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 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.
| What | 2025 | 2026 |
|---|---|---|
| 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.
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.
The federal cost changes above are the same across the country, but a few things work differently for California residents:
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:
A free, no-obligation review can help you see how the 2026 changes affect your plan. Let's talk it through.
Schedule a Free Consultation 📞 805-322-8053Sources 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.