Medicare Cost Estimator

The 2026 cost stack, part by part

Part A (hospital) is premium-free if you or a spouse logged 40 quarters of Medicare-covered work. With 30 to 39 quarters it costs $285 a month in 2026; with fewer, $518. Its deductible is $1,736 per benefit period, not per year, a distinction that matters in a year with two hospital stays separated by 60 wellness days.

Part B (medical) carries the standard premium of $202.90 a month in 2026 and a $283 annual deductible, after which it pays 80% of approved amounts with no out-of-pocket cap in original Medicare. That missing cap is the entire reason Medigap and Medicare Advantage exist as cost categories: Medigap premiums buy down the 20%, Advantage plans bundle the risk differently with their own copays and networks. This estimator treats them only as premium lines you enter, because which structure fits is a health and geography question, not a math one, and this page does not sell plans.

Part D (drugs) is a plan premium you choose (the example uses $38 a month, near the national middle) plus, at higher incomes, an IRMAA surcharge paid to Medicare on top of it.

IRMAA: the income surcharge, and why $1 of income can cost $1,144

IRMAA is a cliff, not a phase-in. A single filer whose 2024 MAGI was $109,001 pays the first tier's surcharge on all twelve months of 2026: ($81.20 Part B + $14.10 Part D) x 12 = $1,144 for the year, triggered by one dollar. Our worked example, a single retiree with a $112,000 MAGI, pays Part B at $284.10 and Part D at $52.10, for $336.20 a month, $4,034 a year, before deductibles. The two-year lookback (2026 premiums read your 2024 return) is what makes IRMAA plannable: the income year and the premium year are different years, and the IRMAA guide covers the appeal rights and the levers, including why Roth conversions at 63 are an IRMAA decision as much as a tax one.

What this estimator leaves out on purpose

Premiums are the predictable floor of Medicare cost, not the total. Original Medicare's uncapped 20% coinsurance, Part D drug copays, and anything Medicare does not cover (most dental, vision, hearing, and long-term care) sit on top. The estimator's job is the fall ritual: before open enrollment closes on December 7, put this year's Part B and IRMAA figures next to last year's, confirm your tier against the notice Social Security mails you, and appeal within 60 days if a listed life event (retirement itself is the common one) has cut the income the lookback is reading.

Enrollment windows and the penalties that never expire

Your initial enrollment period runs seven months: the three months before your 65th birthday month, the month itself, and the three months after. Miss it while having no qualifying employer coverage (your own or a spouse's, from an employer with 20 or more employees) and Part B charges a late penalty of 10% for every full 12 months you were late, added to the premium for life. Delaying Part B while genuinely covered by a large employer's plan is penalty-free, but the burden of proof is paperwork, and COBRA and retiree coverage famously do not count as active-employment coverage, a distinction that has generated a generation of expensive surprises. Part A is penalty-free to delay in almost every case because it is premium-free for most people. Part D has its own smaller late penalty, 1% of the national base premium per uncovered month, also permanent.

Original Medicare versus Advantage, as cost structures

The choice is not which is cheaper in general; it is which shape of cost you prefer. Original Medicare plus a Medigap policy is the high-premium, low-surprise structure: you pay the Part B premium, a Medigap premium that commonly runs $100 to $300 a month at 65 depending on state and plan letter, and in exchange the 20% coinsurance is largely absorbed, with any Medicare-accepting provider in the country in network. Medicare Advantage is the low-premium, managed structure: often $0 beyond Part B, with copays instead of coinsurance, an annual out-of-pocket maximum original Medicare lacks, extra benefits like dental allowances, and a provider network with prior authorization. In a healthy year Advantage usually costs less; in a year with a serious diagnosis the cost and friction profiles invert. The estimator takes either structure's premium as an input precisely because this page prices your costs rather than recommending a structure.

Part D's new ceiling

Since 2025, Part D out-of-pocket drug spending is capped at $2,000 a year (indexed), and the old coverage gap, the donut hole, is gone. For anyone on an expensive maintenance medication, that cap, more than the premium, is now the number to shop: two plans with similar premiums can differ by thousands in how a specific drug list is tiered before the cap binds. Medicare's plan finder, run with your actual prescriptions and pharmacy each fall, is the only honest comparison, which is why employer-style "pick the popular plan" advice fails retirees on medication.

The hold-harmless rule, and who it skips

One protection deserves a footnote because it explains many confusing premium notices: for beneficiaries whose Part B premium is deducted from a Social Security check, a premium increase cannot reduce the check below its prior amount (the hold-harmless provision), so in years when the cost-of-living adjustment is small, most long-time beneficiaries are shielded from Part B increases. The shield skips exactly the people this page is about: anyone paying IRMAA, anyone new to Medicare, and anyone whose premium is billed rather than deducted. A couple can therefore see two different Part B amounts in the same household in the same year, both correct.

Finally, a budgeting note: premiums are deducted monthly, but the Part B deductible and any coinsurance arrive as events, not bills on a schedule. Households that move the annual premium total into a monthly sinking fund, and keep the deductible amount parked beside it, feel Medicare's costs as the flat line the estimator shows instead of as surprises.