Imagine two Medicare plans side by side.

One has a higher monthly plan premium. The other advertises a $0 plan premium and includes additional benefits. 

At first glance, the choice may seem obvious. 

But a $0 plan premium does not necessarily mean $0 total Medicare cost. Depending on the coverage you choose and your circumstances, you will still pay the Medicare Part B premium, deductibles, copayments or coinsurance, prescription drug costs, and, in some cases, income-related surcharges.

The coverage that appears least expensive may not necessarily be the option that best fits your health care preferences, expected use of care, travel needs, and budget.

For 2026, it is worth looking beyond the advertised premium.

Medicare Is Costing More in 2026

For 2026, the standard Medicare Part B premium is $202.90 per month, up from $185 in 2025. The annual Part B deductible is $283, up from $257 in 2025. Some higher-income beneficiaries pay an additional surcharge on top of their standard Part B and Part D premiums, known as the income-related monthly adjustment amount (IRMAA).

For most people who file federal income tax returns, 2026 IRMAA begins when modified adjusted gross income is above $109,000 for an individual or above $218,000 for a married couple filing jointly. Different thresholds apply to married individuals who lived with their spouse during the year but filed a separate tax return.

Moving into a higher IRMAA tier can increase monthly Medicare costs.

For example, in the first 2026 Part B IRMAA tier, a person pays $284.10 per month for Part B rather than the standard $202.90. If that person has Part D prescription drug coverage (including a Medicare Advantage plan that includes drug coverage), the Part D IRMAA surcharge for that tier is $14.50 per month, in addition to the person’s Part D plan premium.

Social Security generally uses income information from a federal tax return from two years earlier to determine IRMAA. As a result, income decisions that affect modified adjusted gross income may impact Medicare costs in a future year. A qualifying life-changing event may allow Social Security to use more recent income information.

This is especially relevant if you’re retiring and transitioning to Medicare, since your Medicare premiums may initially be based on income from when you were still working.

Before Choosing Medicare Advantage, Ask These 8 Questions

Medicare Advantage can be a good fit for some people. For others, Original Medicare, with separate Part D prescription drug coverage and, where available and appropriate, Medigap coverage, may better align with personal circumstances.

Before making a coverage decision, consider these eight questions:

• Are my doctors, specialists, and preferred hospitals covered under this option, and what are the rules for receiving non-emergency care?
• Are my prescriptions covered, which coverage tier applies, and what will I pay at my preferred pharmacy?
• What is the plan’s annual in-network out-of-pocket maximum for covered Part A and Part B services, and which costs do not count toward that limit?
• Could I need prior authorization or a referral for particular services?
• How much flexibility do I want when choosing doctors and hospitals?
• Do I spend significant time outside my local service area or outside the United States, where coverage rules may differ?
• Which additional benefits are included, and am I likely to use them?
• Could my taxable income affect my Part B and Part D costs through IRMAA? 

Medicare.gov recommends considering doctor and hospital access, costs, coverage, and travel when comparing Original Medicare with Medicare Advantage. Original Medicare generally allows beneficiaries to use any doctor or hospital that accepts Medicare anywhere in the United States. Medicare Advantage plans may require members to use providers in the plan’s network for non-emergency care, depending on the plan type and its rules.

Medicare and Your Financial Plan 

Medicare coverage is a health care decision with financial implications.

Retirement timing, taxable income, Roth conversions, distributions from retirement accounts, realized investment gains, and other income events may affect modified adjusted gross income and future Medicare premiums through IRMAA.

Before You Enroll, Look at the Whole Picture.

Medicare’s annual Open Enrollment Period for Advantage and Part D coverage runs from October 15 through December 7. During that period, beneficiaries can make certain changes to Medicare Advantage and Part D coverage for the following year. Changes generally take effect January 1, provided the plan receives the enrollment request by December 7.

There is also a General Enrollment Period from January 1 through March 31 for people who need to enroll in Part B or premium-Part A, missed their initial enrollment period, and do not qualify for a Special Enrollment Period. Coverage begins the month after you enroll, and late-enrollment penalties may apply.

If you are approaching Medicare, reviewing existing coverage, or considering how Medicare costs may fit into your broader retirement and tax picture, we’ll help you identify the financial planning questions to consider as you evaluate your options. 

Simply contact us to start a conversation.