Skip to content
FinanceChauffeur

Medicare without the headacheLesson 4 of 46 min readBy Finance ChauffeurLast reviewed

What Medicare costs — and what it doesn't cover

See every 2026 Medicare cost — premiums, deductibles, the Part D cap and IRMAA — and the gaps Original Medicare leaves, from dental work to long-term custodial care.

You're on Medicare, or about to be, and you want a real number for what it costs in a year. Medicare is not free and it does not cover everything — and the biggest thing it leaves out, long-term custodial care, is the one that can reshape a family's finances.

What Medicare costs in 2026

Cost2026 figure
Part A premium$0 if you or your spouse paid Medicare taxes for at least 10 years; otherwise $311 or $565 a month
Part A hospital deductible$1,736 per benefit period (not per year), covering days 1–60 of a stay
Part A hospital coinsurance$434 a day for days 61–90; $868 a day for up to 60 lifetime reserve days; all costs after that
Skilled nursing facility, after an inpatient stay of at least 3 days$0 for days 1–20; $217 a day for days 21–100; all costs after day 100
Part B premium$202.90 a month (standard)
Part B deductible$283 a year, then you pay 20% of the Medicare-approved amount for most services
Part D premiumSet by your plan; the plan deductible is at most $615
Part D out-of-pocket cap$2,100 a year on covered drugs

The Part B premium comes out of your Social Security check when you receive one; otherwise Medicare bills you. Original Medicare sets no yearly limit on the 20% coinsurance — that is the gap Medigap policies fill, and the reason the choice in Original Medicare + Medigap vs Medicare Advantage matters.

IRMAA: the higher-income surcharge

IRMAA, the income-related monthly adjustment amount, is added to your Part B and Part D premiums when the modified adjusted gross income on your tax return from two years earlier is above the threshold. For 2026 the test uses your 2024 return: at $109,000 or less on an individual return, or $218,000 or less on a joint return, you pay the standard $202.90; above that, the Part B premium starts at $284.10 and rises in tiers with income. Part D carries its own tiered add-on.

What Original Medicare doesn't cover

Not covered by Part A or Part BWhat it means for you
Long-term careHelp with bathing, dressing, eating or supervision — at home, in assisted living or in a nursing home — is not covered
Most dental servicesCleanings, fillings, crowns and dentures come out of pocket; the exceptions tie to specific medical treatments such as transplants or cancer care
Eye exams for glasses, and eyeglassesOut of pocket, apart from narrow exceptions after certain surgeries
Hearing aids and fitting examsOut of pocket
Routine physical exams, cosmetic surgery, massage therapy, concierge feesOut of pocket

Some Medicare Advantage plans add vision, hearing and dental benefits. None of them, and no Medigap policy, covers long-term custodial care.

The biggest gap: long-term custodial care

Medicare pays for skilled care aimed at recovery: after a hospital stay of at least 3 days in a row, Part A covers up to 100 days of skilled nursing facility care per benefit period — days 1–20 at $0 and days 21–100 at $217 a day in 2026. Once the need is ongoing help with daily living rather than skilled treatment, coverage stops. The bill then runs to thousands of dollars a month, paid from savings or long-term-care insurance until (and unless) you meet your state's Medicaid asset and income limits. What elder care actually costs puts numbers on it.

Check your understanding

0 of 4 answered

Pick an answer to check it — you’ll see right away whether you got it, plus a quick explanation.

1.What is the standard Part B premium for 2026?
2.How much can you be charged for covered Part D drugs in 2026 before the cap kicks in?
3.What does a hospital stay cost under Part A in 2026?
4.Which of these does Original Medicare pay $0 toward?

Answer all 4 questions to see your score.

Where this comes from

The figures in this lesson are drawn from these official pages. Check them for the current year's numbers — they change, and the page is always more up to date than any summary of it.

Keep the momentum — these connect to what you just read.