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2026 Medicare Changes in California: What's New (and What It Costs)

By Matt Rolph, Independent Licensed Medicare Broker · Reviewed June 2026

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For 2026, the biggest Medicare change is the Part D out-of-pocket cap, which is $2,100 for the year — once you spend that much on covered prescriptions, your plan pays 100% for the rest of the year. The standard Part B premium rises to $202.90 per month, the Part B deductible is $283, and the Part A hospital deductible is $1,736. These figures are set nationally; what's specific to California is the Medigap Birthday Rule, Medi-Cal for dual-eligible residents, and free HICAP counseling.

The headline change: a $2,100 cap on Part D drug costs

The most meaningful 2026 change for many people is in Part D prescription drug coverage. There is now an annual cap of $2,100 on what you pay out of pocket for covered drugs. Once your true out-of-pocket spending reaches that amount, your Part D plan covers 100% of your covered prescription costs for the remainder of the year. For Californians who take expensive or specialty medications, this can make yearly drug costs far more predictable than in the past.

If even the capped amount is hard to manage all at once, the Medicare Prescription Payment Plan lets you spread your out-of-pocket Part D costs across the year in monthly payments instead of paying large amounts at the pharmacy counter. It does not lower your total cost, but it can smooth out the timing. Any Part D or Medicare Advantage plan with drug coverage must offer this option.

2026 Medicare costs at a glance

What20252026
Part D out-of-pocket cap$2,000$2,100
Standard Part B premium (monthly)$185.00$202.90
Part B annual deductible$257$283
Part A hospital deductible (per benefit period)$1,676$1,736

Most people pay the standard Part B premium, and many have it deducted directly from their Social Security benefit. The figures above are the national amounts that apply in California just as they do everywhere else.

Higher-income beneficiaries: IRMAA in 2026

If your income is above certain levels, you pay an extra amount on top of the standard Part B and Part D premiums. This surcharge is called the Income-Related Monthly Adjustment Amount, or IRMAA. In 2026, the surcharge begins to apply once income is above $109,000 for a single filer or $218,000 for a married couple filing jointly. The exact amount you pay increases in steps as income rises.

IRMAA in 2026 is based on the income reported on your 2024 tax return, since Social Security looks back two years. If your income has dropped since then because of a life event such as retirement, you can ask Social Security to reconsider using a more recent year.

What's specific to California

The federal cost changes above are the same across the country, but a few things work differently for California residents:

What to do during the 2026 Annual Enrollment Period

Medicare plans can change their costs, drug formularies, and provider networks each year, so it is worth reviewing your coverage even if you are happy with it. The Annual Enrollment Period runs October 15 to December 7, when you can join, switch, or drop a Medicare Advantage or Part D plan. A good yearly checklist:

Want help reviewing your 2026 options?

A free, no-obligation review can help you see how the 2026 changes affect your plan. Let's talk it through.

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Frequently asked questions

What is the Medicare Part D out-of-pocket cap in 2026?
In 2026, Part D caps your out-of-pocket spending on covered prescription drugs at $2,100 for the year. After you reach that amount, your plan pays 100% of covered drug costs for the rest of the year.
How much is the Part B premium in 2026?
The standard Part B premium is $202.90 per month in 2026, up from $185.00 in 2025, and the annual Part B deductible is $283. Higher-income beneficiaries may pay more through IRMAA.
Do these changes affect California differently?
The cost figures are national. What is specific to California is the Medigap Birthday Rule, Medi-Cal for dual-eligible residents, free HICAP counseling, and plan availability that varies by ZIP code.
Does it cost anything to get help comparing plans?
No. Independent brokers are paid by the insurance carriers, so help is free to you, and your premium is the same whether you enroll through a broker or on your own.

Sources for 2026 figures: Centers for Medicare & Medicaid Services (CMS) 2026 Parts A & B premiums and deductibles fact sheet and the official Medicare & You handbook at Medicare.gov. Amounts reflect 2026 and can change — confirm current figures at Medicare.gov or 1-800-MEDICARE.