The Centers for Medicare and Medicaid Services (CMS) has announced upcoming changes to Medicare Parts A and B for the coming year, including notable increases in premiums, deductibles, and coinsurance rates. This update coincides with the current open enrollment period for Medicare plans, which runs from October 15 to December 7, allowing beneficiaries to switch plans or modify their existing coverage.
Concerns about rising healthcare costs continue to affect many Americans using diverse plans. The anticipated expiration of enhanced tax credits under the Affordable Care Act (ACA) at the end of this year is projected to lead to average increases of approximately 20 percent for ACA-compliant plans. This surge is expected to disproportionately impact small business employees, retirees, and students. Similarly, employer health benefit plans are likely to see an average increase of over 6 percent.
Several factors contribute to these escalating costs, including inflation, heightened labor expenses following the COVID-19 pandemic, and increased demand for GLP-1 medications such as Ozempic and Wegovy for diabetes management and weight loss.
Changes to Medicare Part A, which covers inpatient hospital and related services, are significant. Inpatient hospital deductibles will rise from $1,676 to $1,736, while coinsurance for the 61st through 90th day of hospitalization will increase to $434 per day, a rise from $419. Lifetime reserve days will see a similar increase to $868 per day from $838. Additionally, for beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 will rise to $217, up from $209.50.
For those with at least 30 quarters of coverage, monthly premiums for Medicare Part A will increase to $311, while those with fewer quarters or individuals with disabilities who have exhausted other entitlements will face a full premium of $565 monthly, an increase of $47 from the previous year.
Medicare Part B, covering various outpatient services, will also see changes. The standard monthly premium will rise to $202.90 from $185, while the annual deductible will increase to $283, up by $26 from the previous year. CMS attributed these hikes to anticipated price changes and utilization increases that align with historical trends.
Importantly, since 2007 the premium for Medicare Part B has been income-based, meaning that individuals with higher incomes pay more. The $202.90 monthly premium applies to those with a modified adjusted gross income of $109,000 or less, while those earning $500,000 or more may pay as much as $689.90.
In a recent statement, CMS noted that if not for actions taken by the Trump Administration to curb spending on skin substitutes, the increase in Part B premiums could have been an additional $11 per month. Recent adjustments included in the 2026 Physician Fee Schedule Final Rule are expected to decrease spending on these substitutes by 90 percent without compromising patient care.
