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Medicare Costs & the Part B Giveback (2026)

Key Takeaways
  • Part A is usually premium-free; Part B has a standard monthly premium (higher earners pay more via IRMAA).
  • IRMAA is an income-based surcharge added to Part B and Part D premiums for higher-income enrollees.
  • Some Medicare Advantage plans offer a Part B 'giveback' that reduces your Part B premium — money back in your Social Security check.
  • Original Medicare has no out-of-pocket cap — which is why people add Medigap or choose Advantage.
  • Specific dollar amounts change yearly — we'll confirm current figures for your situation.

How to Lower Your Medicare Part B Premium (IRMAA & Giveback) - Watch on YouTube

Understanding Medicare costs helps you avoid surprises and find savings. Here's what you'll pay in 2026 — and a lesser-known benefit that can actually put money back in your pocket.

What Are the Main Medicare Costs?

Part A

Premium-free for most (if you or a spouse paid Medicare taxes ~10 years). You may owe a hospital deductible per benefit period.

Part B

A standard monthly premium plus an annual deductible, then typically 20% coinsurance. Higher earners pay more (see IRMAA below).

Part D

Drug plan premiums vary by plan. There's a yearly deductible on many plans, then copays based on the drug tier.

Medigap / Advantage

Medigap adds a premium but slashes out-of-pocket costs. Advantage often has a low/$0 premium with copays as you go.

What Is IRMAA?

The Income-Related Monthly Adjustment Amount (IRMAA) is a surcharge added to your Part B and Part D premiums if your income is above certain thresholds. It's based on your tax return from two years prior. If your income has dropped since then (say, from retiring), you can appeal IRMAA — something we help people do.

What Is the Part B Giveback Benefit?

Money back on your premium

Certain Medicare Advantage plans include a "giveback" that pays part of your Part B premium back — effectively reducing what's deducted from your Social Security check. It's officially called a Part B premium reduction.

Giveback plans aren't available everywhere and aren't always the best overall value — a plan with a giveback but a weak network or high copays may cost you more in the end. It's one factor among many. We help you weigh whether a giveback plan actually makes sense for you.

The cost that catches people off guard

Original Medicare alone has no annual out-of-pocket maximum. That 20% Part B coinsurance keeps going with no cap — so one serious illness could mean enormous bills. This is the single biggest reason people add a Medigap plan (which covers that 20%) or choose a Medicare Advantage plan (which has an out-of-pocket cap). Understanding your true cost exposure — not just premiums — is where we help most. Compare your options with a full Advantage vs Medigap breakdown.

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We'll show your true costs across Medigap and Advantage — including any Part B giveback you qualify for — and help appeal IRMAA if your income dropped. No cost.

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Frequently Asked Questions
▸ How much does Medicare cost in 2026?
Most people get Part A premium-free. Part B has a standard monthly premium (higher earners pay more via IRMAA) plus an annual deductible and typically 20% coinsurance. Part D drug plans and Medigap or Advantage plans have their own premiums. Exact dollar figures change each year - we confirm current amounts for your specific situation.
▸ What is the Medicare Part B giveback benefit?
The Part B giveback is a feature of certain Medicare Advantage plans that pays part of your Part B premium back to you, reducing what's deducted from your Social Security check. It's officially a Part B premium reduction. Not all areas have giveback plans, and a giveback plan isn't automatically the best value - the network and copays matter too.
▸ What is IRMAA and how do I avoid it?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to your Part B and Part D premiums if your income exceeds certain thresholds, based on your tax return from two years prior. If your income has since dropped - for example after retiring - you can file an appeal to have IRMAA reduced. We help clients with this process.
▸ Does Original Medicare have an out-of-pocket maximum?
No - and this surprises many people. Original Medicare (Parts A and B) alone has no annual cap on your out-of-pocket costs. The 20% Part B coinsurance continues with no limit, so a serious illness could mean very large bills. This is the main reason people add a Medigap plan or choose a Medicare Advantage plan, both of which limit your exposure.
▸ How can I lower my Medicare costs?
Options include choosing the right path (Medigap vs Advantage) for how you use care, selecting a Part D plan matched to your exact medications, using the California Birthday Rule to switch Medigap carriers for a better price, appealing IRMAA if your income dropped, and considering a Part B giveback plan if it genuinely fits. We help California clients with all of these at no cost.
The information above is general guidance about California Medicare and may change as rates, plans, and rules are updated each year. It is not a substitute for personalized advice. For current, personalized guidance, please contact us, email help@calhealth.net, or call 800-320-6269. Serving California since 1994.
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