What it actually costs
Six numbers explain almost every Medicare bill. Here they are for 2026, with what each one is for and who ends up paying it.
| Cost | 2026 amount | What it is |
|---|---|---|
| Part A premium | $0 for most | Free if you or a spouse paid Medicare taxes for ten years. Otherwise you can buy it, and we will tell you this year’s price. |
| Part A hospital deductible | about $1,736 | Per benefit period, not per year. Two separate hospital stays 60 days apart means paying it twice. |
| Part B premium | $202.90 a month | The standard amount, usually taken from your Social Security payment. Higher incomes pay more. |
| Part B deductible | $283 a year | You pay this once each calendar year before Part B starts paying its share. |
| Part B coinsurance | 20%, no ceiling | Your share of most Part B services, forever, unless you add a supplement or an Advantage plan. |
| Part D drug spending cap | $2,100 | Once you have paid this much of your own money for covered drugs, you pay nothing more that year. |
If your income was high two years ago
Most people pay the standard Part B premium. If your income was above a threshold on the tax return from two years ago, Social Security adds a surcharge to both your Part B and your Part D premiums. It is called IRMAA, and for 2026 it is based on your 2024 return.
It starts above roughly $109,000 for a single filer and roughly $218,000 for a married couple filing jointly, then rises in steps. Crossing a threshold by one dollar moves you a whole step, which is why it feels so blunt.
The part almost nobody is told
If your income has dropped since that tax year because you retired, stopped working, lost a spouse, divorced, or sold a business, you can ask Social Security to use your current income instead. The form is SSA-44, it is free, and it is often worth several hundred dollars a month.
We will help you fill it in whether or not you are a client.
What a whole year looks like
Three ways of covering the same person: 67, in Lucas County, three routine prescriptions, no hospital stay. Illustrative figures for a demonstration, not a quote.
Original Medicare alone
About $2,435 a year in premiums, plus $283 deductible, plus 20% of everything with no ceiling, plus a lifelong Part D penalty building up.
A quiet year is cheap. A bad year has no upper limit at all.
Plus Plan G and a drug plan
About $4,300 to $4,900 a year in premiums, plus the $283 Part B deductible, plus what the drugs cost up to the $2,100 ceiling.
Any doctor in the country. A bad year costs you almost nothing extra.
A Medicare Advantage plan
About $2,435 a year in premiums if the plan charges nothing on top, plus copays as you use it, up to the plan’s yearly ceiling.
A quiet year is very cheap. A bad year runs to the ceiling, often several thousand dollars.
The honest summary: you are choosing where you would rather carry the risk. Pay more every month and almost nothing when you are ill, or pay less every month and more when you are ill. There is no option where you pay less in both.
The penalties, and how long they last
Both of these are permanent, which is the part people find hardest to believe.
- Part B: 10% added to your premium for each full 12-month period you could have had Part B and did not, for as long as you have Part B. Two years late is 20% for life.
- Part D: 1% of the national base premium for each full month you went without creditable drug coverage, added for as long as you have Part D. Three years late is roughly a third more, for life.
Both are avoidable, and both have exceptions. If you had coverage from an employer, or you were told the wrong thing by a plan, or you were affected by a declared emergency, say so before you accept a penalty.
If money is tight, ask about these first
Two programs are badly under-claimed, and the income limits are higher than most people assume. Both are free to apply for.
- Medicare Savings Programs are run by your state and can pay your Part B premium outright, and sometimes your deductibles and coinsurance too. Qualifying for one also enrolls you automatically in the second.
- Extra Help pays most of the cost of a Part D drug plan. You apply through Social Security.
We will check whether you qualify, and help with the paperwork, whether or not you ever buy anything from us. It is the single highest-value thing we do and it earns us nothing.
What would your year actually cost?
Tell us your ZIP code, your prescriptions and your doctors. We will work out the yearly total for each realistic option and send it to you in writing.