Standard Medicare Part B costs $185/month in 2026, plus Part D drug coverage ($30-100/month) and a Medigap supplement ($100-350/month depending on plan and location). Total monthly costs typically range from $315-$635 per person, and can be much higher if you trigger IRMAA surcharges.
Medicare has four primary cost components: Part A (hospital), Part B (medical/outpatient), Part D (prescription drugs), and supplemental coverage (Medigap or Medicare Advantage). Most people pay nothing for Part A, it's premium-free if you or a spouse worked and paid Medicare taxes for at least 10 years. The main ongoing costs are Parts B, D, and supplemental coverage.
Part B is deducted directly from your Social Security check, or billed quarterly if you aren't yet collecting Social Security. IRMAA surcharges are layered on top of the standard $185/month for higher-income beneficiaries, at the top bracket, Part B alone costs over $600/month per person. The IRMAA surcharge is based on your income from two years prior, which is why income planning in the years around Medicare enrollment directly affects your premiums.
Medigap Plan G is the most popular supplement for 2026 enrollees because it covers virtually all out-of-pocket costs under Original Medicare except the Part B deductible ($257/year). In the Chicago area, Plan G premiums for a 65-year-old female range from approximately $120-$200/month; for a 65-year-old male, slightly higher. Premiums increase with age. The alternative. Medicare Advantage, often has lower premiums but may involve copays, prior authorizations, and narrower provider networks.
Fidelity's 2025 estimate for average couple healthcare costs in retirement is $315,000 in total lifetime healthcare expenses, not including long-term care. For Northern Suburbs retirees with higher incomes and premium healthcare expectations, the number may be higher. We build healthcare costs as an explicit line item in every retirement income plan: it's consistently one of the two largest expense categories in retirement, alongside housing.
Key facts
- Part A: premium-free for most; $1,676 hospital deductible per benefit period in 2026
- Part B: $185/month standard premium in 2026; up to $628.90/month at highest IRMAA bracket
- Part D: average premium ~$46/month in 2026; varies by plan and formulary
- Medigap Plan G (Chicago area, age 65): approximately $120-$220/month depending on insurer and age
- IRMAA threshold: individual MAGI above $106,000 or married above $212,000 triggers surcharges on Parts B and D
- Fidelity 2025 estimate: $315,000 average lifetime healthcare costs per couple in retirement (excluding long-term care)
Does Medicare cover dental, vision, and hearing?
Original Medicare (Parts A and B) doesn't cover routine dental, vision, or hearing care, a significant gap for retirees. Some Medicare Advantage plans include these benefits, though coverage varies widely by plan and location. Standalone dental, vision, and hearing insurance plans are available outside of Medicare. Budget $100-$200/month for these additional coverages if not included in your Medicare Advantage plan.
What is the Medicare Part B penalty and how do I avoid it?
If you don't enroll in Part B during your Initial Enrollment Period (the 7-month window around your 65th birthday), you face a 10% permanent penalty on your Part B premium for every 12-month period you delayed without qualifying coverage. On a $185 base premium, a 2-year delay adds $37/month permanently, totaling thousands of dollars over a typical retirement. Enroll on time unless you have qualifying large-employer coverage.