2026 Agent Medicare Resources

This page is intended for licensed agent's only.

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Original Medicare Part A 

2026 PART A DEDUCTIBLE & COVERAGE

The 2026 Medicare Part A deductible is $1,744 for each inpatient hospital benefit period before Original 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 $257 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 approved amount for Medicare-covered services.
The patient is responsible for the remaining 20%, unless the medical provider accepts assignment, which means they agree to accept Medicare’s approved amount as full payment.

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 Annual Enrollment Period

October 15th to December 7th

1) During the Medicare Annual Enrollment period from October 15th to December 7th the beneficiary can make all the different changes they would like until the last product picked. For instance if a client decied to enroll into one MAPD plan and then chooses to enroll into another MAPD plan the last plan chosen will be the plan that will be applied for the January 1st effective date.
2) New benefits cannot be disclosed until Ocotber 1st and no enrollment applications can be accepted until October 15th.
3) AEP applications are effective January 1st of the new year.

Medicare Open Enrollment Period

January 1st to March 31st

1) During the Medicare Annual Enrollment period from January 1st to March 31st the Medicare beneficiary can change from one MAPD to another MAPD or they can drop there MAPD and go to a PDP.
2) You can not solicit the Medicare Open Enrollment period.
3) OEP applications are effective typically the first of the following month.

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 penalty by multiplying 1% of the “national base beneficiary premium” ($32.74 in 2023) ($34.70 in 2024) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.

The national base beneficiary premium may increase or decrease each year, so your penalty amount may also increase or decrease each year.

***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.