Your Medicare coverage and costs can change each year, so it’s important to understand and review your benefits. Here’s an overview of what’s new in 2026.
Let’s start with Part A costs in 2025:
| Part A premium | If you’ve worked and paid Medicare tax: 10 years or more $0 per month 7.5 to 10 years $311 per month Fewer than 7.5 years $565 per month |
| Part A hospital deductible | $1,736 each benefit period |
| Part A hospital coinsurance | $$0 for the first 60 days of inpatient care each benefit period $434 per day for days 61-90 each benefit period $868 per lifetime reserve day after day 90 in a benefit period (You have 60 lifetime reserve days that can only be used once. They’re not renewable.) |
| Skilled nursing facility insurance | $0 for the first 20 days of inpatient care each benefit period $217 per day for days 21-100 each benefit period |
Medicare Part A covers inpatient hospital services, skilled nursing facility services, some home health care, and hospice. Most people don’t owe a premium for Part A, but if neither you nor your spouse have 10 years of Social Security work credits, you may owe a monthly premium. If you’re admitted to the hospital as an inpatient, you’ll owe a deductible of $1,736 at the beginning of your stay. If you have multiple hospitalizations, you may owe the deductible more than once. After you meet your deductible, your first 60 days in the hospital and your first 20 days in a skilled nursing facility cost $0 per day. After that, you owe an out-of-pocket cost each day for your continued stay.
And now Part B costs in 2026:
| Part B premium (For individuals with incomes below $109,000 or couples with incomes below $218,000 | $202.90 is the standard premium |
| Part B deductible | $283 per year |
| Part B coinsurance | 20% for most services Part B covers |
Medicare Part B covers outpatient costs, such as doctor visits and lab tests. In 2026, the standard Part B premium is $202.90. If your income is above $109,000 as a single person or $218,000 as a married couple, you may pay a higher premium. Keep in mind that if you have a Medicare Advantage plan, you may also pay an additional monthly premium for being enrolled in that plan. If you have Original Medicare, you‘ll owe a Part B deductible of $283 in 2026. You’ll continue to owe 20% coinsurance for most services covered by Part B.
Your prescription drug coverage costs will depend on your specific plan, but there are some numbers that are helpful for everyone to know in 2026:
| National average premium for basic Part D benefit | $38.99 per month |
| Part D maximum deductible | $615 per year |
| Catastrophic coverage | $2,100 |
Medicare Part D covers outpatient prescription drugs. Each year, Part D plans can change the drugs they cover, their pharmacy networks, and their costs. In 2026, your annual out-of-pocket Part D costs are capped at $2,100. After you reach this out-of-pocket limit, you owe nothing for covered drugs for the rest of the year. You’ll have the option to sign up for a payment plan for Part D out-of-pocket costs. The Medicare Prescription Payment Plan, or MPPP, allows you to spread your drug costs throughout the year, with the goal of helping you manage your monthly expenses.
If your income is limited, you may qualify for help with your Medicare costs. Contact your State Health Insurance Assistance Program, or SHIP, to see if you’re eligible. Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
Know your opportunities to change your coverage in 2026.
Many people have to wait until Fall Open Enrollment to change their coverage if they aren’t happy with it. You may have the opportunity to change your coverage earlier in 2025, though, depending on your circumstances.
- If you have a Medicare Advantage plan, you may be able to use the Medicare Advantage Open Enrollment Period, also known as the MA OEP. You can use this period to switch from your Medicare Advantage plan to another Medicare Advantage plan, or to Original Medicare with or without a prescription drug plan. The MA OEP is each year from January 1 through March 31.
- If you have Medicaid, a Medicare Savings Program, or Extra Help, you have a Special Enrollment Period, or SEP, to enroll in a stand-alone Part D plan or switch between them. This SEP is once per month. If you use this SEP to change your coverage, the change will become effective the first of the following month.
- If your Medicare Advantage or Part D plan ended at the close of the year: If your plan ended, it should have sent you a letter in early October explaining that it will no longer be available next year. Because your plan is ending, you have an SEP from December 8, 2025 through February 28, 2026 to change your Medicare health and drug coverage.
- If you enrolled using incorrect provider directory information on Medicare Plan Finder. This is a new, temporary SEP. You can use it to change your Medicare Advantage plan if you enrolled in that plan through Medicare Plan Finder and used the tool’s provider directory information to make the choice. If you realize within three months of the plan’s effective date that your preferred provider is not in the plan’s network, you can use this new SEP.
- If you qualify for another Special Enrollment Period, you may be able to change your coverage. There are several situations when you might qualify for an SEP. For example, if you move outside your plan’s service area or if your Medicare Advantage plan stopped working with a large amount of its network providers.
If you qualify for another Special Enrollment Period, you may be able to change your coverage. There are several situations when you might qualify for an SEP. For example, if you move outside your plan’s service area, if your Medicare Advantage Plan stopped working with a large amount of its network providers, or if you enroll in certain State Pharmaceutical Assistance Programs. To use an SEP, call 1-800-MEDICARE and explain your situation. If you have questions about your SEP eligibility, contact your State Health Insurance Assistance Program, or SHIP.
Finally, beware of “new” Medicare card schemes.
You will not be getting a new Medicare card. Starting in April 2018, CMS sent new Medicare cards to all Medicare beneficiaries. By the end of January 2019, all beneficiaries had their new Medicare cards, which were designed to better protect against identity theft by removing their Social Security number. Although the rollout of these updated cards is complete, scams around these new cards continue.
For example, scammers may falsely tell you that Medicare is issuing an updated or new card—perhaps a plastic one, metal one, or one with a chip. The scammers may tell you that you need to verify your identity for them to send your new Medicare card. This is the scammer’s attempt to gain your personal or financial information.
Here are some red flags to be aware of:
- Unsolicited calls from someone claiming to be from Medicare.
- Anyone saying that they need your information to send you a new Medicare card.
- Anyone claiming that your card is expiring and that you will be charged a fine if you do not get a new one.
- Anyone stating that Medicare is issuing new cards, and you need to verify your Medicare number.
If you believe you have experienced potential fraud, contact your Senior Medicare Patrol (SMP). Find your local SMP by using the online SMP Locator or by calling 877-808-2468.
Still have questions?
Your SHIP is here for you! You can contact your SHIP for any Medicare-related questions or concerns you have. SHIP counselors are government funded to provide trusted, unbiased Medicare counseling at no cost to you. (Depending on your state, your SHIP may go by another name.) Use our online SHIP Locator or call 877-839-2675 (and say ‘Medicare’ when prompted) to find your local SHIP.
If you think you have experienced potential Medicare fraud, errors, or abuse contact your local Senior Medicare Patrol using the online SMP Locator or by calling 877-808-2468.