Medicare got pricier in 2025—and early 2026 projections point to another bump. The good news: Medicaid programs (QMB/SLMB/QI) and Extra Help can cover your Part B premium and most drug costs, and a new $2,000 Part D cap plus a monthly payment option can tame pharmacy shocks. Here’s exactly what changed and how to cushion your costs. CMS+1
2025 costs & 2026 outlook (30-second answer)
- 2025 (official):
- Part B premium: $185.00/month; Part B deductible: $257. CMS
- Part A hospital deductible: $1,676 per benefit period. CMS
- Part D: base premium reference $36.78 (plan premiums vary); $2,000 annual out-of-pocket cap; no 5% catastrophic coinsurance; Prescription Payment Plan lets you pay drug costs in capped monthly installments. CMS+2CMS+2
- 2026 (projected, not final):
- Part B premium projected ~$206.50; deductible ~$288 (Trustees). CMS will confirm later in 2025. Medicare Resources
Bottom line: 2025 costs are set; 2026 is still an estimate. Use Medicaid/Extra Help and the Prescription Payment Plan to buffer increases. Medicare+1
Part B, Part A & IRMAA: what changed in 2025
- Part B standard premium (2025): $185.00 (↑ $10.30 from 2024). Part B deductible: $257. IRMAA brackets start at $106,000 (single) / $212,000 (joint) MAGI for 2023 tax year (used for 2025 assessments). CMS
- Part A (2025): Inpatient deductible $1,676; skilled nursing facility coinsurance $209.50/day (days 21–100). CMS
Bottom line: Expect higher Part B and Part A cost-sharing in 2025—unless you qualify for QMB/SLMB/QI, which can pay your Part B bill and more. Medicare
Part D in 2025: $2,000 cap + monthly “smoothing”
The Inflation Reduction Act redesigned Part D in 2025:
- Your annual out-of-pocket on covered Part D drugs is capped at $2,000; the prior 5% catastrophic coinsurance is eliminated. CMS+1
- The Medicare Prescription Payment Plan lets you convert pharmacy counter charges into even monthly payments through your plan (you still owe the full amount over the year—just spread out). CMS+1
Bottom line: High-cost medications won’t blow up a single month’s budget in 2025—opt in to the Payment Plan with your Part D or MA-PD plan. CMS
2026: what experts project (and why it’s not final)
- The 2025 Medicare Trustees Report projects a 2026 Part B premium of ~$206.50 (↑ ~$21.50; ~11.6%) and a deductible of ~$288. These are model-based estimates; CMS will set the official amounts later this fall. Medicare Resources
- Why increases? Utilization & price growth in outpatient/physician services, and drug-related spending trends in Part B. Social Security
Bottom line: Plan for ~$206.50 in 2026 until CMS publishes final numbers; revisit during October–November announcements. Medicare Resources
The Medicaid cushion: how QMB, SLMB, QI, QDWI reduce what you pay
Medicare Savings Programs (MSPs) are Medicaid-run benefits that pay Medicare costs if your income/resources are within limits:
| Program | What it pays | 2025 monthly income/resource limits* |
|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part B premium + all Medicare deductibles/coinsurance/copays (for Medicare-covered items); Part A premium if not free | Single: $1,325 / $9,660 • Married: $1,783 / $14,470 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium only | Single: $1,585 / $9,660 • Married: $2,135 / $14,470 |
| QI (Qualifying Individual) | Part B premium only (apply each year; first-come, first-served) | Single: $1,781 / $9,660 • Married: $2,400 / $14,470 |
| QDWI | Part A premium (for certain disabled workers) | Single: $5,302 / $4,000 • Married: $7,135 / $6,000 |
* Limits are higher in AK/HI, and states may disregard some income/resources—apply even if you’re close. All MSPs confer Extra Help. Source: Medicare.gov, last checked Sept 24, 2025. Medicare
Why this matters in dollars: If you qualify for QMB/SLMB/QI, your Part B premium ($185 in 2025) is paid by Medicaid, saving $2,220/year in 2025—and protecting you if the 2026 premium rises. QMB also blocks providers from billing you beyond small Medicaid copays. CMS+1
Bottom line: Apply for an MSP if your income is modest—it’s the single biggest cushion against premium hikes. Medicare
Extra Help (LIS) in 2025: drug costs & flexible plan changes
- With MSP or on your own by application, Extra Help can cover Part D premiums, deductibles, and most copays (nominal copays up to $12.15 per covered drug in 2025 for QMB/SLMB/QI). Medicare
- New flexibility (2025): If you have Medicaid or Extra Help, you can change your drug coverage once per month—useful if meds change mid-year. Medicare
Bottom line: Extra Help + the $2,000 cap and smoothing can take a big bite out of pharmacy costs—even before any 2026 changes. CMS+1
Comparison table: 2025–26 with vs. without Medicaid/Extra Help
| Cost item | No Medicaid/Extra Help | With Medicaid/Extra Help |
|---|---|---|
| Part B premium (2025) | Pay $185/mo out of pocket. CMS | $0 if QMB/SLMB/QI pays it. Medicare |
| Part B premium (2026) | Budget ~$206.50/mo (proj.) until CMS final. Medicare Resources | Likely $0 with QMB/SLMB/QI (program pays standard premium). Medicare |
| Part B deductible (2025) | $257. CMS | $0 with QMB (Medicaid pays Medicare cost-sharing). Medicare |
| Part D out-of-pocket (2025) | Capped at $2,000/year; can opt into monthly payments. Medicare+1 | Often $0–low under Extra Help; same cap & payment plan available. Medicare |
| Plan changes mid-year (2025) | Generally only during AEP or special events. | If you have Medicaid or Extra Help, you can switch monthly. Medicare |
Checklist: Cut your Medicare bill in the next 30 days
- Screen for Medicaid/Extra Help: Use your state Medicaid office or benefits counselor; apply even if you’re close to limits (states may disregard income/resources). Source: Medicare.gov MSP page, last checked Sept 24, 2025. Medicare
- Enroll in QMB/SLMB/QI if eligible: This may zero-out your Part B premium and (with QMB) your Medicare cost-sharing. Medicare
- Activate the Prescription Payment Plan with your Part D/MA-PD plan to spread drug costs monthly. CMS
- Use Extra Help’s monthly switch to move to a cheaper drug plan if your meds changed. Medicare
- Re-shop Part D/MA plans during AEP (Oct 15–Dec 7); check premiums, formularies, and out-of-pocket maxes. Source: CMS landscape fact sheet (2025). CMS
Disclaimers
- Not financial/legal advice. Medicare/Medicaid eligibility is individualized and may change; confirm with CMS/Medicare.gov, your state Medicaid agency, or a licensed advisor.
- 2026 figures are projections from the Trustees—not final policy. Check back when CMS publishes official 2026 premiums/deductibles.
Sources (high-authority)
- CMS Fact Sheet: 2025 Part B $185, deductible $257, Part A $1,676; 2025 IRMAA brackets. Source: CMS, last checked Sept 24, 2025. CMS
- CMS: 2025 Part D base beneficiary premium $36.78. Source: CMS, last checked Sept 24, 2025. CMS
- Medicare.gov: Part D $2,000 cap, no 5% catastrophic; Prescription Payment Plan details; monthly switching for Medicaid/Extra Help in 2025. Source: Medicare.gov/CMS, last checked Sept 24, 2025. Medicare+2CMS+2
- Medicare.gov: MSP limits & benefits (QMB/SLMB/QI/QDWI) for 2025. Source: Medicare.gov, last checked Sept 24, 2025. Medicare
- Trustees/Expert Summaries: Projected 2026 Part B $206.50; $288 deductible (estimate). Source: Medicare Trustees via medicareresources.org & AARP, last checked Sept 24, 2025. Medicare Resources+1
- KFF: ~12M beneficiaries get Medicaid help with Medicare costs. Source: KFF, last checked Sept 24, 2025. KFF
Key takeaways
- 2025 is set: Part B $185/mo, deductible $257; Part A deductible $1,676; Part D $2,000 OOP cap + monthly payment option. CMS+1
- 2026 is likely higher: Part B projected ~$206.50 (final CMS number pending). Build it into your budget now. Medicare Resources
- Medicaid is the cushion: QMB/SLMB/QI can pay your Part B premium (and QMB covers cost-sharing). Apply even if you’re close to limits. Medicare
- Extra Help helps more in 2025: Lower drug costs + monthly plan switches for those with Medicaid/Extra Help. Medicare
- Use the Payment Plan: Spread big pharmacy bills across 12 months to avoid spikes. CMS
Next steps
- Screen/apply for MSPs and Extra Help today.
- Call your drug plan to opt into the Prescription Payment Plan.
- Put a reminder to check CMS’s 2026 premium announcement and re-shop during AEP.
FAQs
Q1. What is the Medicare Part B premium and deductible in 2025?
$185.00/month and $257 respectively. CMS
Q2. How much will Medicare Part B cost in 2026?
The Trustees project ~$206.50/month (deductible ~$288), but CMS hasn’t finalized 2026 yet. Medicare Resources
Q3. What changed in Part D for 2025?
There’s a $2,000 annual out-of-pocket cap, no 5% catastrophic coinsurance, and you can spread payments monthly via the Prescription Payment Plan. Medicare+1
Q4. Can Medicaid pay my Medicare premium?
Yes—QMB, SLMB, and QI (Medicare Savings Programs) can pay your Part B premium; QMB also covers Medicare cost-sharing. Medicare
Q5. Who qualifies for QMB/SLMB/QI in 2025?
It depends on income/resources (e.g., QMB single limit $1,325/mo & $9,660 in resources; limits higher in AK/HI and states may ignore some income). Apply even if close. Medicare
Q6. Does Extra Help let me change drug plans mid-year in 2025?
Yes—if you have Medicaid or Extra Help, you can switch once per month in 2025. Medicare
Q7. What’s the 2025 Part D base beneficiary premium?
$36.78 (plans vary by county and coverage). CMS
Q8. How do I smooth high drug bills?
Ask your plan to enroll you in the Medicare Prescription Payment Plan; you’ll pay capped monthly amounts instead of large one-time charges. CMS