2026 Medicare Part B Deductible — What It Means and Who Actually Pays It

If you are turning 65 in 2026, retiring in 2026, or trying to figure out what Medicare will cost next year, the big question is simple. Do you pay the new $283 Part B deductible, or not? The answer depends entirely on the type of coverage you choose, and this is where people get tripped up.

The full video for this topic will be added soon.

• The 2026 Part B deductible is $283
• You pay it with Medigap
• You do not pay for it with Medicare Advantage
• Original Medicare alone pays nothing—you pay the $283 plus unlimited 20 percent
• The deductible is higher because outpatient spending continues to rise
• This amount affects budgets, plan choices, and timing decisions

The Part B deductible is the amount you pay before Medicare starts sharing outpatient costs. In 2026, that amount is $283.

Once you meet it, Original Medicare usually pays 80 percent, and you pay 20 percent. Simple in theory, confusing in practice. The real dividing line is this:

Not everyone feels the deductible. Your coverage type decides it.

If you are comparing Medicare Advantage and Medigap for next year, the 2026 AEP: Should You Switch Your Medicare Plan? breakdown helps you compare paths with a calm, step-by-step approach.

If you are on a Medicare Advantage plan, you do not pay the $283 deductible. These plans have their own copays, coinsurance, and their own annual limit for medical bills.

Many people are surprised by this, but it is a core difference between Medicare Advantage and Medigap.

If you are on Medigap, you do pay the $283 deductible. Every Medigap plan requires it, even Plan G.

It is usually the only medical bill you will see in a normal year with Plan G, which is why it is such an important number for budgeting.

If you have only Parts A and B plus a standalone drug plan, you absolutely pay the deductible. And once you hit it, you also pay 20 percent of outpatient costs with no cap.

That includes MRIs, cancer treatments, outpatient surgeries, and more. This is where unexpected bills happen.

Matt tip: If you are on bare Medicare, the deductible is not the real risk. The unlimited 20 percent is.

The short answer is rising healthcare spending. Medicare’s outpatient costs continue to increase due to:

• More outpatient procedures
  
• Specialist visits
  
• Imaging
  
• Physical therapy
  
• New treatments
  
• Inflation inside the healthcare system
  
• Higher utilization across the board
  

This amount almost always rises year after year. It rarely goes down.

For anyone considering Medigap, especially Plan G or Plan N, the deductible shapes your actual out-of-pocket exposure.

A few reasons it matters:

• It is a fixed annual expense
  
• It resets every January
  
• It influences whether someone picks G or N
  
• It affects what your “real” yearly medical costs look like
  

Some people mistakenly assume Medigap covers it. It does not. You pay it once each year.

Even though Medicare Advantage does not use the Part B deductible directly, it still affects the system indirectly.

Medicare Advantage plans are funded by Medicare, and Medicare bases its payments partly on projected Part B spending. When outpatient spending increases, plans usually adjust in the next contract year.

This can show up as:

• Copay changes
  
• Network shifts
  
• Higher out-of-pocket maximums
  

You may not feel it immediately, but the ripple effect shows up in plan designs.

Here is a clean way to see how the deductible fits into your budget:

1. Start with the Part B premium
   
2. Add the $283 deductible if you do not have Medicare Advantage
   
3. Add your Medicare Advantage or Medigap premium
   
4. Add your expected drug costs
   
5. Add your plan’s out-of-pocket maximum (for Medicare Advantage)
   

If you are on Medigap, your exposure is basically the deductible plus your premium.
If you are on Medicare Advantage, your total exposure depends on drug costs, medical copays, and your MOOP.

Matt tip: Make two columns — a normal year and a worst-case year. Your real life will land between the two.

Many people assume the deductible only matters after they retire. Not always.

Look at:

• What does your employer’s plan cost
  
• Your workplace deductible
  
• Your workplace out-of-pocket limit
  
• If your spouse depends on your employer coverage
  

A lot of people stay on employer insurance longer than they should because they never compare it to Medicare.

If you want help running the numbers without pressure, the Brickhouse Agency specializes in exactly this.

If you want to avoid common errors that lead to high bills or missed deadlines, the 5 Medicare Mistakes to Avoid in 2026 (Especially If You’re Turning 65) article walks through the ones I see the most.

If you want someone to walk through your options clearly, compare your employer plan to Medicare, or help you time your enrollment, you can schedule a conversation with a licensed professional.