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2026 Medicare & ACA Numbers at a Glance

Every key 2026 Medicare and ACA dollar figure — Part B premium, IRMAA brackets, Part D penalty rate, out-of-pocket maximums, and ACA subsidy rules — collected in one reference page.

4 min readReviewed for the 2026 plan year

Medicare Part B (Medical Insurance)

Item2026 Amount
Standard monthly premium$202.90 (up from $185.00 in 2025)
Annual deductible$283
Coinsurance after deductible20% of the Medicare-approved amount, with no annual cap

Medicare Part D (Prescription Drug Coverage)

Item2026 Amount
National base beneficiary premium$38.99/month
Late enrollment penalty1% of the national base premium per month without creditable drug coverage, added permanently

IRMAA (Income-Related Monthly Adjustment Amount)

IRMAA is tiered — five income brackets in total, based on your tax return from two years prior. The entry threshold and top tier for 2026:

Bracket2026 Income ThresholdApprox. Part B Premium
Entry tier$109,000 individual / $218,000 joint~$284/month
Highest tierHighest income bracket~$690/month

Late Enrollment Penalties

  • Part B: 10% added to your premium for every full 12-month period you were eligible but didn't enroll — permanent for as long as you have Part B.
  • Part D: 1% of the national base premium per month without creditable drug coverage — also permanent, and recalculated each year as the base premium changes.

Medicare Advantage

  • Annual out-of-pocket maximum: every plan must set an in-network ceiling on your yearly costs — the exact amount varies by plan and carrier.

ACA Marketplace

  • Update: the temporary "no subsidy cliff" rule (capping premium contributions at 8.5% of income regardless of earnings) expired December 31, 2025, and was not renewed.
  • For 2026 coverage, the traditional 400% Federal Poverty Level cutoff has returned — households above that threshold are generally not eligible for a premium tax credit unless Congress passes new legislation.
  • Cost-Sharing Reductions (CSR) are available on Silver-level plans only, for households between 100% and 250% of the Federal Poverty Level.
  • Example: a family of four earning up to roughly $128,600/year (about 400% FPL) may still qualify for premium assistance; confirm your household's exact eligibility on HealthCare.gov since figures update annually.

Medicare Supplement (Medigap) — Wyoming & Utah

  • Plan G premiums for a 65-year-old nonsmoker typically range $110–$200/month in Wyoming, depending on carrier and county.

Visualized

The 2026 figures, in pictures

Every chart uses official government data, with its source and an accessible data table.

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

Part B monthly premium, 2016–2026
YearPremium/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 annual deductible, 2016–2026

What you pay before Part B coverage kicks in

Part B annual deductible, 2016–2026
YearDeductible
2016$166
2017$183
2018$183
2019$185
2020$198
2021$203
2022$233
2023$226
2024$240
2025$257
2026$283

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

Part B premium by income tier (IRMAA), 2026
TierSingle (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

The new Part D out-of-pocket cap
PeriodAnnual cap
Through 2024No 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.

Who caps your yearly spending?

Only Medicare Advantage and Medigap put a ceiling on your annual exposure

Who caps your yearly spending?
PathAnnual out-of-pocket ceiling
Original Medicare aloneNo limit — No annual out-of-pocket cap — 20% coinsurance has no ceiling
Medicare AdvantageCapped — Every plan sets an annual in-network limit — the amount varies by plan and carrier
Original Medicare + Medigap Plan G$283 — Effectively just the 2026 Part B deductible

Source: CMS: Medicare Advantage plans are required to set an annual in-network out-of-pocket maximum (the amount varies by plan); 2026 Part B deductible. Medigap Plan G covers Part A/B cost-sharing after the Part B deductible.

For education only — amounts change annually; confirm current figures before making a decision.

Medicare Advantage's share over time

Share of beneficiaries (with Parts A & B) enrolled in Medicare Advantage

Medicare Advantage's share over time
YearShare
201024%
201631%
202039%
202454%
202655%

Source: KFF analysis of CMS Medicare Advantage enrollment data (share of beneficiaries with Parts A & B).

Key Takeaways

  • The 2026 standard Part B premium is $202.90/month with a $283 annual deductible; Part B coinsurance has no annual cap on its own.
  • IRMAA surcharges start at $109,000 (individual) / $218,000 (joint) income and are based on tax returns from two years prior.
  • Medicare late enrollment penalties (Part B and Part D) are both permanent — timing your enrollment correctly matters enormously.
  • The temporary ACA subsidy enhancement (no 400% FPL cliff, 8.5%-of-income cap) expired December 31, 2025 — the traditional subsidy cliff has returned for 2026 coverage unless Congress renews it.

These figures reflect 2026 published amounts and are provided for general education only — not a personalized quote. Some Medicare cost-sharing amounts (like Part A hospital deductibles and skilled nursing coinsurance) vary and change annually; confirm current figures at Medicare.gov or with a licensed advisor. Numbers update every year — bookmark this page, but always verify before making an enrollment decision.

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