Calculate your 2026 Medicare costs: Part A, Part B, Part D premiums, and IRMAA income surcharges. See if high income triggers higher premiums and how to potentially reduce your costs.
Medicare 2026: A Complete Cost Breakdown
Medicare is not free, and costs vary dramatically based on your income history, the coverage choices you make, and whether IRMAA applies. Planning ahead can save thousands per year.
What Each Part Costs in 2026
Part
What It Covers
2026 Premium
Part A
Hospital, skilled nursing, hospice
$0 (if 40+ work quarters)
Part B
Doctors, outpatient, preventive
$185/month base
Part D
Prescription drugs
~$40–$60/month (plan varies)
Medigap G
Fills A+B cost gaps
$120–$250/month (age/location)
Medicare Advantage
Replaces A+B+D
Often $0–$100/month
IRMAA Surcharges 2026: Part B Premiums by Income
Single MAGI (2024)
Joint MAGI (2024)
Monthly Part B
Up to $106,000
Up to $212,000
$185.00
$106,001 – $133,000
$212,001 – $266,000
$259.00
$133,001 – $167,000
$266,001 – $334,000
$370.00
$167,001 – $200,000
$334,001 – $400,000
$480.90
$200,001 – $500,000
$400,001 – $750,000
$591.90
Over $500,000
Over $750,000
$628.90
Strategies to Reduce Medicare Costs
Roth conversions before age 63 reduce your future MAGI (which is assessed on a 2-year lookback), potentially keeping you below IRMAA thresholds in retirement. QCDs (Qualified Charitable Distributions) from your IRA reduce MAGI and can help avoid IRMAA brackets. If you experience a qualifying life event (retirement, divorce) that reduced your income, file Form SSA-44 to appeal your IRMAA determination using current income rather than the 2-year lookback.
See how Medicare costs fit into your overall retirement plan with our Retirement Calculator.
Frequently Asked Questions
For most people: Part A is free (if you worked 40+ quarters). Part B is $185/month (base premium in 2026). Part D varies by plan, averaging $40–$60/month. A Medicare supplement (Medigap Plan G) runs $120–$250/month depending on age and location. Total for typical retiree: $350–$500/month covering most medical costs. High earners pay IRMAA surcharges on top of base Part B and D premiums, potentially pushing total Medicare costs to $600–$900/month or more.
IRMAA (Income-Related Monthly Adjustment Amount) adds surcharges to your Part B and Part D premiums if your Modified Adjusted Gross Income from 2 years ago exceeded $106,000 single or $212,000 married. In 2026, IRMAA uses your 2024 income. The surcharge tiers go from +$74/month all the way to +$443.90/month for very high earners. A single retiree with 2024 income of $133,000–$167,000 pays $370/month for Part B instead of $185. If your income has dropped since 2024 (due to retirement), appeal using SSA Form SSA-44.
Medicare Advantage (Part C) offers lower premiums, often $0, but restricts you to a network and typically requires referrals and prior authorizations. Original Medicare with Medigap has higher premiums ($150–$300/month for a good supplement plan) but gives you access to any Medicare-accepting provider nationwide — critical for frequent travelers, people with complex health conditions, or anyone who values flexibility. People who are healthy and local often do well with Advantage; those with chronic conditions or specialists often prefer Original Medicare + Medigap.
Yes — if you're covered by employer insurance through active employment (yours or your spouse's), you can delay Part B without penalty. Once you lose that employer coverage, you have an 8-month Special Enrollment Period to sign up penalty-free. COBRA and retiree health insurance do NOT count as active employer coverage for this purpose. If you delay without qualifying employer coverage, you face a 10% permanent premium penalty for each 12-month period you were eligible but didn't enroll.
Medicare Parts A and B cover hospitalizations, doctor visits, outpatient care, and preventive services — but with significant gaps. Part A: $1,676 deductible per benefit period (2026), then $419/day for days 61–90 in hospital. Part B: 20% coinsurance after the $257 deductible with no out-of-pocket maximum. No coverage for dental, vision, or hearing (the biggest gaps). Medigap plans fill most of these cost-sharing gaps; Medicare Advantage plans often include dental, vision, and hearing with varying coverage levels.
