Over 65 million Americans rely on Medicare — and in 2026, sweeping updates are reshaping costs, benefits, and plan options. Whether you’re new to Medicare or reviewing your coverage, understanding the four parts — A, B, C, and D — could help you navigate this changing landscape more strategically.

This guide details what each part covers, highlights critical 2026 changes, and helps you choose the right plan for your health needs and budget.

Understanding the 4 Parts of Medicare

Part A – Hospital Insurance

• Covers inpatient hospital stays, skilled nursing facilities, hospice, and some home health services.
• 2026 update: Rates not yet finalized, but increases are expected in line with inflation [1].

Part B – Medical Insurance

• Covers doctor visits, outpatient services, preventive care, and medical equipment.
• 2026 projections: Monthly premium expected to rise from $185 (2025) to $206.50 — an 11.6% increase, the largest since 2022. Annual deductible projected to increase from $257 to $288 [2], [3].
• High-income earners may face higher IRMAA surcharges, with Part D surcharges growing faster than Part B [4].

Part C – Medicare Advantage

• Combines Parts A and B, often including Part D, plus extras like dental, vision, and hearing coverage.
• 2026 trend: Continued plan consolidation is likely, though final benefit updates will be released later in 2025 [1].

Part D – Prescription Drug Coverage

• Covers outpatient prescription drugs.
• 2026 update:
  • Out-of-pocket cap increases from $2,000 (2025) to $2,100 [5].
  • Deductible projected at $615 [2].
  • Spending structure remains three phases: deductible → 25% coinsurance → catastrophic coverage at $0 [6].

Key Medicare Changes in 2026 You Need to Know

• Part B premium and deductible increases — higher monthly costs for most beneficiaries [2], [3].
• Part D out-of-pocket cap rises to $2,100, offering more predictability in drug costs [5].
• Updated IRMAA brackets increase costs for higher-income enrollees [4].
• Preventive service expansion and possible Medicare Advantage benefit enhancements (pending CMS updates) [1].

Comparing Medicare Options — Which Part Fits Your Needs?

Original Medicare (Parts A + B)

Pros:

• Nationwide provider access.
• No network restrictions.

Cons:

• No drug coverage (Part D required separately).
• No dental, vision, or hearing benefits.
• May require Medigap for cost protection.

Medicare Advantage (Part C)

Pros:

• Often includes drug coverage and extra benefits.
• One-stop coverage option.

Cons:

• Network restrictions.
• Benefits and costs vary by plan and region.

Table 1 — Quick Comparison:

Feature	Original Medicare	Medicare Advantage
Provider Choice	Any Medicare-accepting provider	Limited to plan network
Drug Coverage	Requires Part D	Often included
Extra Benefits	None	Often dental, vision, hearing
Costs	Premiums + deductibles + coinsurance	Premiums + copays + out-of-pocket max

Cost Considerations for 2026

• Part A: Most pay $0 premium; deductible TBD [1].
• Part B: $206.50/month premium; $288 deductible [2], [3].
• Part D: $615 deductible; $2,100 out-of-pocket cap [2], [5].
• Part C: Varies by plan, some with $0 premium; subject to network and cost-sharing rules [1].

How to Enroll or Make Changes to Your Medicare Coverage

• Initial Enrollment Period (IEP): 7 months around your 65th birthday [1].
• Annual Enrollment Period (AEP): Oct 15 – Dec 7, 2025 for 2026 coverage [1].
• Medicare Advantage Open Enrollment: Jan 1 – Mar 31, 2026 [1].
• Special Enrollment Periods (SEPs): For qualifying life events [1].

Expert Tips for Choosing the Right Medicare Plan in 2026

• Review health and prescription needs before enrolling.
• Calculate total annual costs (premiums + out-of-pocket).
• Check provider networks for Medicare Advantage plans.
• Account for projected premium increases in your budget.
• Use Medicare.gov Plan Finder to compare local options [1].

Conclusion

With Part B costs surging, the Part D cap rising, and policy shifts underway, Medicare in 2026 demands proactive planning. Review your coverage during AEP to avoid penalties and secure the plan that meets both your health and financial needs.

Don’t Let Medicare Changes in 2026 Catch You Off Guard

With premiums, deductibles, and plan structures shifting across Medicare Parts A, B, C, and D, practices can’t afford to be reactive. Shrinking reimbursements, evolving Medicare Advantage networks, and new payment models can quickly impact your bottom line if you’re not prepared.

At Medviz Systems, we help practices navigate the complexity of today’s Medicare landscape — turning shifting regulations and billing challenges into clear, revenue-protecting strategies.

📞 Talk to a real RCM strategist today: +1 (727) 214-2749
📧 Email us directly: success@medviz.ai

We don’t just streamline your billing — we defend your revenue, decode Medicare’s evolving rules, and keep you ahead of every change in 2025 and beyond. Partner with Medviz and protect your practice’s profitability in the new Medicare era.

References

[1] Centers for Medicare & Medicaid Services, “Medicare & You 2026 (Draft),” CMS.gov, Jul. 2025. [Online]. Available: https://www.cms.gov
[2] Kiplinger, “Plan for Higher Health Care Costs in 2026: Projected Medicare Part B and Part D Premiums,” Aug. 2025. [Online]. Available: https://www.kiplinger.com
[3] FingerLakes1, “Medicare Premium Increase Coming in 2026,” Aug. 4, 2025. [Online]. Available: https://www.fingerlakes1.com
[4] IRMAA Solutions, “Possible 2026 IRMAA Brackets,” 2025. [Online]. Available: https://www.irmaasolutions.com
[5] Ritter Insurance Marketing, “The 2026 Medicare Part D Redesign: Updates Agents Should Know,” 2025. [Online]. Available: https://ritterim.com
[6] Medicare Part D Plans, “Medicare Part D Changes in 2026,” 2025. [Online]. Available: https://www.medicarepartdplans.org