Parts A through D, what they actually cost this year, when to sign up, the penalties for waiting, and how Medigap works — the official 2026 numbers in plain English, plus a free printable guide.
Required disclosures: Smooth Health Solutions is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 0–78 organizations which offer 0–2,613 products in your area. The exact number of organizations and products depends on your ZIP code, county, and plan year. Please contact Medicare.gov, 1‑800‑MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This page is educational — it describes how Medicare works, not any specific plan.
Medicare is health insurance for people 65 and older — and for some younger people with a disability, End-Stage Renal Disease, or ALS. Everything you'll decide is built from four parts:
A useful mental model: A + B is the foundation. Advantage, Medigap, and Part D are the three tools for shaping what the foundation doesn't cover.
Neither path is "better" — they trade flexibility against predictability, and the right answer depends on your doctors, medications, travel, and budget:
| Original Medicare (A + B) | Medicare Advantage (Part C) | |
|---|---|---|
| Doctors | Any U.S. provider that accepts Medicare — no networks or referrals | Plan networks (HMO/PPO); referrals in some plans |
| Cost structure | 20% coinsurance after deductible; no yearly cap without Medigap | Plan copays with a yearly out-of-pocket maximum |
| Drugs | Add a stand-alone Part D plan | Usually built in |
| Extras | Not included | Many plans add dental/vision/hearing (varies by plan) |
| Works with Medigap? | Yes | No — illegal for anyone to sell you both |
Plan availability, premiums, networks, and benefits vary by county and change every year — this table describes how the two paths work, not any specific plan.
These are the official amounts from the 2026 "Medicare & You" handbook — they apply to the 2026 plan year:
| Hospital / skilled nursing (2026) | You pay |
|---|---|
| Deductible — each benefit period | $1,736 |
| Hospital days 1–60 | $0/day after deductible |
| Hospital days 61–90 | $434/day |
| Hospital days 91–150 (60 lifetime reserve days) | $868/day |
| Skilled nursing days 21–100 | $217/day |
A benefit period ends after 60 days in a row out of hospital/SNF care — get admitted again later and the $1,736 deductible starts over, even in the same year. This is the gap Medigap was built for.
Under Original Medicare alone, after the $283 Part B deductible you typically pay 20% of the Medicare-approved amount — with no yearly limit. Managing that open-ended 20% is the heart of every good Medicare decision: Medigap caps it, Medicare Advantage plans replace it with their own out-of-pocket maximum.
Higher incomes pay more (IRMAA). If your 2024 modified adjusted gross income was above $109,000 (single) or $218,000 (joint), you may pay an income adjustment on both Part B and Part D. Income dropped since — say, you retired? Ask Social Security to reduce it.
Your Initial Enrollment Period is seven months built around your 65th birthday: three months before your birthday month, your birthday month, and three months after. Already receiving Social Security? You're usually enrolled in A and B automatically. Not receiving benefits yet? Nothing happens until you act — sign up at SSA.gov.
Working past 65? Active employer coverage (yours or your spouse's) usually lets you delay Part B penalty-free, with a Special Enrollment Period when the job ends. But COBRA and retiree coverage don't count — that misunderstanding is one of the most expensive mistakes in all of Medicare.
Tell me your birthday and work situation, and I'll map your exact enrollment dates — plus whether delaying Part B is safe in your case. Ten minutes, free, no obligation. Prefer to start online? The secure intake takes about two minutes.
No cost. No obligation to enroll. We do not offer every plan available in your area.
Once your out-of-pocket spending on covered Part D drugs reaches $2,100 in 2026, you pay $0 for covered drugs for the rest of the calendar year. No donut hole, no catastrophic coinsurance — the cap applies whether your drug coverage is stand-alone or inside an Advantage plan.
How to shop it: never by premium. Formularies (covered-drug lists), pharmacy networks, and tier copays differ by plan and change every January. Enter your actual medications and pharmacy into the Medicare.gov Plan Finder — or have a licensed agent run it — and compare total yearly cost.
If you take no medications: a low-premium Part D plan is still usually worth it, purely as penalty insurance. The 1%-per-month late penalty compounds for as long as you wait and lasts for as long as you have drug coverage.
Medicare Supplement Insurance (Medigap) is sold by private insurers to fill Original Medicare's gaps — the Part A deductible, the open-ended 20%, hospital coinsurance. Three things make it unusual:
If you became eligible for Medicare on or after January 1, 2020, Plans C and F are off the menu — which makes Plan G the most comprehensive available option and Plan N the popular lower-premium alternative (you pay up to $20 for some office visits, up to $50 for ER visits that don't admit you). High-deductible G runs cheaper with a $2,950 deductible in 2026; Plans K and L cost less but split costs with you until yearly limits of $8,000 / $4,000.
The full A–N benefits chart is in the printable guide below — and the CMS/NAIC guide "Choosing a Medigap Policy" is the official reference. Massachusetts, Minnesota, and Wisconsin standardize differently.
Unless you already receive Social Security, nothing happens at 65 until you act — and the penalties for missing your window are permanent.
Neither counts as active employer coverage. The penalty clock runs anyway — this single misunderstanding costs people 10–30% extra on Part B for life.
The 1%-per-month penalty follows you for as long as you have drug coverage. A low-premium plan today is almost always cheaper than the penalty later.
It's the only time every Medigap policy must accept you at healthy-person rates. Decide your path at 65 knowing that switching to Medigap later may mean medical underwriting.
Networks and formularies are plan-specific and change every January. Those three checks matter more than any advertised extra benefit.
Your plan tells you every autumn exactly how it will change next year — premiums, copays, drug list, network. Ten minutes with that letter is the highest-value reading of the year.
Everything on this page plus the full Medigap A–N benefits chart, the complete 2026 cost tables, a turning-65 checklist, and a consultation prep worksheet — in a clean printable PDF. Fill in the quick form and choose text or email — we'll send it right over.
Educational material. Not connected with or endorsed by the U.S. government or the federal Medicare program. Requesting the guide does not enroll you in any plan, and consent to be contacted is not a condition of receiving it.
Your Initial Enrollment Period is seven months built around your 65th birthday — the three months before your birthday month, your birthday month, and the three months after. If you already receive Social Security benefits, you're usually enrolled in Parts A and B automatically; if not, you must sign up yourself at SSA.gov. If you miss your window, the General Enrollment Period runs January 1 to March 31 each year, but late penalties may apply.
For most people in 2026: Part A has no monthly premium but carries a $1,736 deductible per benefit period. Part B's standard premium is $202.90 a month with a $283 annual deductible, after which you typically pay 20% of the Medicare-approved amount — with no yearly cap under Original Medicare alone. Higher incomes (above $109,000 single / $218,000 joint, based on your 2024 return) pay an income adjustment. These are the official amounts from the 2026 Medicare & You handbook.
They solve the same problem — Original Medicare's unlimited out-of-pocket exposure — in opposite ways. Medicare Advantage replaces how you receive your benefits: private plan, network, plan copays, a yearly out-of-pocket maximum, usually drug coverage and extras built in. Medigap supplements Original Medicare: any doctor that accepts Medicare, standardized benefits by plan letter, paired with a separate Part D plan. You cannot have both at once, and neither is universally better — your doctors, medications, travel habits, and budget decide.
In 2026, once your out-of-pocket spending on covered Part D prescription drugs reaches $2,100, you pay nothing for covered drugs for the rest of the calendar year. The cap applies whether your drug coverage comes from a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage.
If you or your spouse are actively working and you're covered by that employer's group health plan, you can usually delay Part B without penalty and get a Special Enrollment Period when the employment or coverage ends. Two cautions: rules differ for smaller employers, so confirm with your benefits administrator how your plan coordinates with Medicare — and COBRA and retiree coverage do not count as active employer coverage for this purpose.
Agent help costs you nothing extra — carriers pay agents, and premiums are the same either way. And no: we do not offer every plan available in your area. Currently we represent 0–78 organizations which offer 0–2,613 products in your area. The exact number of organizations and products depends on your ZIP code, county, and plan year. For information on all of your options, contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP).
All dollar figures on this page (premiums, deductibles, coinsurance, caps, and limits) are the 2026 amounts published in "Medicare & You 2026," the official U.S. government Medicare handbook, and "Choosing a Medigap Policy," developed jointly by CMS and the National Association of Insurance Commissioners, reviewed July 2026. They apply to the 2026 plan year. Plan-specific premiums, networks, formularies, and benefits vary by county and carrier — compare what's filed in your area at Medicare.gov or with a licensed agent.
Talk with Zuriel Kinlock, an independent licensed agent — your enrollment dates, your doctors and prescriptions, your options, mapped in plain English. Free, with zero obligation.
Important: Smooth Health Solutions is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 0–78 organizations which offer 0–2,613 products in your area. The exact number of organizations and products depends on your ZIP code, county, and plan year. Please contact Medicare.gov, 1‑800‑MEDICARE (1‑800‑633‑4227; TTY 1‑877‑486‑2048), or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This page is for general education, reflects 2026 amounts published by CMS, and is not a complete description of benefits or a recommendation of any specific plan. Enrollment cannot be guaranteed until an application is accepted by the applicable insurance company or program. Plan availability, benefits, premiums, and eligibility vary by plan, carrier, location, and individual circumstances.
