Medicare in 2026: Parts, Costs & Enrollment
Medicare provides health insurance for people 65+, many disabled individuals, and those with ESRD/ALS. In 2026, key changes include higher premiums/deductibles and continued $2,000 Part D cap. This guide covers eligibility, parts, IRMAA, enrollment, and top providers.
Who’s Eligible for Medicare?
- Age 65+ and U.S. citizen or legal resident (5+ continuous years).
- Under 65 with SSDI for 24 months (automatic enrollment).
- ESRD or ALS (immediate eligibility).
Example: Maria turns 65 in April 2026 — eligible for Parts A/B. Tom, 58, on SSDI since 2024 — enrolled in 2026.
Medicare Parts Overview (2026 Costs)
| Part | Coverage | 2026 Standard Cost |
|---|---|---|
| Part A | Hospital, skilled nursing, hospice | Premium-free (40+ quarters work); $499/month otherwise |
| Part B | Doctor visits, outpatient, preventive | $185/month (standard) + IRMAA if high income |
| Part C (Advantage) | A+B (often D) + extras (vision/dental/hearing) | Varies by plan ($0–$200+/month premium) |
| Part D | Prescription drugs | $0–$120+/month premium; $2,000 annual out-of-pocket cap |
| Medigap | Supplemental to Original (A+B) | $60–$350+/month (Plan G most popular) |
2026 Deductibles: Part A $1,676/benefit period; Part B $257/year.
Enrollment Periods
- Initial Enrollment Period (IEP): 7 months around 65th birthday (no late penalty if enroll during).
- General Enrollment: Jan 1–Mar 31 (coverage July 1; late Part B penalty 10%/year delayed).
- Special Enrollment Period (SEP): 8 months after employer group coverage ends (no penalty).
- Medicare Advantage/Open Enrollment: Oct 15–Dec 7 (switch plans); Jan 1–Mar 31 (Advantage to Original or new Advantage).
How to Enroll
Automatic if receiving Social Security at 65; otherwise:
- Online: ssa.gov/medicare/sign-up or Medicare.gov
- Phone: 1-800-MEDICARE (1-800-633-4227)
- In-person: Local SSA office (locator)
Video: How to sign up for Medicare.
Income-Related Monthly Adjustment Amount (IRMAA) 2026
High earners pay extra for Part B/D based on 2024 MAGI:
| MAGI Single | MAGI Married Joint | Part B Premium (2026) | Part D Extra |
|---|---|---|---|
| ≤ $106,000 | ≤ $212,000 | $185.00 | $0 |
| $106,001–$133,000 | $212,001–$266,000 | $259.00 | $13.70 |
| $133,001–$167,000 | $266,001–$334,000 | $369.90 | $35.30 |
| $167,001–$200,000 | $334,001–$400,000 | $480.80 | $56.90 |
| $200,001–$500,000 | $400,001–$750,000 | $591.80 | $78.50 |
| > $500,000 | > $750,000 | $628.90 | $85.80 |
Appeal IRMAA: File Form SSA-44 if life event (retirement, divorce) lowered income.
Medicare Advantage (Part C) vs Original
Private plans (often $0 premium) with extras; networks vs. broader Original flexibility.
Original vs Advantage Comparison
Compare plans: Medicare.gov Plan Finder
Part D & Medigap in 2026
- Part D: $2,000 annual out-of-pocket cap; no deductible for many low-cost plans.
- Medigap: Plan G (most popular) covers Part B excess; avg. $160–$250/month. Plan F no longer sold to new enrollees.
Extra Help (Low-Income Assistance)
Reduces Part D costs:
- Income ~$23,475 (single) / $31,725 (couple) — full/partial help.
- Apply: SSA.gov or Medicare.gov.
Frequently Asked Questions
Do I need Medigap with Advantage?
No — Advantage has its own out-of-pocket max; Medigap only works with Original Medicare.
How to appeal IRMAA?
Use Form SSA-44 with proof of income drop — SSA reviews within 60 days.
Can I switch plans mid-year?
Usually no — only during Open Enrollment or SEP (e.g., move, lose coverage).
Get Started with Medicare
Medicare.gov Plan Finder Enroll/Sign Up Compare Plans
Call 1-800-MEDICARE (1-800-633-4227) or SSA 1-800-772-1213