Medicare Part A and Part B premiums are rising in 2026, with 91% of beneficiaries enrolled in these plans affected.
Unbiased will match you with a financial advisor who can help you create a financial plan and prepare for the unexpected.
How is Medicare changing in 2026?
Alongside changing costs, detailed further in this article, each year Medicare introduces a number of changes that affect retirees.
Here is a breakdown of some of the changes being introduced in 2026:
1. Medicare-negotiated lower drug prices
In 2026, Medicare will offer lower prices on 10 high-cost prescription drugs, for conditions including arthritis, blood clots, cancer, and diabetes, under the Inflation Reduction Act.
These new negotiated prices will become effective January 1 and will be available to eligible Medicare beneficiaries.
The savings are expected to lower recipients’ out-of-pocket spending by an estimated $1.5 billion in 2026, with savings continuing each year.
2. Prescription payment plan
In 2025, original Medicare enrollees in Part D prescription plans and Medicare Advantage plans with prescription coverage could opt to pay out-of-pocket costs in monthly installments rather than in a single lump sum.
Those who took part in the scheme in 2025 will be automatically reenrolled for 2026, unless they choose to opt out or change plans.
3. Medicare to cover weight loss drugs
Starting in 2026, Medicare will cover the cost of drugs used for weight loss, including Mounjaro, Ozempic, Wegovy, and Zepbound.
Medicare will pay $245 per month, down from list prices ranging from $1,000 to $1,350.
Beneficiaries will pay a maximum of a $50 copay.
4.AI prior authorizations for traditional Medicare
Historically, traditional Medicare, also known as original Medicare, required little to no pre-authorization for beneficiaries seeking services.
From January 1, 2026, the Centers for Medicare & Medicaid Services (CMS) will start using AI to "test ways to provide an improved and expedited prior authorization process relative to Original Medicare’s existing processes, helping patients and providers avoid unnecessary or inappropriate care and safeguarding federal taxpayer dollars.”
The CMS has assured users that AI will not be determining whether a procedure is approved or denied; a human being will review the information.
This change applies to six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.
What is the Medicare premium for 2026?
One of the most impactful changes to Medicare in 2026 are the premiums.
Here is a detailed look at the costs associated with Medicare in 2026:
Medicare Part A
For Medicare Part A (hospital insurance), the amount you pay depends on the number of Medicare-covered employment quarters.
Those with 40 calendar quarters of work and Social Security and Medicare taxes paid are eligible for premium-free Medicare Part A (hospital insurance).
Those with fewer than 30 quarters of coverage, or who have a spouse with at least 30 quarters, can pay a $31 monthly premium to enroll in Medicare Part A. This is a $26 increase from 2025.
Certain uninsured retirement aged individuals with fewer than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlements will pay the full premium, which will be $565 a month in 2026, a $47 increase from 2025.
Here is a breakdown of the cost differences between Part A deductibles and coinsurance amounts in 2025 and 2026, according to the CMS:
| Part A deductible and coinsurance amounts for 2025 and 2026 by type of cost sharing | ||
|---|---|---|
| 2025 | 2026 | |
| Inpatient hospital deductible | $1,676 | $1,736 |
| Daily hospital coinsurance for days 61-90 | $419 | $434 |
| Daily hospital coinsurance for lifetime reserve days | $838 | $868 |
| Skilled nursing facility daily coinsurance (days 21-100) | $209.50 | $217 |
Medicare Part B
The CMS also announced that those who pay monthly Part B premiums will see their costs rise to $202.90, up from $185 in 2025.
Alongside this premium, you may pay a monthly surcharge.
This is based on an income-related monthly adjustment amount (IRMAA). High earners will pay an additional Part B surcharge ranging from $81.20 to $487.
Additionally, the annual Part B deductible, which most people must pay before their Medicare coverage begins, will rise to $283, up $26 from 2025.
Medicare Part C
How much you pay for Medicare Advantage Plan (Part C) will vary depending on your plan. It’s important to remember that you must have Medicare Part B and keep paying your premiums to stay in your plan.
According to the National Council on Aging, in 2026, the average monthly Medicare Advantage/Part C premiums will decrease to $14, down from $16.40 in 2025.
Additionally, the out-of-pocket maximum for Part C plans will decrease by $100 to $9,250 for approved services in 2026. However, individual plans can set lower limits if they wish.
Medicare Part D
For those who have Medicare Part D, which covers drug costs, the average standalone Part D plan total premium is projected to decrease from $38.31 in 2025 to $34.50 in 2026.
For those with Medicare Advantage plan that charges a Part D total premium, that cost is projected to decrease to $11.50 in 2026, down from $13.32 in 2025.
The maximum Part D deductible is set at $615 for 2026, an increase of $25 from 2025.
Finally, the cap on Part D out-of-pocket costs is $2,100, up $100 from 2025.
How to prepare for Medicare changes in 2026
To prepare for 2026 Medicare changes, start by reviewing your current coverage and costs to understand how new premiums and deductibles may impact your budget.
Consulting with a Medicare specialist can provide personalized insights and help you adjust your healthcare plan if needed.
Staying informed about updates and exploring supplemental coverage options can also ensure you’re well prepared to manage additional healthcare expenses.
Get expert financial advice
Staying on top of changes to Medicare for 2026 can help you make the most of your benefits while managing costs effectively.
By reviewing your plan, consulting experts, and considering supplemental options, you’ll be well-prepared to navigate these updates confidently.
A little preparation now can go a long way in ensuring that your healthcare needs are met smoothly in the coming year.
Let Unbiased match you with a financial advisor for expert financial advice to help you navigate changes to Medicare in 2026 and find the best options for your healthcare and budget needs.