Medicare 101
Medicare, Explained Simply
The four parts of Medicare, what each covers, and how they fit together — without the alphabet-soup confusion.
Medicare is the federal health insurance program for people 65 and older and certain younger people with disabilities. Most people get coverage through Parts A and B combined with either a Medicare Supplement or a Medicare Advantage plan, plus a Part D drug plan.
The Four Parts
What each part covers
Part A
Hospital Insurance
Covers
Typically Does NOT Cover
Part B
Medical Insurance
Covers
Typically Does NOT Cover
Part C
Medicare Advantage
Covers
Typically Does NOT Cover
Part D
Prescription Drug Plans
Covers
Typically Does NOT Cover
Enrollment Windows
When you can enroll or switch
Missing your Initial Enrollment Period can result in permanent premium penalties. Know your dates.
Initial Enrollment Period
3 months before — month of — 3 months after 65th birthday
General Enrollment Period
January 1 – March 31 each year (if you missed your IEP)
Add to CalendarAnnual Enrollment Period (AEP)
October 15 – December 7 — switch or update plans
Add to CalendarMedicare Advantage Open Enrollment
January 1 – March 31 — switch MA plans or return to Original Medicare
Add to CalendarSpecial Enrollment Periods
Triggered by qualifying events (job loss, relocation, etc.)
The numbers
Medicare costs, visualized
Official CMS figures — so you can see the trend, not just a number in isolation.
2026 Medicare costs at a glance
The published figures that shape your year
$202.90
Part B premium
standard, per month
$283
Part B deductible
per year
$1,736
Part A hospital deductible
per benefit period
$38.99
Part D base premium
national average, per month
$2,100
Part D drug out-of-pocket cap
new hard cap for the year
Varies
Medicare Advantage OOP max
every plan sets an in-network limit; the amount depends on the plan
Source: CMS, 2026 Medicare cost figures (Parts A, B, D) and Medicare Advantage out-of-pocket maximum.
For education only — amounts change annually; confirm current figures before making a decision.
Part B monthly premium, 2016–2026
Standard monthly Medicare Part B premium
| Year | Premium/mo |
|---|---|
| 2016 | $121.80 |
| 2017 | $134.00 |
| 2018 | $134.00 |
| 2019 | $135.50 |
| 2020 | $144.60 |
| 2021 | $148.50 |
| 2022 | $170.10 |
| 2023 | $164.90 |
| 2024 | $174.70 |
| 2025 | $185.00 |
| 2026 | $202.90 |
Source: CMS — annual Medicare Parts A & B Premiums and Deductibles fact sheets (2016–2026).
For education only — amounts change annually; confirm current figures before making a decision.
Part B premium by income tier (IRMAA), 2026
Higher incomes add a surcharge on top of the $202.90 standard premium
| Tier | Single (MAGI) | Joint (MAGI) | Premium/mo |
|---|---|---|---|
| Standard | $109,000 or less | $218,000 or less | $202.90 |
| Tier 2 | $109k–$137k | $218k–$274k | $284.10 |
| Tier 3 | $137k–$171k | $274k–$342k | $405.90 |
| Tier 4 | $171k–$205k | $342k–$410k | $527.70 |
| Tier 5 | $205k–$500k | $410k–$750k | $649.50 |
| Top tier | $500,000 or more | $750,000 or more | $689.90 |
Source: CMS, 2026 Medicare Parts A & B Premiums & Deductibles; SSA IRMAA sliding scale. Based on 2024 MAGI.
For education only — amounts change annually; confirm current figures before making a decision.
The new Part D out-of-pocket cap
For the first time, your out-of-pocket drug spending has a hard annual limit
No annual cap
First-ever hard cap
Indexed for inflation
| Period | Annual cap |
|---|---|
| Through 2024 | No cap |
| 2025 | $2,000 |
| 2026 | $2,100 |
Source: CMS Part D Redesign program instructions (Inflation Reduction Act), 2025–2026.
For education only — amounts change annually; confirm current figures before making a decision.
Your Coverage Path
Two paths to full Medicare coverage
Path 1 — Medicare Advantage
All-in-one coverage through a private insurer.
Path 2 — Original Medicare + Supplement
Government coverage paired with a Medigap policy.
Content reviewed against 2026 plan-year figures. Dollar amounts change annually — we'll confirm the current numbers in your consultation.
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