Published figures, with sources
What Medicare costs in 2026
These are the national figures from the CMS fact sheets, not estimates. They are the same in North Carolina as anywhere else. What each one means for you is the part worth a conversation.
Part B: the premium most people notice
Part B covers doctors, outpatient care and equipment. The premium usually comes straight out of a Social Security payment, so it is the number people see first.
| Standard monthly premium | $202.90 |
|---|---|
| Annual deductible | $283 |
| Coinsurance after the deductible | 20% of the approved amount |
| Late enrollment penalty | +10% per full year late, for as long as you have Part B |
| Immunosuppressive drug benefit premium | $121.60 |
That 20% has no ceiling of its own, which is the whole reason supplemental coverage exists. How Advantage and Medigap handle it differs more than the premiums suggest.
Worried a late start has cost you? Work out the penalty from two dates.
Part A: free for almost everyone, until you are admitted
About 99 in 100 people pay no Part A premium, because they or a spouse worked enough quarters. The costs below start when you are admitted to a hospital.
| Hospital deductible, per benefit period | $1,736 |
|---|---|
| Days 1–60 in hospital | No further cost |
| Days 61–90 | $434 a day |
| Lifetime reserve days (60 in total) | $868 a day |
| Skilled nursing, days 21–100 | $217 a day |
| Premium, 30–39 quarters worked | $311 a month |
| Premium, under 30 quarters | $565 a month |
Per benefit period, not per year. A benefit period ends after you have been out of the hospital or a skilled nursing facility for 60 days in a row. Go back in after that and the deductible starts again — twice in one year is possible.
Part D: the cap is the news
Drug plan premiums are set by each plan, so no single figure covers them. What is set nationally is how far your own spending can go.
| Your out-of-pocket cap | $2,100 a year |
|---|---|
| Highest deductible a plan may charge | $615 |
| Base premium the penalty is figured from | $38.99 |
| Late enrollment penalty | +1% of that base for each month without creditable coverage |
| Gap that triggers the penalty | 63 days or more in a row |
Reaching the cap means you pay nothing further for covered drugs that year. It does not mean every drug you take is covered — each plan has its own list, and checking yours against it is the single most useful hour of the whole process.
IRMAA: what higher income adds
About 8% of people pay an income-related amount on top of the standard premiums. It is based on the modified adjusted gross income from your 2024 tax return, because Social Security looks back two years.
| Filing single | Filing jointly | Part B | Part D adds |
|---|---|---|---|
| Up to $109,000 | Up to $218,000 | $202.90 | — |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 | +$14.50 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 | +$37.50 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 | +$60.40 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.20 | +$83.30 |
| $500,000 and up | $750,000 and up | $689.90 | +$91.00 |
The bands are cliffs, not slopes. One dollar over a threshold moves you into the next band for the whole year, which is why the timing of a Roth conversion or a home sale matters as much as the amount. See what a conversion would do to your bracket.
If your income has dropped since 2024 because you retired, lost a spouse, or had work stop or reduce, you can ask Social Security to use current income instead. How that request works.
The questions behind the numbers
Knowing the figure is not the same as knowing what to do.
I sit down with people in Greensboro, High Point and Winston-Salem, go through where these numbers land for them, and point them to whoever can help with the parts I don’t handle myself. No cost, and no obligation.
Go through it with meor call (336) 365-7422
How much is Medicare Part B in 2026?
The standard Part B premium for 2026 is $202.90 a month, with an annual deductible of $283. Most people pay the standard amount. If your 2024 income was above $109,000 filing single or $218,000 filing jointly, an income-related amount is added on top, up to $689.90 a month.
What is the 2026 Medicare Part A deductible?
$1,736 per benefit period — not per year. A benefit period starts the day you go into a hospital and ends once you have been out for 60 days in a row, so it is possible to pay it more than once in a calendar year. Days 61 to 90 cost $434 a day, and lifetime reserve days cost $868 a day.
Is there a cap on what I pay for prescriptions in 2026?
Yes. Part D out-of-pocket spending is capped at $2,100 for 2026. Once you reach it you pay nothing more for covered drugs for the rest of the year. No Part D plan may charge a deductible above $615, and many charge less.
Which year's income decides my 2026 Medicare premium?
Your 2024 tax return. Social Security looks back two years, which is why a one-time event in 2024 — selling a house, a Roth conversion, a large distribution — can raise a premium two years later. If your income has since dropped because of a life change such as retirement or the death of a spouse, you can ask for it to be reconsidered using form SSA-44.
Do these figures apply in North Carolina?
Part A, Part B and the IRMAA amounts are federal and identical in every state. What varies locally is which Medicare Advantage and Part D plans are sold, what they charge, and which doctors and hospitals are in them — so in Guilford or Forsyth County the plan costs are a local question even though the figures on this page are not.
What happens if I sign up for Part B late?
10% is added to the standard premium for every full 12 months you could have had Part B and did not, and it stays for as long as you have Part B. Coverage from a job you or your spouse currently work at usually protects you from it. Part D has its own penalty: 1% of the $38.99 base premium for each month you went without creditable drug coverage.
Where these figures come from
Every number on this page is published by the Centers for Medicare & Medicaid Services. Nothing here is estimated, averaged or rounded for effect.
- CMS: 2026 Medicare Parts A & B Premiums and Deductibles — Part A, Part B, and both IRMAA tables.
- CMS: Final CY 2026 Part D Redesign Program Instructions — the Part D deductible ceiling, out-of-pocket cap and base premium.
Figures change once a year, usually in November. This page was checked against both sources on 18 September 2026.