How Much Does Medicare Actually Cost in 2026?
By Logan Steele · June 24, 2026 · 6 min read
"How much does Medicare cost?" is the most-asked question and the most poorly answered. The honest reply isn't a single number — it's a small stack of them. Here's the stack, with real figures for 2025/2026, so you can see what your actual monthly Medicare bill will look like.
Part A: usually $0
If you (or your spouse) worked at least 40 quarters paying Medicare taxes, Part A has no premium. If not, it can run up to $518/month — but that's rare.
The cost you do pay: a hospital deductible of about $1,676 per benefit period in 2025, plus daily coinsurance if a stay runs past 60 days.
Part B: the standard premium
Standard Part B premium for 2025 is $185/month, with a small annual deductible (around $257). After the deductible, Part B pays 80% of approved amounts. You pay 20% — with no cap on Original Medicare. That's why people add Medigap or pick an Advantage plan with an out-of-pocket maximum.
Part B + IRMAA: when income makes it more
Higher-income retirees pay an IRMAA surcharge on top of standard Part B and Part D. It's based on your tax return from two years ago, and at the top tier it can add $443+/month to your Part B premium alone. If your retirement plan involves Roth conversions, big capital gains, or RMDs, this number matters.
Part D: drug coverage
Standalone Part D premiums range from about $15 to $100/monthdepending on the plan. Big news for 2025: out-of-pocket drug costs are capped at $2,000/year, and you can opt to spread that across the year in monthly payments.
Medigap: the predictability tax
Medigap (Medicare Supplement) plans like Plan G typically run $120 to $250/month depending on age, gender, ZIP, and carrier. In exchange, you pay almost nothing at the point of care beyond the small annual Part B deductible.
Medicare Advantage: low premium, variable cost
Many Advantage plans have a $0 premium beyond what you already pay for Part B. The real cost shows up as copays ($0–$50 for primary care, $30–$60 for specialists, $250–$400/day for hospital stays) and the annual out-of-pocket maximum, which averages around $5,000–$8,000 for in-network care.
A realistic monthly picture
| Setup | Typical monthly cost | What you trade |
|---|---|---|
| Original Medicare only | ~$185 + drug costs | No cap on 20% coinsurance |
| Original + Medigap G + Part D | ~$340–$475 | Higher monthly, very low surprise risk |
| Medicare Advantage ($0 plan) | ~$185 + copays as used | Network rules, variable out-of-pocket |
| High-income (IRMAA, top tier) | Add $400+/month on top | Plan timing of income years |
The takeaway
Medicare isn't free, but it's predictable once you understand the pieces. The "cheapest" plan is rarely the cheapest in the year you actually use it. Plan around your doctors, your drugs, your tolerance for surprise bills — and your income, if IRMAA is on the table.
Educational only — not tax or medical advice. CMS publishes official premium and deductible amounts each fall; verify before making decisions.