| 2026 Costs at a Glance | |
|---|---|
| Part B Premium | Most people pay $202.90 each month. |
| Part B Deductible | $283 per year. |
| Part A premium | Most people don't pay a monthly premium for Part A. For those who purchase Part A, you will pay up to $565 each month. |
Medicare Part A (Hospital Insurance)
Hospital inpatient stay
- $1,736 deductible for each benefit period
- Days 1–60: $0 coinsurance for each benefit period
- Days 61–90: $434 coinsurance per day of each benefit period
- Days 91 and beyond: $868 copayment each day while using your 60 lifetime reserve days
- Beyond lifetime reserve days: You pay all costs
Skilled Nursing Facility (SNF) Care
- Days 1–20: $0 for each benefit period.
- Days 21–100: $217 coinsurance per day of each benefit period
- Days 101 and beyond: You pay all costs
Medicare Part B (Medical Insurance)
Clinical laboratory services
- You pay $0 for Medicare-approved services.
Home health services
- $0 for home health care services.
- 20% of the Medicare-approved amount for durable medical equipment
Medical and other services
- You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.
Outpatient mental health services
You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment.
20% of the Medicare-approved amount for visits to a doctor or other health care provider to diagnose or treat your condition. The Part B deductible applies.
If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.
These costs can be significant. For example, an individual with multiple chronic conditions (e.g., congestive heart failure and Parkinson’s disease) can spend thousands of dollars per year on prescription medications alone. These same individuals may be in and out of the hospital several times each year. If each visit represents a new benefit period, a new deductible is required for each. Deductibles and co-payments on Part B doctor visits can also add up over time. In more serious situations, extended hospital stays can result in substantial out-of-pocket costs once Medicare coverage limits are reached.
No retirement plan should overlook these potential costs.
Retirees facing this challenge should consider strategies for addressing healthcare costs after age 65. Strategies for filling gaps between actual healthcare costs and Medicare coverage include:
- The purchase of Medigap insurance from private insurers
- Enrolling in a Medicare Advantage (Part C) plan
- Maintaining coverage through an employer-provided health insurance plan, if available
- For those who qualify, state assistance programs such as Medicaid
Medigap insurance is designed to supplement Medicare’s benefits by covering certain out-of-pocket costs such as deductibles and coinsurance. Plan costs and coverage can vary, so it is important to evaluate options carefully based on individual needs.
To discuss the impact of health care costs on your retirement income plan and the optimal solution for your personal situation, contact a Mainstay Capital Management Senior Wealth Advisor toll-free at 866-444-6246.
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