Medicare isn’t free — even though you spent decades paying Medicare taxes to earn it. Most seniors entering Medicare are surprised to learn that premiums, deductibles, copays, and coinsurance add up quickly. And under Original Medicare, there is no annual out-of-pocket cap — meaning a serious illness can expose you to tens of thousands of dollars in bills.
This guide breaks down every cost category for Medicare in 2026 — Part A, Part B, Medicare Advantage, and Part D — with specific figures for Nevada and Las Vegas-area plans, plus income surcharges (IRMAA) and how to get cost assistance if you qualify.
What Does Medicare Cost in 2026?
Medicare costs fall into four categories, each working differently:
- Premiums — Monthly charges you pay to maintain coverage, regardless of whether you use any medical services
- Deductibles — Amounts you pay out of pocket before Medicare begins paying its share
- Copays and coinsurance — Your share of the cost for each medical service after the deductible is met (copays are flat dollar amounts; coinsurance is a percentage)
- Out-of-pocket maximums (MOOP) — A cap on how much you can be required to pay in a year. Original Medicare has no cap. Medicare Advantage plans are required by law to set one.
Key insight: The biggest financial risk in Original Medicare is the uncapped 20% Part B coinsurance. There is no ceiling. For expensive procedures, surgeries, or cancer treatment, this exposure can run into five or six figures. The two most common solutions are Medigap (which covers what Medicare leaves unpaid) or Medicare Advantage (which caps your annual exposure). See our Medigap Plans Nevada 2026 guide and Medicare Advantage vs. Original Medicare guide for a full comparison of both approaches.
Part A Costs (Hospital Insurance)
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care.
Part A Premium
Most people pay $0 per month for Part A. If you (or your spouse) worked at least 40 quarters — 10 years — and paid Medicare taxes, Part A is premium-free. If you have 30–39 quarters, the premium is $278/month in 2026. Fewer than 30 quarters: $505/month.
Part A Deductible
The Part A deductible is $1,632 per benefit period in 2026. This is not an annual deductible — it resets every benefit period, which starts the day you are admitted to a hospital and ends after you have been out of the hospital and any skilled nursing facility for 60 consecutive days. If you are admitted twice in a year with more than 60 days between stays, you owe the $1,632 deductible both times.
Part A Coinsurance (Hospital)
| Hospital Days | Your Cost in 2026 |
|---|---|
| Days 1–60 | $0 (covered after $1,632 deductible) |
| Days 61–90 | $408 per day |
| Days 91+ (lifetime reserve days) | $816 per day (60 lifetime reserve days total) |
| Beyond lifetime reserve days | You pay 100% of all costs |
Skilled Nursing Facility (SNF) Coinsurance
| SNF Days | Your Cost in 2026 |
|---|---|
| Days 1–20 | $0 |
| Days 21–100 | $204 per day |
| Days 101+ | You pay 100% of all costs |
Note: to qualify for Medicare-covered SNF care, you must have had a qualifying inpatient hospital stay of at least 3 days. Observation status stays — even if you slept in a hospital bed — do not count.
Part B Costs (Medical Insurance)
Part B covers outpatient services: doctor visits, lab tests, preventive care, durable medical equipment, and outpatient procedures.
Part B Premium
The standard Part B premium is $185.00 per month in 2026. Most Medicare beneficiaries pay this amount. Higher earners pay more through IRMAA surcharges — covered in the income section below.
Part B Deductible
The annual Part B deductible is $257 in 2026. You pay this once per year before Medicare begins covering outpatient services.
Part B Coinsurance
After meeting the deductible, Medicare covers 80% of most approved Part B services. You pay the remaining 20% — with no annual ceiling.
The uncapped risk: A $500,000 cancer treatment course would leave you with a $100,000 bill under Original Medicare alone. A $200,000 surgery: $40,000 out of pocket. This is not a theoretical scenario — it’s the standard Medicare cost structure. It’s why Medigap Plan G (which covers 100% of Part B coinsurance) costs $120–$250/month in Nevada and is worth considering for most seniors on Original Medicare.
Wondering how much Medicare will actually cost you in Nevada?
MediPilot helps Nevada seniors compare their total cost picture — Original Medicare + Medigap vs. Medicare Advantage — with real 2026 plan data from every carrier available in your ZIP code. Free, no obligation.
Get My Medicare Cost Estimate →Medicare Advantage Costs in Nevada
Medicare Advantage (Part C) plans replace Original Medicare with a private insurer’s coverage and must cap your annual out-of-pocket costs — the maximum out-of-pocket (MOOP). Clark County (Las Vegas, Henderson, North Las Vegas) has one of the stronger Medicare Advantage markets in the country, with several $0 premium plans available.
| Plan | Monthly Premium | In-Network MOOP | Drug Coverage | Network Type |
|---|---|---|---|---|
| UHC AARP MA HMO | $0/mo | $4,200 | Included | HMO |
| Anthem Blue Cross PPO | $29/mo | $6,700 | Included | PPO |
| Humana Gold Plus | $0/mo | $3,400 | Included | HMO |
| Alignment Health | $0/mo | $5,900 | Included | HMO |
Important: MA MOOP limits apply to in-network services only. Out-of-network costs can be higher (or not covered at all under HMO plans). PPO plans like Anthem offer out-of-network coverage but with a higher MOOP — sometimes $10,000+ for out-of-network spending. Verify your specific doctors and any specialists are in-network before enrolling.
For a deeper breakdown of Clark County carriers, HMO vs. PPO tradeoffs, and the Valley Health vs. Sunrise/HCA network comparison, see our Best Medicare Plans in Las Vegas 2026 guide. For the full MA vs. Original Medicare cost-and-coverage decision framework, see our Medicare Advantage vs. Original Medicare Nevada guide.
Part D Costs (Prescription Drugs)
Part D covers prescription drugs. You get it either through a standalone Part D plan (if you have Original Medicare) or bundled into a Medicare Advantage plan (most MA plans include drug coverage).
Part D Premiums
Standalone Part D plan premiums in Nevada range from roughly $7 to $95 per month in 2026, depending on the carrier and formulary. Low-premium plans often have higher cost-sharing on brand-name drugs. Choose based on your specific medications, not just the premium.
Part D Deductible
The standard Part D deductible is $590 in 2026. Not all plans charge the full deductible — some waive it for generic drugs or certain formulary tiers. Compare plan-specific deductibles when shopping.
New $2,000 Annual Out-of-Pocket Cap
Starting in 2025, the Inflation Reduction Act eliminated the Part D “donut hole” (coverage gap) and capped annual drug out-of-pocket costs at $2,000 per year. In 2026, this cap covers both brand-name and generic drugs. This is a significant change: previously, high-cost drug users could face unlimited Part D spending. Now, your total annual drug cost is capped regardless of what you take.
For a full breakdown of the top Nevada Part D carriers, formulary tiers, pharmacy networks, and how Extra Help (LIS) works, see our Medicare Part D Plans Nevada 2026 guide.
Not sure if your prescriptions are covered — or what they’ll cost?
Medicare drug costs vary widely by plan and formulary. MediPilot can match you with a Nevada plan that covers your specific medications at the lowest cost. Takes about 60 seconds.
Check My Drug Coverage Options →How Income Affects Your Medicare Costs (IRMAA)
The Income-Related Monthly Adjustment Amount (IRMAA) is a surcharge added on top of standard Part B and Part D premiums for higher-income Medicare beneficiaries. CMS determines your IRMAA using your federal tax return from two years prior — so 2026 premiums are based on 2024 income.
| Individual Income (2024) | Couple Income (2024) | Part B Monthly Premium | Part D Monthly Surcharge |
|---|---|---|---|
| ≤$106,000 | ≤$212,000 | $185.00 | $0 |
| $106,001–$133,500 | $212,001–$267,000 | $259.50 | $13.70 |
| $133,501–$167,000 | $267,001–$334,000 | $370.00 | $35.30 |
| $167,001–$500,000 | $334,001–$750,000 | $480.50 | $57.00 |
| >$500,000 | >$750,000 | $594.00 | $78.60 |
IRMAA is determined per person. A married couple where each spouse earns $120,000 would each pay the second IRMAA tier ($259.50/month), not just one surcharge between them.
Income dropped recently? If your income fell significantly since the base year (due to retirement, divorce, death of a spouse, or loss of income-producing property), you can request an IRMAA reconsideration from Social Security using Form SSA-44. Social Security will use a more recent year’s income instead, which can reduce or eliminate the surcharge immediately.
Nevada-Specific Cost Assistance Programs
If costs are a concern, Nevada has several programs that can pay your premiums and cost-sharing — or reduce them substantially.
Nevada SHIP (State Health Insurance Assistance Program)
SHIP provides free, one-on-one Medicare counseling from trained volunteers with no sales incentive. SHIP counselors can review your current plan, explain cost assistance programs you may qualify for, and help you compare plans at no cost to you. Call 1-800-307-4444 or visit the Nevada SHIP website to schedule a session.
Medicare Savings Programs (MSPs)
Medicare Savings Programs are state-administered programs that help low-income Medicare beneficiaries with premium and cost-sharing expenses. There are three main levels:
- Qualified Medicare Beneficiary (QMB) — Pays your Part A and Part B premiums, deductibles, copays, and coinsurance. This is the most comprehensive tier.
- Specified Low-Income Medicare Beneficiary (SLMB) — Pays your Part B premium only.
- Qualifying Individual (QI) — Pays most of your Part B premium. Enrollment is first-come, first-served each year.
MSPs are administered by Nevada Medicaid. Income and asset limits apply. Contact the Nevada Division of Welfare and Supportive Services (DWSS) or call the ADSD hotline to apply.
Extra Help / Low-Income Subsidy (LIS) for Part D
Extra Help (also called the Low-Income Subsidy) reduces or eliminates Part D drug costs including premiums, deductibles, and copays. In 2026, full Extra Help recipients pay no more than $4.50 per generic drug and $11.20 per brand-name drug, with no coverage gap. Apply through Social Security at ssa.gov or by calling 1-800-772-1213.
ADSD Benefits Counseling Hotline
The Nevada Aging and Disability Services Division (ADSD) coordinates Medicare counseling statewide and can connect you with local counselors, MSP applications, and Extra Help enrollment assistance. Their main benefits counseling hotline is 1-866-303-6323.
Next Steps
Understanding what Medicare costs is step one. Choosing the right plan structure — Original Medicare with or without Medigap, or Medicare Advantage — determines how much of that cost you’ll actually pay in the years ahead.
- Return to the MediPilot blog for the full Nevada Medicare guide library
- Compare Medigap plans in Nevada 2026 to see how Plan G and Plan N cap your Part B exposure
- See the Medicare Advantage vs. Original Medicare guide for a full cost-and-coverage decision framework
- Compare Best Medicare Plans in Las Vegas 2026 for Clark County-specific MA options and out-of-pocket maximums
- Review the Medicare Part D Plans Nevada 2026 guide for standalone drug plan options
- Check Medicare enrollment period timing to avoid late enrollment penalties that permanently increase your costs
- Read the Medicare FAQ for answers to common Nevada senior questions