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Most Medicare beneficiaries will see their premiums rise 10% next year, as CMS recently announced that Medicare Part B premiums will rise from $185 per month this year to around $203 a month next year.
Medicare premiums rise 10%
Medicare Part B covers a variety of routine outpatient care, including lab services, same-day hospital care, and any IV or injectable drugs administered at a doctor's office.
However, the cost of Part B premiums have increased significantly over the past decade, partly due to more Medicare beneficiaries getting care amid the COVID-19 pandemic as well as projections associated with drugs like Aduhelm.
CMS said in its announcement that total monthly premiums for Medicare Part B will be $202.90, with some adjustments made based on a household's income level.
In addition, CMS announced that the Medicare Part B deductible will increase from $257 this year to $283 next year. Deductibles and coinsurance for hospital stays are also increasing for traditional Medicare. The deductible for an inpatient stay will increase from $1,676 this year to $1,736 next year.
That deductible will cover the first 60 days of inpatient hospital care. From day 61 onward, beneficiaries will be required to pay coinsurance, which will total $434 per day in 2026 compared to $419 in 2025 in a benefit period and $868 per day in lifetime reserve days.
Meanwhile, coinsurance for individuals in skilled nursing facilities kicks in on day 21 through day 100 and will cost $217 per day in 2026 compared to $209.50 this year.
Advisory Board's medicare resources
- Medicare sequestration: Answers to your 10 biggest questions
- Inside CMS' proposed rule changes for 2026
- How will the IPPS final rule impact your MS-DRG payments?
- Policy Scenario Impact Calculator
- Diagnostic audit: Medicare Market Explorer
- Your guide to CMS' 14 value-based payment models
What's behind the price hike
Medicare's actuaries said many higher premiums for next year are a result of the cost of care received in outpatient hospital settings and the higher costs associated with running Medicare Advantage, the version of Medicare also called Medicare Part C that's run by private health insurers.
Actuaries also said the use of physician-administered drugs helped bring premium costs down but didn't elaborate if that was a result of lower use of all drugs or a higher use of biosimilars.
In a press release, CMS said that, had the agency not made changes to the 2026 Medicare Physician Fee Schedule final rule that addressed spending on skin substitutes, premiums for Medicare Part B would have been around $11 more per month.
(Herman, STAT+ [subscription required], 11/14; Minemyer, Fierce Healthcare, 11/16; CMS press release, 11/14)
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