2026 Agent Medicare Resources

This page is intended for licensed agents only.

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Original Medicare Part A 

2026 PART A DEDUCTIBLE & COVERAGE

The 2026 Medicare Part A deductible is $1,736 for each inpatient hospital benefit period beforeOriginal Medicare begins to pay.
A benefit period starts the day you are admitted to a hospital or skilled nursing facility (SNF) as an inpatient and ends when you have not received inpatient hospital care or skilled nursing care for 60 consecutive days.
If you are readmitted to a hospital or SNF after one benefit period has ended, a new benefit period begins — and you’ll be responsible for paying the deductible again.
2) Medicare Part A Coverage
Medicare Part A (Hospital Insurance) helps cover inpatient care in:
- Hospitals
- Skilled Nursing Facilities (SNFs)
- Hospice care
- Home health care (limited services)
It does not cover long-term or custodial care.

LINK TO MEDICARE.GOV PART A

Original Medicare Part B

2026 PART B MEDICAL COINSURANCE, COPAYS AND COVERAGE

1) 2026 Medicare Part B Medical Deductible

The 2026 Medicare Part B annual deductible is $283 before Original Medicare begins to pay.
This deductible is paid once per year, and no benefit periods apply to Part B coverage.

2) The 80/20 Rule

After meeting the annual deductible, Original Medicare Part B typically pays 80% of the Medicare-approved amount for Medicare-covered services.

You usually pay the remaining 20% of the Medicare-approved amount for covered services. If a provider accepts Medicare assignment, they agree to accept the Medicare-approved amount as full payment for covered services.

The standard 2026 Medicare Part B monthly premium is $202.90. Some beneficiaries may pay more based on income.

3) Medicare Part B Coverage

Medicare Part B (Medical Insurance) helps cover, but is not limited to:

-Primary care office visits
-Specialist visits
-Part B medications (drugs administered by a doctor in an office or clinical setting)
-Durable Medical Equipment (DME) such as wheelchairs, walkers, and diabetic monitoring supplies

Preventive services, including screenings and vaccines
LINK TO MEDICARE.GOV PART B

MEDICARE ENROLLMENT PERIODS

Medicare Open Enrollment Period

October 15th to December 7th

1) During the Medicare Open Enrollment Period from October 15 to December 7, beneficiaries can join, switch, or drop a Medicare Advantage Plan. They can also join, switch, or drop a Medicare drug plan if they have Original Medicare. Beneficiaries can also switch from Original Medicare to a Medicare Advantage Plan or from a Medicare Advantage Plan to Original Medicare.

2) Changes made during the Open Enrollment Period generally take effect January 1 of the following year, as long as the plan receives the enrollment request by December 7.

3) Beneficiaries can review and change their Medicare health or drug coverage during this period based on their coverage needs.

Medicare Advantage Open Enrollment Period

January 1st to March 31st

1) During the Medicare Advantage Open Enrollment Period from January 1 to March 31, people who are already enrolled in a Medicare Advantage Plan can switch to another Medicare Advantage Plan or return to Original Medicare. They can also join a separate Medicare drug plan.

2) This period is available only to people who are already enrolled in a Medicare Advantage Plan.

3) Beneficiaries can make only one change during this period. Changes generally take effect the first day of the month after the plan receives the enrollment request.
LINK TO MEDICARE.GOV ENROLLMENT PERIODS

PART D PENALTY CALCULATOR

THIS CALCULATOR IS FOR EDUCATIONAL PURPOSES ONLY, CALL MEDICARE TO TRULY CALCULATE IF YOU HAVE A PENALTY. 1-800-MEDICARE (1-800-633-4227)

The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage.

Medicare calculates the Part D late enrollment penalty by multiplying 1% of the “national base beneficiary premium” by the number of full, uncovered months you were eligible for Part D but didn’t have Part D or other creditable prescription drug coverage. The penalty amount is rounded to the nearest $0.10 and added to your monthly Part D premium.

For 2026, the national base beneficiary premium is $38.99. This amount can change each year, so the penalty amount may also change.

 

Disclaimer: This calculator provides an estimate only and is intended for educational purposes. Your actual Medicare Part D Late Enrollment Penalty is determined by Medicare and your Part D plan based on your complete coverage history. Uplink Health Insurance Agency does not guarantee the accuracy of the estimated results and assumes no liability for decisions based on this calculator.