Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025.
For 2026, the standard Medicare Part B premium is $202.90/month, an increase from 2025, with higher premiums for higher incomes (IRMAA), and the Part A deductible is $1,736, while Part D drug plan base costs start around $38.99/month, with potential surcharges for high earners. These costs are set by CMS and reflect rising healthcare expenses, impacting beneficiaries across Original Medicare (A & B) and Medicare Advantage/Part D plans.
Starting in 2025, there is an annual limit on what you pay out-of-pocket for prescription medications through Medicare and Medicare Advantage prescription drug plans. All prescription medications, including specialty medications, covered by Part D plans are included under this cap.
In 2026, the Centers for Medicare and Medicaid Services (CMS) is ending a program called the Value-Based Insurance Design (VBID) model. This program helped health plans give extra non-medical benefits, like credits for healthy food and utilities.
In 2026, Medicare brings higher costs for Parts A & B (premiums, deductibles), but also significant prescription drug savings, including a new $2,100 Part D out-of-pocket cap, continued $35 insulin cap, and new negotiated drug prices; plus, enhanced preventive care (like mental health/heart screenings) and stricter Medicare Advantage rules are coming, driven by the Inflation Reduction Act.
The extra $144 added to Social Security usually comes from the Medicare Part B Giveback benefit, offered by some Medicare Advantage (Part C) plans, which pays back some or all your Part B premium, showing up as extra money in your check if it's deducted from your Social Security. To qualify, you need Original Medicare (Parts A & B), pay your own Part B premium, live in a plan's service area, and enroll in a specific Medicare Advantage plan that offers this "rebate," with the amount varying by plan and location.
The "best" Medicare Advantage plan for 2026 depends on your location and needs, but top-rated companies often include UnitedHealthcare, Humana, Aetna, Kaiser Permanente, and Wellcare, excelling in areas like low costs, patient experience, and extra benefits (dental, vision). Health systems dropping MA plans and insurer changes (like Humana reducing some coverage) highlight the need to use official Medicare tools or agents to compare plan specifics in your ZIP code for 2026.
Yes, the Medicare Part D "donut hole" (coverage gap) is officially eliminated as of January 1, 2025, thanks to the Inflation Reduction Act, simplifying coverage into three phases: deductible, initial coverage, and catastrophic, with a new $2,000 out-of-pocket spending cap that eliminates the gap where higher costs used to occur.
Yes, Medicare costs are going up in 2026, with the standard Part B monthly premium increasing by $17.90 to $202.90, and the Part B deductible rising to $283; these increases are due to rising healthcare costs, affecting out-of-pocket expenses for many beneficiaries.
For the average retired worker, the 2.8 percent COLA is expected to increase their monthly benefit by about $56. This will raise the average payment from approximately $2,008 in 2025 to about $2,064 in 2026. Social Security retirement beneficiaries will see this increase reflected in their January 2026 payments.
Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. Review Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.
For 2025, major Medicare changes for seniors include a new $2,000 annual cap on out-of-pocket Part D prescription drug costs, closing the coverage gap, and introducing monthly payment options for Part D, alongside expected increases in standard Part A & B premiums/deductibles and new Part D price negotiations for popular drugs, requiring beneficiaries to review plans carefully.
Tips on How to Avoid the Donut Hole Coverage Gap
Discuss lower-cost drug alternatives with your healthcare professionals. Seek out discounts on medications. Choose generic drugs over brand-name drugs. Opt for in-network pharmacies only.
In 2026, Medicare brings higher costs for Parts A & B (premiums, deductibles), but also significant prescription drug savings, including a new $2,100 Part D out-of-pocket cap, continued $35 insulin cap, and new negotiated drug prices; plus, enhanced preventive care (like mental health/heart screenings) and stricter Medicare Advantage rules are coming, driven by the Inflation Reduction Act.
Here are some of the biggest Medicare mistakes to avoid:
People leave Medicare Advantage (MA) plans due to difficulty accessing needed care (especially with worsening health), restrictive provider networks, complex prior authorization rules, and dissatisfaction with care quality, often feeling trapped as their health needs grow despite initial low costs and extra perks that become limiting. Issues with provider availability, network changes, and sometimes misleading marketing also drive disenrollment, pushing people back to Traditional Medicare for greater freedom, notes KFF.
There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.
Cost-of-Living Adjustment (COLA) Information for 2026
The 2.8 percent cost-of-living adjustment (COLA) will begin with benefits payable to nearly 71 million Social Security beneficiaries in January 2026. Increased payments to nearly 7.5 million SSI recipients will begin on December 31, 2025.