Medicare is the federal health insurance program primarily for people 65 and older, along with some younger people with disabilities or specific conditions. It covers a lot, but it isn’t free and it isn’t automatic to understand, so this guide explains the parts, what they cost in 2026, and how and when to enroll — with the current figures rather than last year’s.
The Four Parts of Medicare
Medicare is built from four parts. Part A is hospital insurance, covering inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Part B is medical insurance, covering doctor visits, outpatient care, preventive services, and durable medical equipment. Together, Parts A and B are known as Original Medicare.
Part C, or Medicare Advantage, is an alternative offered by private insurers that bundles Parts A and B (usually with drug coverage and extras) into one plan. Part D is prescription drug coverage, sold by private plans. Most people choose either Original Medicare (often with a Part D plan and a Medigap supplement) or a Medicare Advantage plan.
What Medicare Costs in 2026
Most people pay no monthly premium for Part A because they or a spouse paid Medicare taxes for at least 10 years. If you don’t have enough work history, the Part A premium in 2026 is $311 a month with 30–39 quarters of work, or $565 a month with fewer than 30. The Part A hospital deductible is $1,736 per benefit period in 2026, with daily coinsurance of $434 for days 61–90 and $868 for each lifetime reserve day.
For Part B, the standard monthly premium in 2026 is $202.90, and the annual deductible is $283; after that, you typically pay 20% of the Medicare-approved amount for most services. Higher earners pay more for Parts B and D through an income-related surcharge (IRMAA). And a major recent change: Part D now caps your out-of-pocket prescription costs — $2,100 in 2026 — after which you pay nothing more for covered drugs that year.
Who Is Eligible and When to Enroll
You generally qualify for Medicare at 65 if you’re a U.S. citizen or a legal resident of at least five years. People under 65 can qualify after 24 months of Social Security disability benefits, or immediately with ALS or end-stage renal disease. Your Initial Enrollment Period is the seven months around your 65th birthday — the three months before, your birthday month, and the three months after.
Timing matters because late enrollment can bring lifelong penalties. If you’re already receiving Social Security, you’re usually enrolled in Parts A and B automatically; otherwise you sign up through Social Security. If you’re still working with employer coverage at 65, special rules may let you delay Part B without penalty — worth confirming before you decide.
Filling the Gaps: Medigap and Drug Coverage
Original Medicare leaves gaps — there’s no annual out-of-pocket limit on Parts A and B, and it doesn’t cover most dental, vision, or hearing. Many people with Original Medicare buy a Medigap (Medicare Supplement) policy from a private insurer to cover deductibles and coinsurance, which makes costs far more predictable. The best time to buy Medigap is during your six-month Medigap Open Enrollment Period, when insurers can’t deny you or charge more for health reasons.
For prescriptions, you’ll want a Part D plan (or a Medicare Advantage plan that includes drug coverage), and it’s worth comparing plans against your specific medications each year, since formularies and prices change. The plan finder at Medicare.gov lets you enter your drugs and see real costs.
Getting Help With the Costs
Medicare’s out-of-pocket costs add up, so several programs help. Medicaid covers many costs for people with limited income, and Medicare Savings Programs can pay your premiums and more if you qualify. The Part D ‘Extra Help’ program lowers prescription costs for lower-income beneficiaries.
For free, unbiased guidance, your State Health Insurance Assistance Program (SHIP) offers one-on-one Medicare counseling at no cost. It’s the best place to sort through Original Medicare versus Advantage, Medigap options, and which drug plan fits your medications.
Common Questions
How much does Medicare cost in 2026? Most people pay $0 for Part A. Part B’s standard premium is $202.90 a month with a $283 annual deductible, and the Part A hospital deductible is $1,736 per benefit period. Higher earners pay surcharges, and exact costs depend on your plan choices — confirm current figures at Medicare.gov.
When should I sign up for Medicare? Your Initial Enrollment Period runs for seven months around your 65th birthday. If you’re getting Social Security you may be enrolled automatically; otherwise sign up through Social Security. Enrolling late can cause lifelong penalties unless you have qualifying employer coverage.
What’s the difference between Original Medicare and Medicare Advantage? Original Medicare (Parts A and B) is the federal program, often paired with a Part D drug plan and a Medigap supplement. Medicare Advantage (Part C) is a private all-in-one alternative that usually includes drug coverage and extras but uses set networks. Which is better depends on your needs — a SHIP counselor can help you compare.
Does Medicare Cover…?
Coverage depends on the service and your plan. Check what Medicare pays for common needs:
- Long-Term Care
- Ambulance Costs
- Shingles Shots
- Lift Chairs
- Nursing Homes
- Botox for Migraines
- Annual Physicals
- Breast Reduction
- Eliquis
- Mental Health
- Acupuncture
- Cancer Treatment
- Bunion Surgery
- Bone Density Tests
- Colonoscopy
- Birth Control
- CPAP Machines
- Physical Therapy
- Hospice
- Dermatology
- Home Health Care
- Chiropractic
- Hearing Aids
- Eye Exams
- Cataract Surgery
Medicare Basics & Plans
Understand your Medicare options and costs:
- Medigap
- Traditional Medicare
- Medicare Alternatives
- Approved DME Suppliers
- Having Both Medicare & Medicaid
- Medicare vs Medicaid
Medicare is one of several coverage paths — see our health insurance overview, including Medicaid, Medigap, and private plans.
Eligibility, benefit amounts, covered services, and application procedures can vary by state and year, so verify current agency rules.
