What Medicare costs: every number, and which ones you can change

Part B: the premium everyone pays

The 2027 Part B figures were still unpublished on October 12, 2026, three days before open enrollment opened. CMS normally announces in November. Projections come from the 2026 Medicare Trustees Report and are not official amounts.

Part B is deducted from your Social Security payment if you receive one, which is why a premium increase shows up as a smaller deposit rather than a bill (why your check shrank). A protection called hold harmless generally prevents the standard premium increase from exceeding your cost-of-living adjustment for most people already receiving benefits, though it does not protect people paying IRMAA.

Part A: free for most, expensive if not

The deductible resets per benefit period, not per calendar year. A benefit period ends after 60 consecutive days without inpatient or skilled care.

That per-benefit-period rule is the most misunderstood cost in Medicare and is explained fully in the hospital guide. Buying into Part A without enough work history is covered in the eligibility article, and the spouse-record route that often makes it free is in the spouse article.

Part D: drug costs, with a real ceiling

Part D figures for 2027 are final, confirmed in CMS announcements. Once your out-of-pocket spending hits the cap, covered drugs cost nothing for the rest of the year, and every plan must offer monthly payment smoothing.

The cap is the most valuable change in Medicare in a generation for people with expensive prescriptions. The Part D guide covers the phases, and the cap article explains smoothing.

Medigap and Advantage premiums

Medigap premiums are not standardized even though the benefits are: the same Plan G can differ two or three times over between insurers in one ZIP code, and the pricing method (attained-age, issue-age, or community-rated) determines whether the policy that is cheap at 65 becomes expensive at 80. The pricing article explains the trap. Medicare Advantage plans often charge $0 beyond the Part B premium; CMS projects the weighted average Advantage premium falling to about $12 a month in 2027. What you pay instead is copays, bounded by the plan’s out-of-pocket maximum, commonly several thousand dollars in-network.

Income surcharges (IRMAA)

Based on your tax return from two years earlier. If a life-changing event has reduced your income since, file form SSA-44 to have current income used instead.

IRMAA catches people the year after they sell a house, do a Roth conversion, or retire. All of those are appealable life events or planning problems; the IRMAA article covers both.

The four ways to lower the bill

• Medicare Savings Programs pay the Part B premium, and in the QMB tier also deductibles and coinsurance. Income limits are higher than most people assume.
• Extra Help cuts drug costs to a few dollars and often eliminates the Part D premium.
• Re-shopping your drug plan every fall. The spread between plans on the same prescription list is routinely hundreds of dollars a year (how to compare).
• Appealing IRMAA with form SSA-44 after retirement, widowhood, divorce, or loss of income-producing property.

Every figure here also lives on the printable numbers card, which we update within days of each CMS announcement.

Questions people also ask

Sources for this article

• CMS.gov2026 Medicare Parts A and B premiums and deductibles: premiums, deductibles, coinsurance, and IRMAA brackets.
• CMS.gov2027 Part D bid announcement: the confirmed 2027 drug-coverage parameters.
• Medicare.govPart D costs: deductible, out-of-pocket cap, and payment smoothing.

Figures checked against these sources on October 12, 2026. We update within days when CMS publishes new amounts.