How much does Medicare cost per month?

Medicare Part A is free for most people (if you or your spouse worked 10+ years). Part B costs $185/month in 2026 (standard premium). Part D (drug coverage) averages $35-$45/month. Medicare Advantage (Part C) plans are often $0-$50/month additional. High earners pay more through IRMAA surcharges.

When should I sign up for Medicare?

Your Initial Enrollment Period starts 3 months before the month you turn 65 and ends 3 months after. Missing this window can result in a 10% premium penalty per year of delay for Part B that lasts for life. If you have employer coverage, you can delay without penalty.

What does Medicare not cover?

Medicare does not cover long-term care/nursing home stays, most dental care, eye exams for glasses, hearing aids, cosmetic surgery, or care outside the US. Many people buy supplemental (Medigap) insurance to cover gaps.

Medicare Explained: Parts A, B, C, D and What They Cost (2026)

Medicare is the federal health insurance program for Americans 65 and older (and some younger people with disabilities). Understanding its parts, costs, and enrollment deadlines can save you thousands.

Medicare Parts at a Glance

Part	What It Covers	Monthly Premium (2026)	Deductible
Part A (Hospital)	Inpatient hospital, skilled nursing, hospice	$0 (most people)*	$1,676/benefit period
Part B (Medical)	Doctor visits, outpatient care, preventive services	$185 (standard)	$257/year
Part C (Medicare Advantage)	Parts A + B + usually D, often extras	$0-$50 (on top of Part B)	Plan-specific
Part D (Drug Coverage)	Prescription medications	$35-$45 average	$545/year

*Free if you or your spouse worked 40+ quarters (10 years) paying Medicare taxes.

Medicare Coverage Details

Part A: Hospital Insurance

Service	Medicare Pays	You Pay
Hospital stay (days 1-60)	All but deductible	$1,676 deductible
Hospital stay (days 61-90)	All but coinsurance	$419/day
Hospital stay (days 91-150, lifetime reserve)	All but coinsurance	$838/day
Skilled nursing facility (days 1-20)	100%	$0
Skilled nursing facility (days 21-100)	All but coinsurance	$209.50/day
Home health services	100% (if medically necessary)	$0
Hospice care	100% (most services)	Small copays for drugs

Part B: Medical Insurance

Service	Medicare Pays	You Pay
Doctor visits	80% after deductible	20% + $257 annual deductible
Outpatient surgery	80% after deductible	20%
Lab tests	100%	$0
Preventive care (annual wellness, screenings)	100%	$0
Durable medical equipment	80%	20%
Mental health (outpatient)	80% after deductible	20%
Ambulance	80% after deductible	20%

Part D: Drug Coverage

Coverage Phase	2026 Structure
Deductible	$545
Initial coverage	25% copay (plan pays 75%)
Coverage gap (“donut hole”)	Drug companies discount 75%; you pay 25% for brand-name
Catastrophic coverage	$0 out-of-pocket after $2,000 max

2026 change: The Inflation Reduction Act capped total out-of-pocket drug costs at $2,000/year.

Medicare Advantage (Part C) vs. Original Medicare

Feature	Original Medicare (A + B)	Medicare Advantage (Part C)
Network	Any doctor that accepts Medicare	Usually HMO or PPO network
Out-of-pocket maximum	No cap	Capped (typically $3,000-$8,000)
Extra benefits	None (unless you add Medigap)	Often includes dental, vision, hearing, fitness
Drug coverage	Separate Part D plan needed	Usually included
Monthly premium	Part B ($185) + Medigap ($150-$300)	Part B ($185) + $0-$50
Referral needed	No	Sometimes (HMO plans)
Travel coverage	Limited outside US	Usually limited to network area
Cost predictability	Less predictable (20% coinsurance is uncapped)	More predictable (annual cap)

Enrollment Deadlines

Period	When	What You Can Do
Initial Enrollment	3 months before to 3 months after turning 65	Enroll in Parts A, B, C, D
General Enrollment	Jan 1 - Mar 31 each year	Enroll in Part B (with penalty)
Open Enrollment (AEP)	Oct 15 - Dec 7 each year	Switch Advantage plans or Part D
Medicare Advantage Open Enrollment	Jan 1 - Mar 31 each year	Switch Advantage plans or go to Original
Special Enrollment	After qualifying life event	Various changes

Late Enrollment Penalties

Part	Penalty	Duration
Part A	10% higher premium for 2× years you were eligible but didn’t enroll	Temporary
Part B	10% higher premium for each 12-month period you were eligible but didn’t enroll	Permanent (for life)
Part D	1% of national base premium × months without coverage	Permanent

Example: If you delay Part B by 3 years, you pay a 30% penalty on your premium for life. At $185/month, that’s $55.50/month extra—forever.

High earners pay more for Part B and Part D:

Individual Income (2024 Tax Return)	Joint Income	Part B Premium (2026)	Part D Surcharge
$106,000 or less	$212,000 or less	$185.00	$0
$106,001-$133,000	$212,001-$266,000	$259.00	$13.70
$133,001-$167,000	$266,001-$334,000	$370.00	$35.30
$167,001-$200,000	$334,001-$400,000	$480.90	$57.00
$200,001-$500,000	$400,001-$750,000	$591.90	$78.60
Above $500,000	Above $750,000	$628.90	$85.80

The Bottom Line

Enroll in Medicare on time to avoid lifetime penalties. Most people need Part A (free), Part B ($185/month), and either a Medigap supplement or Medicare Advantage plan. The 2026 $2,000 annual cap on drug costs is a major benefit. If you’re still working at 65 with employer coverage, you can delay Part B without penalty—but get the timing right with your HR department.