Medicare costs most 65-year-olds about $218 to $434 a month in 2026, once you add up the Part B premium of $202.90, drug coverage and either a Medigap policy or a Medicare Advantage plan. Part A is premium-free for people with 40 work quarters. Higher earners pay more, and signing up late adds a penalty that can last for life.
You need this number to the dollar. Medicare is the first big health bill after you stop working, and whether you're planning a cheaper life in a low-cost state or another country, it shapes the whole budget. All 2026 figures below come from CMS, Medicare.gov and the Social Security Administration unless a different source is named.
What Medicare costs in 2026: the numbers in one table
CMS released the 2026 Part A and Part B figures on November 14, 2025. The drug-plan numbers come from the CMS Part D fact sheet and Medicare.gov.
| Item | 2026 amount |
|---|---|
| Part A premium, 40 or more work quarters | $0 (about 99% of people) |
| Part A premium, 30 to 39 quarters | $311 a month |
| Part A premium, under 30 quarters | $565 a month |
| Part A hospital deductible | $1,736 per benefit period |
| Part A coinsurance, hospital days 61 to 90 | $434 a day |
| Part B standard premium | $202.90 a month (was $185.00 in 2025) |
| Part B yearly deductible | $283 (was $257) |
| Part D base beneficiary premium (national benchmark) | $38.99 a month |
| Part D maximum deductible | $615 |
| Part D out-of-pocket cap | $2,100 for the year |
| Medicare Advantage extra premium (KFF, enrollment-weighted average) | $15 a month, plus Part B |
| Medicare Advantage out-of-pocket limit (KFF) | Average $5,421; legal maximum $9,250 in-network |
| Medigap Plan G (KFF) | Average $164 a month in 2023; 2026 rates up roughly 12% to 26% at major insurers |
Two notes on that table. The $38.99 Part D figure is a benchmark the government uses to calculate penalties and surcharges, not what your plan charges; real plan premiums vary by county and drug list. And Medigap has no federal price. Insurers set it, so the KFF average (reported in KFF Health News, May 2026) is the best public anchor. In that story, one broker's example was a 65-year-old woman whose Plan G went from $172 to $192 a month. Get actual quotes for your ZIP code and birthday.
Higher income, higher premium: the 2026 IRMAA brackets
If your income is above a threshold, you pay the standard Part B premium plus a surcharge called IRMAA. Social Security uses your modified adjusted gross income from two years earlier, which is your 2024 tax return for 2026 premiums. The Part B totals are from CMS; the Part D amounts are from the SSA operating manual and are added to your drug plan premium.
| Single filer income | Joint filers income | Total Part B a month | Part D surcharge |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | $60.40 |
| $205,001 to under $500,000 | $410,001 to under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
The brackets are cliffs, not slopes. One dollar over $109,000 costs a single filer about $81 more a month, roughly $974 a year. The two-year lookback also catches one-time income such as selling a house, a Roth conversion or a big retirement account withdrawal. Married people filing separately face harsher brackets, starting at $83.30 for Part D once income passes $109,000.
What a typical 65-year-old actually pays each month
Here are three common setups. They use only figures from the tables above and assume income under $109,000 unless noted. Plan prices in your county will differ, so treat these as a frame for comparing quotes.
| Setup | Monthly premiums | Total | Other costs to expect |
|---|---|---|---|
| Original Medicare, Medigap Plan G and a Part D plan | Part B $202.90, Medigap $164 to $192, Part D benchmark $38.99 | About $406 to $434 | $283 Part B deductible; drug costs capped at $2,100 a year |
| Medicare Advantage plan with drug coverage | Part B $202.90, plan about $15 (zero for most) | About $218 | Copays until you hit the plan's limit, averaging $5,421 and never above $9,250 in-network |
| Medicare Advantage, single filer at $120,000 income | Part B $284.10, Part D surcharge $14.50, plan about $15 | About $314 | Same plan limits as above |
The first row costs $188 to $216 more a month than the second, roughly $2,300 to $2,600 a year. What you buy with that is predictability: Plan G pays most of what Original Medicare leaves behind, and you can see any doctor who takes Medicare. Advantage plans are cheaper up front but use networks, and the out-of-pocket limit can reach thousands in a bad year. Neither is the right answer for everyone. A fee-only planner or a licensed Medicare counselor can compare plans against your doctors and prescriptions.
One more point: Medigap rates jumped in 2026, so last year's price is not this year's. If you are building a budget, our guide to the cheapest states to retire shows how the same Medicare bill sits against very different housing costs, and the cheapest places in the US goes city by city.
Late enrollment penalties: what missing your window costs
Your Initial Enrollment Period surrounds your 65th birthday. Miss it without qualifying coverage, such as insurance from a job you or a spouse still works at, and Medicare adds permanent charges. Medicare.gov lists three.
| Penalty | How it works | 2026 example |
|---|---|---|
| Part B late enrollment penalty | 10% of the standard premium for each full 12 months you could have enrolled; for most people it lasts a lifetime | Two years late: $243.50 a month instead of $202.90 |
| Part A (only if you must buy it) | Premium may rise 10%; the penalty lasts twice as many years as you waited | Applies to the $311 or $565 premiums |
| Part D penalty | 1% of the $38.99 benchmark for each month without creditable drug coverage, once you go 63 days or more | Two years without: 24% of $38.99, about $9.36 a month |
The Part D penalty looks small, but it never goes away while you have drug coverage, and it grows with the benchmark each year. People with Extra Help do not pay it. Because the Part B penalty is a percentage of a premium that rises every year, a late sign-up costs more in year ten than in year one.
Help if your income is low
Medicare Savings Programs and Extra Help can wipe out most of the costs above. Each is run by your state, and you apply there. The 2026 limits from Medicare.gov:
| Program | What it pays | Monthly income limit (single / couple) | Resource limit (single / couple) |
|---|---|---|---|
| QMB | Part B premium, Part A premium if any, deductibles and coinsurance | $1,350 / $1,824 | $9,950 / $14,910 |
| SLMB | Part B premium | $1,616 / $2,184 | $9,950 / $14,910 |
| QI | Part B premium | $1,816 / $2,455 | $9,950 / $14,910 |
Alaska, Hawaii and some states use different rules, and anyone who gets one of these programs automatically qualifies for Extra Help. Extra Help (the Part D Low-Income Subsidy) on its own is available at annual income up to $23,940 for one person or $32,460 for a couple, with resources up to $18,090 or $36,100, according to Medicare.gov. Medicare.gov's advice is to apply even if you think you do not qualify. Enrolling in a Medicare Savings Program can also avoid the Part B late penalty.
Moving to a cheaper state does not change these premiums, but it can change eligibility, because states set some of the rules. Compare housing and tax costs in states that don't tax Social Security alongside the Medicare picture.
Medicare if you retire abroad
The premiums do not change when you move overseas, but the coverage almost does. Medicare.gov says it usually does not cover health care outside the U.S., with narrow exceptions: a foreign hospital closer than the nearest U.S. one in an emergency, the drive between Alaska and the lower 48 through Canada, and cruise ships within 6 hours of a U.S. port. Drugs bought abroad are never covered. Puerto Rico, Guam and the other U.S. territories count as inside the U.S.
That leaves a money decision. Keeping Part B costs $202.90 a month, or about $2,435 a year, for care you cannot use at home in Lisbon or Chiang Mai. Dropping it saves that but risks the 10 percent per year penalty if you ever return. Many expats keep Part A, which is premium-free for most, and decide on Part B based on how likely they are to come back. We walk through the choice, Medigap's foreign travel benefit and local insurance in does Medicare work overseas, and the Social Security side in how to collect Social Security abroad.
Before you enroll
- Check your Part A premium on your Social Security record. Forty quarters of work, yours or a spouse's, means no premium.
- Look at your tax return from two years back. If it is near an IRMAA line, plan one-time income carefully and ask a tax professional.
- Get Medigap quotes early and ask each insurer how its rates change with age and over time.
- Compare drug plans every fall for the next year on Medicare.gov, because premiums and formularies change annually. The 2027 out-of-pocket cap is already set at $2,400.
- If you are still working with employer coverage, confirm in writing whether you can delay Part B without a penalty.
This page explains public Medicare rules and figures as of November 2026. It is not personal financial, legal or medical advice. Confirm your own numbers with Medicare.gov, Social Security (1-800-772-1213) or a state SHIP counselor.