Medicare Part A covers inpatient hospital care, skilled nursing facility stays, hospice, and some home health services, while Medicare Part B covers doctor visits, outpatient care, preventive services, and durable medical equipment — together forming “Original Medicare” for roughly 69 million Americans in 2026. The standard Part B premium rose to $202.90 a month in 2026, a $17.90 increase, while the Part A inpatient hospital deductible climbed to $1,736 per benefit period.
Medicare Part A and B – Introduction
Medicare Part A and Part B together make up what the federal government calls “Original Medicare,” the traditional fee-for-service health insurance program covering Americans aged 65 and older, along with certain younger people with qualifying disabilities. The two parts split coverage along a simple line: Part A handles care you receive as a hospital inpatient or in a facility setting, while Part B handles care you receive as an outpatient, including routine doctor visits, lab tests, and preventive screenings. Most beneficiaries pay no monthly premium for Part A, having earned that coverage through payroll taxes during their working years, while Part B carries a standard monthly premium that rises most years and adjusts upward further for higher-income beneficiaries.
Both parts come with real out-of-pocket exposure. Part A charges a deductible for each benefit period rather than a calendar year, meaning a beneficiary hospitalized twice in one year for unrelated conditions could pay the deductible twice. Part B, by contrast, uses a standard annual deductible followed by 20% coinsurance on most covered services, with no overall cap on what a beneficiary might pay out of pocket in a given year under Original Medicare alone — a gap that drives many beneficiaries to pair Part A and B with supplemental Medigap coverage or to enroll in a Medicare Advantage plan instead. The sections below break down exactly what each part covers and what it costs in 2026, based on the Centers for Medicare & Medicaid Services’ official cost announcements.
Interesting Facts about Medicare Part A and B in 2026
| Category | Figure |
|---|---|
| Total Medicare enrollment (2026) | ~69 million |
| 2026 standard Part B monthly premium | $202.90 (up $17.90 from 2025) |
| 2026 Part B annual deductible | $283 (up $26 from 2025) |
| 2026 Part A inpatient hospital deductible (per benefit period) | $1,736 (up $60 from 2025) |
| Part A daily coinsurance, days 61-90 | $434 |
| Part A daily coinsurance, lifetime reserve days | $868 |
| Part A full monthly premium (fewer than 30 work quarters) | $565 |
| Share of Part B enrollees who pay an income-related surcharge (IRMAA) | ~8% (about 5.2-5.3 million people) |
| Medicare eligibility age | 65 (or younger with qualifying disability) |
The single most useful fact for understanding Medicare Part A and B together is that the vast majority of beneficiaries pay nothing in monthly premiums for Part A but pay a mandatory premium for Part B that climbs nearly every year. That asymmetry traces back to how each part is funded: Part A draws primarily from a dedicated payroll-tax trust fund that most workers contribute to for decades before becoming eligible, while Part B is funded largely through general tax revenue and beneficiary premiums, making its cost more directly visible to enrollees month to month.
The 2026 Part B premium increase of $17.90, bringing the standard rate to $202.90, represents one of the larger year-over-year jumps in the program’s recent history, a roughly 9.7% increase that the Medicare Rights Center noted was still lower than some earlier projections but remains a meaningful hit to fixed-income retirees, since Part B premiums are typically deducted directly from Social Security checks. The roughly 8% of beneficiaries who fall into an income-related adjustment bracket, known as IRMAA, pay considerably more — up to $689.90 a month at the very top tier — a surcharge calculated using tax return data from two years prior.
What Medicare Part A Covers in 2026
MEDICARE PART A: PRIMARY COVERAGE CATEGORIES
INPATIENT HOSPITAL CARE ██████████████████████████████
SKILLED NURSING FACILITY CARE ████████████████████████████
HOSPICE CARE ████████████████████████
LIMITED HOME HEALTH CARE ██████████████████
| Covered Service | Key Detail |
|---|---|
| Inpatient hospital care | Semi-private room, meals, nursing care, drugs, and other hospital services/supplies |
| Skilled nursing facility (SNF) care | Covered after a qualifying 3-day inpatient hospital stay, up to 100 days per benefit period |
| Hospice care | For terminally ill patients with a life expectancy of 6 months or less, certified by a doctor |
| Home health care | Limited, part-time skilled nursing or therapy for homebound patients, ordered by a doctor |
| Not covered | Long-term custodial care, most dental care, and routine non-skilled personal care |
Data Source: Centers for Medicare & Medicaid Services (CMS), Medicare.gov
Medicare Part A, often called “hospital insurance,” covers the institutional side of a beneficiary’s care. Its single largest category is inpatient hospital care, covering a semi-private room, meals, general nursing, and medications administered during the stay, along with other hospital services and supplies the inpatient team provides. Coverage for a skilled nursing facility stay — typically for rehabilitation after a hospitalization — kicks in only after a beneficiary has had a qualifying inpatient hospital stay of at least three consecutive days, and is capped at up to 100 days within a single benefit period, with cost-sharing increasing sharply after the first 20 days.
Part A’s hospice benefit covers comfort-focused care for beneficiaries with a terminal diagnosis and a life expectancy of six months or less, a benefit that has grown substantially in usage over the past two decades. Part A also covers a narrower slice of home health care than many assume — specifically part-time or intermittent skilled nursing and therapy services for beneficiaries who are considered homebound, rather than ongoing custodial help with daily activities like bathing or dressing, which Medicare generally does not cover at all. That last distinction, the exclusion of long-term custodial care, remains one of the most consequential coverage gaps in Original Medicare, pushing many families toward Medicaid or private long-term care insurance once ongoing non-skilled assistance becomes necessary. For more on how Medicare’s hospice benefit specifically functions in practice, see our Palliative Care Statistics in US report.
What Medicare Part B Covers in 2026
MEDICARE PART B: PRIMARY COVERAGE CATEGORIES
DOCTOR VISITS & OUTPATIENT CARE ██████████████████████████
PREVENTIVE SERVICES ███████████████████████
DURABLE MEDICAL EQUIPMENT ████████████████████
LIMITED HOME HEALTH & OTHER ██████████████████
| Covered Service | Key Detail |
|---|---|
| Doctor visits and outpatient care | Physician services, outpatient hospital care, outpatient surgery |
| Preventive services | Annual wellness visit, many cancer screenings, vaccines — often $0 cost-sharing |
| Durable medical equipment (DME) | Wheelchairs, walkers, oxygen equipment, hospital beds |
| Mental health services | Outpatient counseling, psychiatric evaluation and treatment |
| Ambulance services | Medically necessary transport to a hospital or facility |
| Standard cost-sharing | 20% coinsurance after the annual deductible is met |
Data Source: Centers for Medicare & Medicaid Services (CMS), Medicare.gov
Medicare Part B, or “medical insurance,” covers the outpatient and physician-based side of care, forming the counterpart to Part A’s institutional focus. Its core coverage includes doctor visits, whether in an office, clinic, or outpatient hospital setting, along with outpatient surgery, lab tests, and diagnostic imaging. Part B also covers an extensive list of preventive services — including an annual wellness visit, many cancer screenings such as colonoscopies and mammograms, and routine vaccinations — many of which are covered at $0 cost-sharing when a provider accepts Medicare assignment, reflecting a deliberate policy push to encourage preventive care over costlier downstream treatment.
Beyond routine visits, Part B also covers durable medical equipment such as wheelchairs, walkers, and home oxygen equipment, along with outpatient mental health services, ambulance transport when medically necessary, and a portion of home health care when it doesn’t qualify as the more limited benefit covered fully under Part A. Once a beneficiary meets the $283 annual deductible in 2026, Medicare generally pays 80% of the Medicare-approved amount for most covered Part B services, leaving the beneficiary responsible for the remaining 20% coinsurance — a cost-sharing structure with no built-in annual cap, which is precisely why many Part B enrollees also carry supplemental Medigap coverage to limit that open-ended exposure.
Medicare Part A Costs in 2026
PART A HOSPITAL DEDUCTIBLE, 2025 vs. 2026
2025 ████████████████████████████████████ $1,676
2026 ███████████████████████████████████████ $1,736
| Cost Item | 2025 | 2026 |
|---|---|---|
| Inpatient hospital deductible (per benefit period) | $1,676 | $1,736 |
| Daily coinsurance, hospital days 61-90 | $419 | $434 |
| Daily coinsurance, lifetime reserve days (60 total) | $838 | $868 |
| Daily coinsurance, SNF days 21-100 | $209.50 | $217 |
| Full monthly premium (fewer than 30 work quarters) | $518 | $565 |
| Reduced monthly premium (30-39 work quarters, 45% reduction) | — | $311 |
Data Source: CMS 2026 Medicare Parts A & B Premiums and Deductibles Fact Sheet
Roughly 99% of Medicare beneficiaries pay no monthly premium for Part A, having qualified through at least 40 quarters (about 10 years) of Medicare-covered employment, either their own or a spouse’s. For the small share of beneficiaries without sufficient work history, the full Part A premium rose to $565 a month in 2026, up $47 from 2025, while those with 30 to 39 quarters of coverage qualify for a reduced premium of $311 under a 45% discount built into the program’s statutory formula.
For everyone enrolled in Part A, the real cost exposure comes from the per-benefit-period deductible, which rose to $1,736 in 2026 — notably, this deductible resets every time a new benefit period begins (generally, 60 days after a beneficiary has been out of the hospital or a skilled nursing facility), meaning a beneficiary hospitalized for unrelated conditions twice in a single year could face the deductible twice over. Extended hospital stays carry escalating daily coinsurance: $434 a day for days 61 through 90 of a single benefit period, and $868 a day for any of the 60 lifetime reserve days a beneficiary can draw on after exhausting the standard 90 days — reserve days that, once used, do not renew.
Medicare Part B Costs and IRMAA in 2026
2026 PART B TOTAL MONTHLY PREMIUM BY IRMAA TIER
STANDARD (≤$109K single) ████████ $202.90
TIER 2 ($109K-$137K) ███████████ $284.10
TIER 3 ($137K-$171K) ████████████████ $405.80
TIER 4 ($171K-$205K) ████████████████████ $527.50
TIER 5 ($205K-$500K) █████████████████████████ $649.20
TIER 6 (≥$500K) ██████████████████████████ $689.90
| IRMAA Tier | 2024 Income (Single) | 2026 Total Part B Premium |
|---|---|---|
| Standard | $109,000 or less | $202.90 |
| Tier 2 | $109,001-$137,000 | $284.10 |
| Tier 3 | $137,001-$171,000 | $405.80 |
| Tier 4 | $171,001-$205,000 | $527.50 |
| Tier 5 | $205,001-$499,999 | $649.20 |
| Tier 6 | $500,000 or more | $689.90 |
Data Source: CMS 2026 Medicare Parts A & B Premiums and Deductibles Fact Sheet, Humana IRMAA summary
The standard Part B premium of $202.90 a month applies to the roughly 92% of beneficiaries whose income falls below the first IRMAA threshold. For beneficiaries whose 2024 tax return showed income above $109,000 (single filers) or $218,000 (married filing jointly), Medicare adds an Income-Related Monthly Adjustment Amount on top of the standard premium, using a six-tier structure that climbs as high as $689.90 a month for single filers earning $500,000 or more, or joint filers earning $750,000 or more. IRMAA uses a two-year income lookback specifically so Social Security can calculate and apply the surcharge before the coverage year begins, which also means a significant drop in income — from retirement or a major life event — can sometimes be appealed using Form SSA-44.
Roughly 8% of Part B enrollees, an estimated 5.2 to 5.3 million people nationwide, pay some level of IRMAA surcharge in 2026, a share that has crept upward in recent years as income thresholds have not always kept pace with wage growth for higher earners. IRMAA applies to Part D prescription drug premiums as well, using the same income brackets, meaning a higher-income beneficiary enrolled in both Part B and a stand-alone Part D plan faces two separate surcharges calculated off the same income figure. For broader context on how Medicare eligibility intersects with the overall US retirement system, see our American Retirement Age Statistics report.
Medicare Enrollment and Eligibility in 2026
MEDICARE ELIGIBILITY PATHWAYS
AGE 65+ ███████████████████████████
UNDER 65 WITH QUALIFYING DISABILITY ████████████
ESRD OR ALS DIAGNOSIS ████████
| Eligibility Pathway | Detail |
|---|---|
| Standard eligibility age | 65, regardless of retirement status |
| Younger beneficiaries with disabilities | Eligible after receiving disability benefits for 24 months |
| End-Stage Renal Disease (ESRD) | Eligible regardless of age, with a shorter qualifying period |
| Amyotrophic Lateral Sclerosis (ALS) | Eligible immediately upon receiving disability benefits, no waiting period |
| Total Medicare enrollment | ~69 million across all eligibility pathways |
Data Source: CMS, Medicare.gov, Wikipedia
Medicare eligibility begins at age 65 for most Americans, regardless of whether they are still working, though enrolling in Part B while still covered by qualifying employer insurance can sometimes be delayed without penalty. A meaningful share of the Medicare population qualifies through pathways other than age: beneficiaries under 65 who have received Social Security Disability Insurance for at least 24 months become automatically eligible, while beneficiaries diagnosed with End-Stage Renal Disease qualify regardless of age after a shorter waiting period, and those diagnosed with ALS (Lou Gehrig’s disease) become eligible for Medicare immediately upon qualifying for disability benefits, without any waiting period at all — a specific carve-out Congress added given the disease’s typically rapid progression.
Altogether, Medicare now covers roughly 69 million Americans, the overwhelming majority of them enrolled through the standard age-65 pathway, with several million more qualifying through disability, ESRD, or ALS. That population continues to grow steadily as the Baby Boomer generation ages into eligibility, a demographic shift that has kept Medicare spending growth, program solvency, and premium increases like 2026’s Part B jump near the center of ongoing federal budget debates. For more on how Medicaid, Medicare’s companion program for low-income Americans, compares in scale and enrollment, see our US Welfare Statistics by Race report.
Frequently Asked Questions
What is the difference between Medicare Part A and Part B?
Part A covers inpatient hospital care, skilled nursing facility stays, hospice, and limited home health care. Part B covers outpatient and physician services, including doctor visits, preventive care, lab tests, and durable medical equipment. Together they make up “Original Medicare.”
How much does Medicare Part B cost in 2026?
The standard Part B premium is $202.90 a month in 2026, up $17.90 from 2025. Higher-income beneficiaries pay an additional income-related surcharge (IRMAA) that can push the total monthly premium as high as $689.90.
Is Medicare Part A free?
For most beneficiaries, yes — roughly 99% pay no monthly premium for Part A, having qualified through at least 40 quarters of Medicare-covered work history. Those with less work history pay a premium of $311 to $565 a month in 2026, depending on quarters worked.
What is the Medicare Part A deductible for 2026?
The Part A inpatient hospital deductible is $1,736 per benefit period in 2026, up $60 from 2025. This deductible applies per benefit period, not per calendar year, so it can apply more than once annually for separate hospitalizations.
What is IRMAA and who has to pay it?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to Part B and Part D premiums for higher-income beneficiaries, based on income reported two years earlier. In 2026, it applies to single filers earning above $109,000 and joint filers earning above $218,000, affecting roughly 8% of Part B enrollees.
Does Medicare Part A or B cover long-term care?
No. Neither Part A nor Part B covers long-term custodial care, such as ongoing help with bathing, dressing, or daily activities in a nursing home. Part A covers only short-term skilled nursing facility care following a qualifying hospital stay, up to 100 days.
At what age can you enroll in Medicare?
Standard Medicare eligibility begins at age 65. Younger people can qualify earlier if they have received Social Security disability benefits for 24 months, have End-Stage Renal Disease, or have been diagnosed with ALS, which carries no waiting period.
How much is the Medicare Part B deductible in 2026?
The annual Part B deductible is $283 in 2026, up $26 from 2025. After meeting the deductible, Medicare generally pays 80% of the approved cost for covered services, leaving beneficiaries responsible for the remaining 20% coinsurance.
Disclaimer: The data research report we present here is based on information found from various sources. We are not liable for any financial loss, errors, or damages of any kind that may result from the use of the information herein. We acknowledge that though we try to report accurately, we cannot verify the absolute facts of everything that has been represented.
