Medicare 101
Medicare Costs Breakdown
Understanding what Medicare actually costs helps you budget with confidence. There isn't one 'Medicare bill' — you pay for the pieces you use: Part A (usually premium-free), the Part B premium, any plan premium, deductibles, and copays up to your plan's maximum out-of-pocket. Higher earners pay an income surcharge called IRMAA. Here's how the numbers fit together for 2026; always confirm current-year figures on Medicare.gov.
Part A costs
Most people pay no Part A premium thanks to 40 quarters of Medicare-taxed work. When you're hospitalized you pay a per-benefit-period deductible, and long stays add daily coinsurance. If you didn't earn enough quarters, you can buy Part A at a monthly rate Medicare sets each year.
Part B costs and the deductible
Part B has a standard monthly premium most people pay, plus a modest annual deductible, after which Medicare generally pays 80% of covered services and you pay 20% — unless you have a Medigap plan or an Advantage plan's out-of-pocket cap to limit that 20%. Medicare.gov posts the exact 2026 premium and deductible.
IRMAA — the high-income surcharge
If your modified adjusted gross income from two years ago is above the federal thresholds, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of your Part B and Part D premiums. It's tiered, so a dollar over a threshold matters. If your income dropped due to a life event like retirement, you can appeal — we show clients how.
Part D and drug costs
Part D has its own premium, a possible deductible, and copays by tier — capped by the 2026 out-of-pocket maximum (about $2,100). Extra Help can reduce all of it for lower incomes. Your true Part D cost depends entirely on which drugs you take and which plan covers them best.
Advantage vs. Medigap: two cost shapes
A Medigap plan means a higher, predictable monthly premium and very little at the point of care. A Medicare Advantage plan means a lower or $0 premium but copays as you use services, up to a yearly maximum. We map your expected total cost both ways before you decide — because the 'cheaper' option on paper isn't always cheaper for how you actually use care.
The costs Medicare doesn't cover
It's just as important to budget for what Medicare leaves out: routine dental, vision, and hearing (unless a plan adds them), and long-term custodial care, which neither Original Medicare nor Advantage covers. Many people fill these gaps with a plan's extra benefits or standalone dental, vision, hearing, or long-term care coverage. We flag these gaps up front so nothing catches you off guard.
Ways to lower what you pay
There are real levers: choosing a Part D plan matched to your exact drugs, qualifying for Extra Help or a Medicare Savings Program if your income allows, appealing IRMAA after a drop in income, and picking the Advantage-vs-Medigap structure that fits how you use care. We check every one of these for each client — the savings often add up to more than people expect.
A quick example
Say you're a 66-year-old in Grand Junction taking two brand-name drugs. One plan advertises a low premium but puts your medications on a high tier; another costs a few dollars more per month but covers both at a lower tier and hits the out-of-pocket cap sooner. Over a year, the 'more expensive' plan can save you hundreds. That's why we compare total annual cost — premium plus deductibles plus drug tiers — not just the number on the brochure.
Local Medicare help across the Western Slope
Medicare rules are federal, but the plans, provider networks, and prices are local — and they change every year. Medicare On Main is an independent agency based in Grand Junction, Colorado (Mesa County), serving Grand Junction, Fruita, and Palisade plus Moab (Grand County) and Monticello (San Juan County), Utah — and Brian Penner is licensed in 18 states. We compare the plans we offer in your county against your own doctors, prescriptions, and budget, confirm your local providers are in-network, and stay your advisor for claims, appeals, and the annual review — at no cost to you, because carriers pay licensed agents, not you. That local, year-round help is the difference between reading about Medicare and having a plan built around your life.
Questions, answered
What is IRMAA?
IRMAA is an income-related surcharge added to your Part B and Part D premiums if your modified adjusted gross income (from your tax return two years ago) is above set thresholds. We can estimate whether it applies to you and help you appeal if your income has since dropped.
How much does Medicare cost per month in 2026?
It varies. Most people pay the standard Part B premium plus any plan premium; higher earners add IRMAA. We build a personal estimate for your situation. Medicare.gov lists the current-year standard amounts.
Is a Medigap plan or a Medicare Advantage plan cheaper?
It depends on how you use care. Medigap costs more monthly but less at the doctor; Advantage costs less monthly but adds copays up to a yearly cap. We compare your expected total cost both ways.
Can I lower my Medicare costs?
Often yes — through Extra Help or a Medicare Savings Program if your income qualifies, by choosing a Part D plan matched to your drugs, or by appealing IRMAA after a drop in income. We check all of these for free.
Official Medicare sources
We point you to the federal sources so you can verify everything. For current-year figures and to compare the plans available in your area:
- Medicare.gov — the official U.S. government site for Medicare costs, coverage, and rules.
- Medicare Plan Compare — the official tool to compare Medicare Advantage and Part D plans by ZIP.
- Social Security (ssa.gov) — enroll in Medicare Parts A & B and check your eligibility.
- CMS.gov — Centers for Medicare & Medicaid Services, which runs the program.
Education and estimates only — confirm current figures on Medicare.gov before enrolling. We do not offer every plan available in your area.
Talk to a local Medicare advisor
Free, no pressure — we compare your options for you.
Last updated . Maintained by the Medicare On Main Data Desk · reviewed by Brian Penner, Independent Medicare advisor (NPN 16493717).