalized guidance, call a licensed SJM Cares advisor at 917-373-0117.
We do not offer every plan available in your area. Currently we represent 10 organizations which offer Medicare Advantage HMO, PPO, PFFS, and PDP plans in your area. Please contact Medicare.gov, 1-800-MEDICARE (TTY: 1-877-486-2048), or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.
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