Quick answers
- What is the Part B premium in 2026?
- $202.90 a month for most people, with a $283 yearly deductible. People with higher incomes pay more (IRMAA).
- What is the Part A deductible in 2026?
- $1,736 for each benefit period. Most people pay no Part A premium because they or a spouse paid Medicare taxes for 40 quarters, including most Ohio public employees hired after March 31, 1986.
- Is there a cap on drug costs?
- Yes. In 2026 you pay no more than $2,100 out of pocket for covered Part D drugs, and there is no coverage gap.
- Does Ohio's state income tax change IRMAA?
- No. IRMAA uses the modified adjusted gross income on your federal tax return. Your Ohio return isn't used.
- Who helps Ohioans pay Medicare costs?
- Ohio Medicaid's Medicare Premium Assistance Programs (QMB, SLMB, QI-1), applied for at benefits.ohio.gov or your county Job and Family Services office, and Extra Help through Social Security.
Every amount below is for calendar year 2026, from CMS and Social Security. Medicare's costs are federal, so they're the same in Columbus, Cleveland, Cincinnati, Toledo, Athens or Van Wert. Jump to: Part A · Part B · Paying your premium · IRMAA · Part D · Medicare Advantage · Medigap · Extra Help · Ohio premium help · 2025 vs 2026 · By county
What does Part A cost in 2026?
| Part A cost | 2026 |
|---|---|
| Premium with 40 or more quarters of Medicare-covered work (yours or a spouse's) | No premium |
| Premium with 30 to 39 quarters | $311 a month |
| Premium with fewer than 30 quarters | $565 a month |
| Inpatient deductible (each benefit period) | $1,736 |
| Hospital days 61 to 90 | $434 a day |
| Lifetime reserve days (60 in a lifetime) | $868 a day |
| Skilled nursing facility days 21 to 100 | $217 a day |
Hospital days 1 to 60 and skilled nursing days 1 to 20 have no coinsurance after the deductible. A benefit period ends after 60 days in a row without inpatient or skilled nursing care, so a second hospital stay later in the year can mean a second deductible.
Ohio public employees and Part A. Most Ohio teachers, school staff, police, firefighters and state and local workers don't pay into Social Security, but anyone hired or rehired after March 31, 1986 pays the Medicare tax, so most earn premium-free Part A. People hired before April 1986 who never paid the Medicare tax may need a spouse's record or must pay a Part A premium. Each retirement system handles that differently; see Ohio public retirement systems and Medicare and Part A.
What does Part B cost in 2026?
| Part B cost | 2026 |
|---|---|
| Standard monthly premium | $202.90 |
| Yearly deductible | $283 |
| Coinsurance for most services | 20% of the Medicare-approved amount |
| Late enrollment penalty | 10% of the standard premium for each full 12 months you delayed |
OPERS, STRS Ohio, SERS and OP&F all require Medicare-age retirees in their health care programs to enroll in Part B, and STRS Ohio and SERS end retiree medical coverage if you drop it. Retiree coverage isn't coverage from current work, so it doesn't protect you from the Part B late penalty. More on Part B; estimate a penalty with the penalty calculator.
How do you pay the premium in Ohio?
If you get Social Security or Railroad Retirement benefits, your Part B premium is usually taken out of your monthly payment. Ohio's public pensions are different: OPERS, STRS Ohio, SERS, OP&F and HPRS don't deduct the Part B premium, so a retiree with no Social Security check gets a premium bill from Medicare.
- How often: every 3 months if you have only Part B (including any Part B IRMAA), and every month if you also pay a Part A premium or a Part D IRMAA. Bills are due on the 25th.
- How to pay: online through your Medicare.gov account; Medicare Easy Pay, which takes the premium from your bank account each month (setup takes 6 to 8 weeks); your bank's online bill pay; or by mail with the payment coupon.
- Help from your system: some systems help with Part B through a reimbursement, a premium credit or a health reimbursement account (HRA). Each system publishes its own amount; see OPERS vs STRS vs SERS retiree coverage.
Since the Social Security Fairness Act repealed the Windfall Elimination Provision and Government Pension Offset in January 2025, more Ohio public retirees and their spouses get a Social Security check. If you start getting one, Social Security can begin taking the Part B premium out of it.
IRMAA: who pays more for Part B and Part D?
If your modified adjusted gross income (MAGI) on your 2024 federal tax return was above the first threshold, you pay more for Part B and Part D in 2026. The Part D amount is added to your plan's premium and paid to Medicare. The brackets are cliffs: one dollar into a higher bracket means the whole higher amount applies.
| 2024 MAGI, single | 2024 MAGI, married filing jointly | 2026 Part B premium (monthly) | Part D surcharge (monthly) |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | None |
| $109,001 to $137,000 | $218,001 to $274,000 | $284.10 | $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | $405.80 | $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | $527.50 | $60.40 |
| $205,001 to under $500,000 | $410,001 to under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91 |
Married people who lived with their spouse at some point during the year and file separate returns have their own brackets:
| 2024 MAGI, married filing separately | 2026 Part B premium (monthly) | Part D surcharge (monthly) |
|---|---|---|
| $109,000 or less | $202.90 | None |
| $109,001 to under $391,000 | $649.20 | $83.30 |
| $391,000 or more | $689.90 | $91 |
Ohio's income tax doesn't enter into it. Social Security sets IRMAA only from the MAGI the IRS reports from your federal return: adjusted gross income plus tax-exempt interest. Ohio deductions and credits on your state return don't lower it. What does count is federal taxable income such as an OPERS, STRS Ohio, SERS, OP&F or HPRS pension, a DROP or other lump sum you take as cash, required minimum distributions, Roth conversions and capital gains.
A one-time gain, such as selling a business, farmland or a second home, counts in the year it happens and can raise your premiums two years later. If your income has fallen because of a life-changing event such as retirement, ask Social Security to recalculate with Form SSA-44. SERS warns that its retiree coverage can end if a member doesn't pay a Part D IRMAA, so don't ignore an IRMAA bill. Try the IRMAA calculator.
What does Part D cost in 2026?
| Part D amount | 2026 |
|---|---|
| Maximum yearly deductible a plan can charge | $615 |
| Yearly cap on your out-of-pocket drug costs | $2,100 |
| Most you pay for a month's supply of each covered insulin | $35 |
| National base beneficiary premium (used to figure the late penalty) | $38.99 a month |
Plans set their own premiums and can have a lower deductible or none. Once your out-of-pocket costs for covered drugs reach the cap, you pay nothing more for covered Part D drugs for the rest of the year. There's no longer a coverage gap. The Part D late enrollment penalty is 1% of the national base beneficiary premium for each month you went without creditable drug coverage. You can spread drug costs across the year with the Medicare Prescription Payment Plan. More on Part D in Ohio, or use the drug cap calculator.
What are the Medicare Advantage out-of-pocket limits?
| Medicare Advantage limit | 2026 maximum |
|---|---|
| In-network services (HMO and PPO) | $9,250 |
| In- and out-of-network services combined (PPO) | $13,900 |
These are the highest limits Medicare allows for Part A and Part B services; each plan sets its own limit at or below them. Drug costs count toward the separate Part D cap. You still pay the Part B premium with a Medicare Advantage plan. More on Medicare Advantage in Ohio.
Which Medigap amounts does Medicare set?
Insurance companies set Medigap premiums and file them with the Ohio Department of Insurance, but Medicare sets a few amounts for the standardized plans:
| Medigap amount | 2026 |
|---|---|
| High-deductible Plan G (and Plan F for those eligible before 2020) deductible | $2,950 |
| Plan K yearly out-of-pocket limit | $8,000 |
| Plan L yearly out-of-pocket limit | $4,000 |
| Plan N copays | Up to $20 for some office visits, up to $50 for emergency room visits that don't lead to admission |
Ohio has no Medigap birthday rule, so outside your six-month Medigap open enrollment period or a guaranteed-issue right, a company can usually review your health before selling you a policy. More on Medigap in Ohio.
How much does Extra Help save on drugs?
Extra Help (the Part D Low-Income Subsidy) lowers drug plan premiums, deductibles and copays. For 2026:
| Extra Help | Individual | Married couple |
|---|---|---|
| Yearly income limit (150% of the federal poverty level) | $23,940 | $32,460 |
| Resource limit | $16,590 | $33,100 |
| Resource limit if you expect to use some for burial | $18,090 | $36,100 |
| Most you pay per prescription with Extra Help in 2026 | Generic | Brand name |
|---|---|---|
| Most people with Extra Help | $5.10 | $12.65 |
| People with full Ohio Medicaid and income at or below 100% of the poverty level | $1.60 | $4.90 |
Your home, one car and certain other things don't count as resources. Apply through Social Security at ssa.gov/extrahelp or 1-800-772-1213. If you have full Ohio Medicaid, a Medicare Premium Assistance Program or Supplemental Security Income, you qualify automatically. See Extra Help in Ohio.
What are Ohio's Medicare Premium Assistance Program limits?
Ohio calls its Medicare Savings Programs the Medicare Premium Assistance Programs. They are part of Ohio Medicaid, set out in Ohio Administrative Code rule 5160:1-3-02.1, and your county Department of Job and Family Services decides who qualifies. Ohio uses the federal minimum income levels and keeps an asset test.
| Program (2026) | Monthly income, one person | Monthly income, couple | What it pays |
|---|---|---|---|
| QMB (up to 100% of poverty level) | $1,350 | $1,824 | Part A and Part B premiums, deductibles, copays and coinsurance |
| SLMB (up to 120%) | $1,616 | $2,184 | Part B premium |
| QI-1 (up to 135%) | $1,816 | $2,455 | Part B premium |
| Resource limit, all three | $9,950 | $14,910 | Countable savings and property |
The income limits shown include the standard monthly income disregard. Ohio Medicaid's own 2026 table shows amounts a little lower because it lists the poverty-level figures before that disregard; both describe the same rule. Your home and one car don't count as resources. QMB starts the month after you're approved and can't be backdated; SLMB and QI-1 can reach back up to three months. Apply at benefits.ohio.gov or your county JFS office, and check your numbers with the savings programs screener. More on Medicare Savings Programs in Ohio.
What changed from 2025 to 2026?
| Amount | 2025 | 2026 | Change |
|---|---|---|---|
| Part B standard premium (monthly) | $185 | $202.90 | +$17.90 |
| Part B deductible | $257 | $283 | +$26 |
| Part A deductible | $1,676 | $1,736 | +$60 |
| Part D out-of-pocket cap | $2,000 | $2,100 | +$100 |
| First IRMAA threshold, single | $106,000 | $109,000 | +$3,000 |
| First IRMAA threshold, married filing jointly | $212,000 | $218,000 | +$6,000 |
CMS announces the next year's Part A and Part B amounts each fall. What CMS has already published for 2027 (Part D, Medicare Advantage limits, Medigap amounts, Extra Help copays) is on Medicare costs in 2027.
Do costs differ by Ohio county?
Original Medicare costs the same in all 88 counties. Your plan choices don't: for 2027, CMS lists 68 Medicare Advantage plans open to everyone in Summit County and 22 in Scioto County, and each plan sets its own premium, deductible and copays. Every county still has regular Medicare Advantage plans in 2027, but some plans are ending; see Ohio plans ending in 2027 and your county on the county list.
Where can Ohioans get help paying Medicare costs?
Medicare Premium Assistance Programs
QMB, SLMB and QI-1 pay the Part B premium, and QMB also pays Part A premiums, deductibles and coinsurance. Apply at benefits.ohio.gov or your county JFS office; questions go to the Ohio Medicaid Consumer Hotline, 1-800-324-8680. Learn more.
Extra Help
Lowers Part D premiums, deductibles and copays, and comes automatically with a premium assistance program, full Ohio Medicaid or SSI. Others apply through Social Security. Extra Help in Ohio.
Full Ohio Medicaid and MyCare Ohio
Full Medicaid pays after Medicare for covered services, and adults 21 and older with both can get them coordinated through MyCare Ohio. Ohio Medicaid and Medicare.
A licensed insurance agent
To see how plans from the companies they work with handle these costs, at no cost to you, you can request a call from a licensed insurance agent.
To compare coverage, see plans for your ZIP code.
Sources
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Medicare.gov — Medicare costs
- Medicare.gov — Pay Medicare premiums (Medicare Easy Pay, premium bills)
- Social Security — Premiums: rules for higher-income beneficiaries
- Social Security POMS HI 01101.010 — Modified adjusted gross income and the tax year used for IRMAA
- Social Security — Mandatory Medicare coverage for state and local government employees
- Social Security — Social Security Fairness Act: WEP and GPO update
- CMS — CY2026 resource and cost-sharing limits for the Low-Income Subsidy
- Medicare.gov — Medicare Savings Programs
- Ohio Administrative Code 5160:1-3-02.1 — Medicare premium assistance programs (MPAP)
- Ohio Department of Medicaid — 2026 Monthly Financial Eligibility, Aged, Blind or Disabled Individuals (PDF)
- SERS — 2027 Member Health Care Guide (Part B and Part D IRMAA requirements) (PDF)
- CMS — CY2027 Medicare Advantage and Part D Landscape files (Ohio plan counts)
Every question in this guide
Frequently asked questions
Does Social Security take the Part B premium out of my check?
Usually, yes. If you get Social Security or Railroad Retirement benefits, the Part B premium is normally deducted from your monthly payment. Ohio's public retirement systems don't deduct the Part B premium from a pension, so retirees without a Social Security check get a bill from Medicare instead.
How do I pay my Medicare premium if I don't get Social Security?
Medicare sends you a premium bill, every 3 months if you have only Part B and every month if you pay a Part A premium or a Part D IRMAA. You can pay online through your Medicare account, sign up for Medicare Easy Pay to have it taken from your bank account each month, use your bank's bill pay, or mail a check, money order or card payment.
Does Original Medicare have an out-of-pocket maximum?
No. Original Medicare has no yearly out-of-pocket limit for Part A and Part B. Medicare Advantage plans must have one, up to $9,250 for in-network services in 2026, and Part D has its own $2,100 cap. Many people with Original Medicare add a Medigap policy to limit their costs.
How much does Medicare pay for a skilled nursing facility stay?
After a qualifying inpatient hospital stay of at least three days, Part A pays the full cost of days 1 to 20 in a Medicare-certified skilled nursing facility. For days 21 to 100 you pay $217 a day in 2026, and after day 100 you pay all costs.
Do Medicare costs change from one Ohio county to another?
Not for Original Medicare. The Part A and Part B premiums, deductibles and coinsurance are federal and the same in every county. What changes by county is your choice of Medicare Advantage plans, and each plan sets its own premium and copays.
How much did Medicare go up from 2025 to 2026?
The standard Part B premium rose from $185 to $202.90 a month, the Part B deductible from $257 to $283, the Part A deductible from $1,676 to $1,736, and the Part D out-of-pocket cap from $2,000 to $2,100.
Medicare in your Ohio county
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