Medicare Changes for 2026
The 2026 Medicare rates haven't been released yet, but there are other changes you should be aware of.
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You'll pay up to $2,100 for your medications in 2026 if you have a Part D plan. That's $100 more than in 2025.
And if you live in Arizona, New Jersey, Ohio, Oklahoma, Texas or Washington and have Original Medicare, you may have to get approval before you get some types of medical care. A new AI-driven system to cut Medicare fraud is being tested in those six states.
Starting in 2026, six states (Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington) are testing a new system that could require you to get prior authorization for certain procedures. Original Medicare previously hasn't required prior authorization for most medical care, but the new system is targeted at reducing fraud and waste.
The new system is called the Wasteful and Inappropriate Service Reduction Model, or WISeR, and it uses both AI and people to review requests for certain types of medical care, such as electrical nerve stimulator implants and certain treatments for knee arthritis. WISeR targets medical care that often doesn't help patients and can be used by doctors to get more money from Medicare.
If your doctor wants you to have one of the procedures that WISeR monitors, the request will be reviewed first before it's approved. That could mean your medical care is slowed down, but it could also mean you get better and more appropriate treatment.
Medicare Part A costs in 2025
In 2025, most Part A costs went up by about 3%.
The Part A deductible increased from $1,632 to $1,676 in 2025.
Part A cost | 2024 amount | 2025 amount | Change |
|---|---|---|---|
| Hospital deductible | $1,632 | $1,676 | +$44 |
| Hospital coinsurance days 61-90 | $408 | $419 | +$11 |
| Hospital coinsurance days 91+ | $816 | $838 | +$22 |
| Skilled nursing facility coinsurance days 21-100 | $204 | $209.50 | +$5.50 |
| Monthly rate if you worked 7.5 years or fewer | $505 | $518 | +$13 |
Part A premiums only apply if you paid Medicare taxes for fewer than 40 quarters.
Part A premiums
Most people don't pay a monthly rate for Medicare Part A, and that won't change. The monthly cost is free if you worked and paid Medicare taxes for at least 10 years (40 quarters).
If you paid Medicare taxes for fewer than 10 years, you have to pay for Medicare Part A. If you worked between seven and a half to just under 10 years, which is 30 and 39 quarters, you pay $285 each month for Part A. This is $7 more each month compared to 2024.
If you paid Medicare taxes for less than seven-and-a-half years, you'll pay $518 per month for Part A, up from $505 in 2024.
Part A deductible
The Part A deductible is $1,676 in 2025, an increase of $44. You pay the Part A deductible for most hospital stays.
Part A hospital coinsurance
The first 60 days in the hospital come at no cost to you after you pay your deductible. If you're in the hospital more than 60 days, you and Medicare split the bill for each day. This is called coinsurance. The 2025 Part A coinsurance amounts increase by just under 3% compared to 2024.
- Days 1 to 60 in the hospital: You pay the $1,676 deductible. You won't pay any coinsurance for the first 60 days in the hospital.
- Days 61 to 90 in the hospital: You pay $419 per day, up from $408 in 2024.
- Days 91 and over in the hospital: You pay $838 for each day over day 90, an increase of $22 per day from 2024. These are called "lifetime reserve days," and you get a total of 60.
Part A skilled nursing facility coinsurance
If you need to be in a skilled nursing facility, you'll pay more in 2025. Like other Part A costs, the coinsurance for skilled nursing care is increasing by about 3%.
- Days 1 to 20 in a skilled nursing facility: You pay the $1,676 Part A deductible. There is no coinsurance for the first 20 days of care.
- Days 21 to 100 in a skilled nursing facility: You pay $209.50 per day. That's an increase from $204 per day in 2024.
- Days 101 and over in a skilled nursing facility: You pay all costs for skilled nursing care.
Part B costs in 2025
Medicare Part B costs more per month in 2025, and the deductible is higher.
The cost of Medicare Part B went from $174.70 per month in 2024 to $185 in 2025. That's an increase of $10.30 per month, or about $124 per year.
The Medicare Part B deductible also went up slightly in 2025. The annual Part B deductible went from $240 in 2024 to $257 in 2024, an increase of $17.
Part B cost | 2024 amount | 2025 amount | Change |
|---|---|---|---|
| Premium | $174.70 | $185 | +$10.30 |
| Annual deductible | $240 | $257 | +$17 |
Medicare Part D changes
A Part D prescription drug plan costs an average of $65 in 2025, up from $59 in 2024.
Some 2026 Part D numbers have been released. The maximum Part D deductible in 2026 is $615, up from $590 in 2025. After that, you'll pay 25% of the cost for your covered medications, until you have paid $2,100 total. At that point, you won't pay anything for covered prescriptions.
Part D cost | 2025 amount | 2026 amount | Change |
|---|---|---|---|
| Maximum annual deductible | $590 | $615 | +$25 |
| Out-of-pocket maximum | $2,000 | $2,100 | +$100 |
Medicare Advantage changes for 2025
On average, a Medicare Advantage plan costs $28 in 2025.
The most you might pay for your medical care with a Medicare Advantage plan in 2025 is $9,350 if you use in-network doctors. That's an increase of $500 compared to 2024.
Most Medicare Advantage plans, which are also called Part C plans, include prescription drug coverage. The changes to Medicare Part D also apply to the drug coverage on Medicare Advantage policies.
There are also some important changes to Medicare Advantage plans that don't have to do with costs. The Centers for Medicare & Medicaid Services (CMS) has put more restrictions on Medicare Advantage ads to help cut down on misleading or confusing information. This should help you better understand any plans that you might consider based on an advertisement.
Medicare Advantage plans in 2024 will also have limitations on when a preauthorization can be required. Now, Medicare Advantage plans can only require a preauthorization to confirm a diagnosis or to confirm that a treatment is medically necessary. This could help speed up how quickly you can get medical care.
Medigap changes
The average monthly cost for most Medicare Supplement plans increased in 2025.
Plans F and G, which are the most popular options, both have a 2% increase in their average monthly costs. Plan N is also a popular choice, and its average monthly cost stays the same for 2024. Plans L and M have a decrease in their average monthly rates, although these plans are not common choices.
Medigap plan | 2024 rate | 2025 rate | Change |
|---|---|---|---|
| A | $141 | $151 | +$10 |
| B | $179 | $196 | +$17 |
| C | $210 | $222 | +$12 |
| D | $167 | $178 | +$11 |
| F | $184 | $199 | +$15 |
Rates are average monthly costs for a 65-year-old nonsmoking woman.
The deductible for the high-deductible version of Plans F and G increases from $2,800 to $2,870 in 2025.
Medigap Plans K and L put a cap on your total yearly health care spending. This is called an out-of-pocket maximum. The cap for Plan K is $7,220 in 2025, up from $7,060 in 2024. Plan L's cap in 2024 is $3,610, an increase from $3,530 in 2024.
Frequently asked questions
Is Medicare changing in 2026?
Yes, Medicare programs will change in 2026, but not all the info is available yet. It's like that Part B will cost more each month, and Part A deductibles and coinsurance will also probably increase. In six states, Medicare is also testing a pre-approval program for certain types of medical care.
Is Medicare's age changing to 67 in 2025?
No, the age at which you can get Medicare is still 65 for most people. If you have a disability, Lou Gerhig's disease or kidney failure, you can usually get Medicaid at a younger age.
How much is Medicare going up in 2025?
In 2025, Part B costs $185 per month, up from $174.70 in 2024. That's a difference of $10.30 per month or about $124 per year.
Sources
All Medicare cost, coverage and benefit information was obtained from Medicare.gov and CMS.gov.
Medicare Advantage rates are averages based on data from the Centers for Medicare & Medicaid Services (CMS). Average rates include only plans that have prescription drug coverage. Rates exclude group plans, Health Care Prepayment Plans (HCPPs), Medicare-Medicaid Plans (MMPs), Medical Savings Account (MSA) plans, Programs of All-Inclusive Care for the Elderly (PACE) plans, sanctioned plans and Special Needs Plans (SNPs).
Medicare Supplement rates are based on actuarial data for private health insurance companies. Rates are averages for a 65-year-old woman who doesn't smoke and has preferred rates, without health conditions factored in. Rates are also for the initial sign-up period, when a person is first eligible for Medigap coverage.
Cate Deventer
Insurance Writer
Cate Deventer is a ValuePenguin writer who specializes in health insurance, Medicare, auto and home insurance. She's been a licensed insurance agent since 2011.
She started her insurance career working as a customer service agent for State Farm. She later moved to an independent agency, where she worked with several insurance companies and hundreds of clients. She quoted policies, filed claims and answered insurance questions. In 2021, she pivoted her career and began writing about insurance for Bankrate. She moved to ValuePenguin in 2023 and began writing about health insurance and Medicare.
Cate has a passion for helping readers choose insurance to fit their needs. She enjoys knowing that her research and knowledge help people choose insurance products that make a positive difference in their lives.
How insurance helped Cate
Cate used her health insurance knowledge to navigate a surgery in 2023. Understanding how her policy worked let her focus on recovery instead of worrying about bills.
Expertise
- Health insurance
- Medicare
- Auto insurance
- Home insurance
- Life insurance
Credentials
- Licensed Life, Accident and Health Insurance Agent
- Licensed Property & Casualty Insurance Agent
Referenced by
- CBS
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- Wall Street Journal
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- BA, Theatre, Purdue University
- BA, English, Indiana University
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