Part A costs (hospital)
Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health. Most Medicare beneficiaries don't pay a premium for Part A (because they or a spouse paid Medicare taxes for 40+ quarters during working years).
| 2026 Part A cost | Amount |
|---|---|
| Monthly premium (most beneficiaries) | $0 |
| Hospital deductible (per benefit period) | $1,736 |
| Hospital coinsurance, days 61-90 | $434/day |
| Lifetime reserve days (60 total) | $868/day |
| Skilled nursing facility, days 21-100 | $217/day |
| Hospice care | $0 (small copays for drugs, respite) |
Part A premium for those who didn't pay enough Medicare taxes: $278/month (with 30-39 quarters of work) or $505/month (with fewer than 30 quarters). Most Ohio beneficiaries have full quarters and pay nothing.
Part B costs (medical)
Medicare Part B covers outpatient care, doctor visits, durable medical equipment, preventive services, mental health, and some home health. Part B has a monthly premium that nearly all beneficiaries pay.
| 2026 Part B cost | Amount |
|---|---|
| Standard monthly premium | $202.90 |
| Annual deductible | $283 |
| Coinsurance after deductible | 20% of approved amount |
| IRMAA surcharge (top tier) | +$487.00/month (=$689.90 total) |
| Late enrollment penalty | +10% per full 12 months delayed, for life |
The 20% coinsurance has no cap in Original Medicare alone — this is the primary reason most Original Medicare beneficiaries pair with Medigap. See the Part B Penalty Calculator if you delayed enrollment and the IRMAA Calculator if your MAGI is above $109K single / $218K joint.
Part C / Medicare Advantage costs
Medicare Advantage (MA) plans bundle Parts A and B, often with Part D and supplemental benefits. Premiums vary by plan and county.
| 2026 MA cost component | Typical range in Ohio |
|---|---|
| Monthly premium | $0 – $80 (still pay Part B $202.90) |
| Doctor visit copay | $0 – $25 |
| Specialist visit copay | $25 – $50 |
| Hospital stay (per day, days 1-5) | $200 – $400 |
| Maximum out-of-pocket (in-network) | $3,000 – $9,250 |
| Maximum out-of-pocket (PPO combined) | up to $14,000 |
MA plan premiums and benefits vary significantly by carrier and county. CareSource, Aultcare, SummaCare, and Paramount Elite are regional Ohio carriers; Aetna, Anthem, Humana, UnitedHealthcare, Medical Mutual, and Wellcare are major national carriers with Ohio presence. The 2026 federal MA MOOP maximum decreased $100 from 2025's $9,350 to $9,250.
Part D costs (prescriptions)
Medicare Part D covers outpatient prescriptions. 2026 brings the biggest structural changes in Part D's history — the Inflation Reduction Act fully implemented the $2,000 out-of-pocket cap (slightly higher actual at $2,100 due to inflation adjustment).
| 2026 Part D cost | Amount |
|---|---|
| Standalone PDP premium range (Ohio) | $5 – $80/month |
| National base premium (for IRMAA calc) | $38.99 |
| Maximum annual deductible | $615 |
| Annual out-of-pocket cap | $2,100 |
| Insulin cap per prescription | $35/month |
| Part D IRMAA (top tier) | +$91.00/month |
The $2,100 OOP cap is a major change: once you hit it, your remaining prescriptions are covered at 100% for the rest of the year. The Medicare Prescription Payment Plan (M3P, optional) lets you spread that cap evenly across the year instead of paying it upfront.
Medigap plan premiums and MOOPs
Medigap (Medicare Supplement) policies pair with Original Medicare and cover the cost-sharing Medicare doesn't. Premiums vary by carrier; plan letter determines benefits.
| Plan | Ohio premium range (age 65) | Key feature |
|---|---|---|
| Plan G | $120 – $200/month | Most popular; covers everything except Part B deductible |
| Plan N | $85 – $140/month | Lower premium; $20 office copay, $50 ER copay |
| Plan G-HD (high deductible) | $40 – $70/month | $2,950 annual deductible, then full Plan G coverage |
| Plan K | $60 – $100/month | $8,000 MOOP; 50% cost-sharing below MOOP |
| Plan L | $90 – $140/month | $4,000 MOOP; 75% cost-sharing below MOOP |
| Plan F (closed to newly-eligible 2020+) | $150 – $230/month | Most comprehensive; covers Part B deductible too |
Premiums increase with age for most carriers (attained-age rating). The same plan letter from different carriers covers identical benefits — compare on price and carrier financial strength. See our Medigap deep-dive for the full benefits matrix.
IRMAA surcharge brackets
IRMAA adds to your Part B and Part D premium based on your 2024 MAGI (2-year lookback):
| 2024 MAGI (Single) | 2024 MAGI (Joint) | 2026 Part B premium | Part D add-on |
|---|---|---|---|
| ≤ $109K | ≤ $218K | $202.90 | $0 |
| $109K – $137K | $218K – $274K | $284.10 | +$14.50 |
| $137K – $171K | $274K – $342K | $405.80 | +$37.50 |
| $171K – $205K | $342K – $410K | $527.50 | +$60.40 |
| $205K – $500K | $410K – $750K | $649.20 | +$83.30 |
| ≥ $500K | ≥ $750K | $689.90 | +$91.00 |
Brackets are cliffs — $1 over moves you up the entire tier. Use the IRMAA Calculator for your specific situation.
Maximum out-of-pocket (MOOP) caps
Annual caps on cost-sharing — protect you from catastrophic medical bills:
- Medicare Advantage in-network MOOP: $9,250 maximum (2026); most plans set lower (typical median ~$5,900).
- Medicare Advantage PPO combined MOOP: up to ~$14,000 for in-network + out-of-network combined.
- Original Medicare alone: NO MOOP — uncapped 20% Part B coinsurance + Part A deductibles per benefit period. Major reason for pairing with Medigap.
- Medigap Plan K: $8,000 annual MOOP.
- Medigap Plan L: $4,000 annual MOOP.
- Medigap G, N, and most others: functionally produce $0 or near-$0 cost-sharing for covered services after Part B deductible.
- Part D OOP cap: $2,100 annually (separate from medical MOOP).
Annual cost scenarios for typical Ohio retirees
Total estimated 2026 costs for typical scenarios (Ohio retiree, age 67, average health, no IRMAA):
| Scenario | Premium (monthly) | Cost-sharing (annual) | Worst-case total (annual) |
|---|---|---|---|
| Original Medicare alone | $202.90 (Part B) | Unlimited (Part B 20%, Part A deductibles) | Potentially $20,000+ |
| Original Medicare + Medigap G + Part D | ~$350 (Part B + Medigap G + Part D) | $283 Part B deductible only | ~$4,500 total (premium + deductible + max Part D OOP) |
| Medicare Advantage (HMO, $0 premium) | $202.90 (Part B only) | Plan copays up to MOOP | ~$12,000 (premium × 12 + MOOP $9,250) |
| Medicare Advantage (PPO, $30 premium) | $232.90 (Part B + premium) | Plan copays up to MOOP | ~$12,500 (in-network) or $17,000+ (with out-of-network) |
Medigap-paired Original Medicare typically produces the most predictable annual costs. Medicare Advantage has lower premium but higher worst-case exposure if you have a high-utilization year. Neither is universally better — choose based on your health, providers, travel patterns, and budget tolerance.