What changed for 2026

The short answer

Most of the movement for 2026 is in the Part B premium and deductible, the Part D out-of-pocket cap, and the IRMAA thresholds. The late-enrollment penalty rates did not change: Part B still adds 10% for each full 12-month period, and Part D still adds 1% of the national base beneficiary premium for each uncovered month.

Part B premium and deductible

The standard Part B premium rose from $185.00 to $202.90 a month. Over a year, the standard premium is $2,434.80 before any IRMAA or late-enrollment penalty.

The Part B deductible rose from $257.00 to $283.00. After the deductible, Original Medicare generally pays 80% of the approved amount for covered services, and you pay the other 20% unless another plan covers it.

A higher premium does not change the penalty rate. The Part B penalty is still 10% of the standard premium for each full 12-month period without qualifying coverage. Because the standard premium is higher, the same penalty percentage now costs more in dollars. The Part B penalty calculator shows the current amount.

Part D premium, deductible, and cap

The national base beneficiary premium is $38.99 a month, up from $36.78. That base figure is used to calculate the Part D late-enrollment penalty. It is not the premium of every plan.

The Part D deductible is $615.00, and the annual out-of-pocket cap for covered drugs is $2,100.00. The cap is up $100.00 from 2025. Premiums and IRMAA are outside the cap.

Read the Part D out-of-pocket cap guide for what counts toward the cap and what stays outside it.

IRMAA thresholds and surcharges

IRMAA uses the income from two years earlier. The 2026 premium therefore generally uses 2024 income. The first surcharge tier starts at $109,001.00 for a single filer, $218,001.00 for a married couple filing jointly, and $109,001.00 for a married person filing separately.

The IRMAA cliff checker shows the full table, the next bracket, and the headroom before a Roth conversion. The guide to lowering IRMAA explains the SSA-44 appeal and the income timing rules.

Part A premiums and hospital deductible

Most people get premium-free Part A with 40 or more work quarters. For people with 30 to 39 quarters, the reduced premium is $311.00 a month, up from $285.00. With fewer than 30 quarters, the full premium is $565.00 a month, up from $518.00.

The inpatient hospital deductible is $1,736.00, up $60.00 from 2025. The Part A premium guide explains the work-quarter test.

ACA affordability and out-of-pocket limits

The employer affordability percentage rose from 9.02% to 9.96%. A higher percentage makes it easier for an employer plan to pass the test, because the employee premium is compared with a larger share of household income.

The self-only Marketplace out-of-pocket maximum is $10,600.00, up from $9,200.00. The family maximum is $21,200.00.

The enhanced premium tax credit provisions expired at the end of 2025. For 2026, premium tax credits are generally limited to households at or below 400% of the federal poverty level. The 400% FPL guide explains the current status and the dollar limits.