Medicare Changes 2026
What Palm Coast Seniors Need to Know
Every Medicare cost and benefit that changed for 2026 — explained in plain English for Flagler County seniors. Updated figures, what they mean for you, and how to minimize your costs.
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$202.90/mo
Part B Premium
$283
Part B Deductible
$1,736
Part A Deductible
$2,100
Part D OOP Cap
$106,000
IRMAA Threshold
Part B (Medical)
Part B Monthly Premium
Up from $174.70 in 2025
$202.90/mo
Part B Annual Deductible
Up from $240 in 2025
$283
Part B Coinsurance
Unchanged
20% after deductible
Part A (Hospital)
Part A Inpatient Deductible
Up from $1,632 in 2025
$1,736 per benefit period
Days 1–60 Coinsurance
Covered by deductible
$0
Days 61–90 Coinsurance
Up from $408/day
$433/day
Lifetime Reserve Days
Up from $816/day
$866/day
Part D (Prescription Drugs)
Out-of-Pocket Cap
NEW in 2026 — major improvement
$2,100/year
Catastrophic Coverage
No more 5% coinsurance
$0 after cap
Deductible Maximum
Up from $545 in 2025
$590
Medigap (Supplement)
Plan G High-Deductible
Up from $2,800 in 2025
$2,870 deductible
Plan G (standard)
Only gap: $283 Part B deductible
Covers Part B 20%
Plan N
Lower premium than Plan G
Up to $20 office copay
IRMAA (High-Income Surcharge)
IRMAA Threshold (Individual)
Income above this triggers surcharge
$106,000/year
IRMAA Threshold (Joint)
Based on 2024 tax return (2-year lookback)
$212,000/year
Part B IRMAA Tier 1
Added to $202.90 base premium
+$70.00/mo
The Biggest 2026 Change: Part D $2,100 Out-of-Pocket Cap
For Palm Coast seniors on expensive medications, the 2026 Part D out-of-pocket cap of $2,100 is the most significant Medicare change in years. Once you spend $2,100 on covered drugs, your cost drops to $0 for the rest of the year.
This replaces the old "donut hole" structure and eliminates the 5% catastrophic coinsurance that previously had no cap. If you take specialty medications, cancer drugs, or multiple expensive prescriptions, this change could save you thousands per year.
What Palm Coast Seniors Should Do Now
Review your Annual Notice of Change
Every Medicare Advantage and Part D plan sends an Annual Notice of Change (ANOC) each fall. Review it carefully — premiums, copays, formularies, and networks can all change year to year.
Compare your current plan against alternatives
Even if your plan seems fine, better options may exist. William compares every plan available in your Palm Coast ZIP code against your current coverage — free, every fall.
Check your medications on the new formulary
Part D formularies change annually. A drug that was Tier 2 last year may be Tier 3 this year. William runs your full medication list against every plan to find the lowest total drug cost.
Verify your doctors are still in-network
Medicare Advantage networks change. A doctor who was in-network last year may not be this year. William verifies your specific providers before Annual Enrollment closes.
Act before December 7
Annual Enrollment closes December 7. Changes take effect January 1. Don't wait until the last minute — call William now for a free 2026 plan review.
Frequently Asked Questions
2026 Medicare changes — what Palm Coast seniors need to know
What is the Medicare Part B premium in 2026?+
The standard Medicare Part B premium in 2026 is $202.90 per month. Higher-income beneficiaries pay more due to IRMAA surcharges, which begin at incomes above $106,000 for individuals.
What is the Medicare Part D out-of-pocket cap in 2026?+
In 2026, Medicare Part D has a $2,100 annual out-of-pocket cap. Once you reach this amount, your prescription drugs cost $0 for the rest of the year. This is a major improvement from previous years.
What is the Medicare Part A deductible in 2026?+
The Medicare Part A inpatient hospital deductible is $1,736 per benefit period in 2026. Medigap Plan G covers this deductible in full.
What is the High Deductible Plan G deductible in 2026?+
The High Deductible Plan G (HDG) deductible is $2,870 in 2026. Once you meet this deductible, coverage is identical to standard Plan G. HDG offers the lowest monthly premium of any Medigap plan.
Questions About 2026 Medicare Changes?
William explains every change in plain English and reviews your current plan against every 2026 option in Palm Coast — free.