Independent agents, save this post! We’ve compiled the key Medicare costs 2026 brings – plus other must-know health finance figures – into one quick reference. This agent cheat sheet covers the updated Medicare costs for 2026 (like the higher Part B premium and the new Part D cap), along with ACA enrollment deadlines and HSA limits 2026. No fluff – just the numbers independent insurance agents need at their fingertips. Why does it matter? Having accurate costs on hand means faster client calls, fewer mistakes, and more confidence. Bookmark this page now so you can skim these 2026 figures in 30 seconds whenever you need them.

Medicare Part B costs ticked up in 2026, which affects all your Medicare clients. Know these numbers to quote premiums and out-of-pocket amounts correctly in Q1 client conversations:

• Monthly Part B premium: $202.90 (standard rate) – up from $185.00 in 2025. This is what most seniors will pay per month for Part B.
• Annual Part B deductible: $283 – up from $257 last year. This is the amount a client pays out-of-pocket for Part B services in 2026 before Medicare starts paying 80%.

Why this matters: If you quote last year’s Part B premium or deductible by accident, you could understate your client’s costs. Make sure $202.90 and $283 are the numbers you reference on calls (update any cheat sheets from 2025). These higher Medicare Part B costs for 2026 may slightly reduce your clients’ Social Security checks (if premiums are deducted), so be ready to explain the change.

Big changes arrived for Part D prescription coverage in 2026. There’s now a true out-of-pocket cap on drug spending – a game-changer for clients with high medication costs. Here’s the breakdown:

• Part D maximum deductible: $615 – That’s the highest deductible a Part D plan can charge in 2026 (up from $505 a couple years ago; it increased again). Clients in plans with a deductible must pay up to this amount for prescriptions before coverage kicks in.

• Part D out-of-pocket cap: $2,100 – New! After an enrollee has paid $2,100 total for covered drugs in 2026, they pay $0 for covered prescriptions for the rest of the year. This Part D cap is a crucial number – it means no Part D patient should spend more than $2,100 out-of-pocket this year on covered meds. Advise clients hitting the donut hole that a safety net now kicks in at $2.1k.

• Insulin copay limit: $35/month (no change) – Insulin continues to be capped at $35 for a month’s supply of each covered insulin product, thanks to the Inflation Reduction Act. If a client uses insulin, remind them they won’t pay more than $35 per insulin per month in Part D.

• Adult vaccine cost: $0 (no change) – All ACIP-recommended vaccines (like shingles and Tdap, etc., for adults on Medicare drug plans) remain $0 under Part D in 2026. Agents should reassure clients that vaccines are free with their Part D coverage, which can encourage preventive care.

Why this matters: The new $2,100 cap eliminates catastrophic drug spending. Your high-utilizer clients will welcome this relief – it’s a selling point for Medicare Advantage and Part D plans in 2026. Ensure you highlight that Medicare Part D now has an out-of-pocket maximum – a first for prescription coverage. This can set you apart by showing you’re on top of current Medicare changes. Also, continuing $35 insulin and $0 vaccines are quality-of-life facts: use them to build trust (“No, Mrs. Jones, you won’t pay more than $35 for your insulin now – that’s a federal cap.”). Being fluent in these numbers saves you call time and positions you as a knowledgeable advisor.

(Need a one-page client handout? Download the “Medicare 2026: Cost & Coverage Guide” PDF for a printable summary of these Medicare numbers.)

Affordable Care Act Open Enrollment for 2026 individual & family health plans ends January 15, 2026 in most states. That’s the final day for your under-65 clients to enroll in Marketplace coverage for this year. Key deadlines to remember: clients who enrolled by Dec 15, 2025 got coverage effective Jan 1, 2026, and those enrolling between Dec 16 and Jan 15, 2026 will start coverage Feb 1. Action item: if you have any clients still uninsured or procrastinating, Jan 15 is the last call. After that, they’ll need a qualifying event for a Special Enrollment Period.

(Why it matters: Missing the Open Enrollment deadline could leave your clients uncovered – and leave you with lost sales opportunities. Mark 1/15/2026 on your calendar and do a quick outreach to any prospects on the fence.)*

For clients with High Deductible Health Plans (HDHPs) – or those planning for retirement healthcare – Health Savings Account (HSA) limits in 2026 have increased. Even though Medicare clients generally can’t contribute to HSAs once enrolled in Medicare, as an agent you might handle pre-65 clients or get questions from those still working. Here are the 2026 HSA limits to know:

• HSA contribution (self-only HDHP coverage): $4,400 max for 2026.
• HSA contribution (family HDHP coverage): $8,750 max for 2026.
• Add: +$1,000 catch-up if age 55 or older (unchanged, still $1,000).

These limits are $100 higher (individual) and $200 higher (family) than last year. Encourage eligible clients to take advantage of the tax benefits by maxing out contributions. It’s also a good conversation starter for under-65 clients about saving for future medical costs (just remember: once they enroll in Medicare, they should stop contributing to their HSA to avoid tax penalties).

Bookmark This Page: This is your 2026 agent cheat sheet for Medicare costs and other key health numbers – bookmark it now for quick access all quarter. Whether you’re on a call discussing a client’s Medicare Part B premium or double-checking the new Part D cap, you can rely on these figures (sourced directly from CMS and our IAD reference guides). By saving this page, you’ll save time and avoid scrambling for answers. Insurance Advisors Direct will keep updating you with timely, agent-first info like this, so you can focus on serving your clients and growing your business.

(Now, go ahead and add this post to your browser favorites – it’s built to be your daily-use tool!).*