Medicare Costs in Texas for 2026

Part A: usually free, but not costless

Most people pay no premium for Part A because they or a spouse paid Medicare taxes for at least 40 quarters. That does not make hospital care free: the Part A deductible is $1,736 per benefit period in 2026, and a benefit period can restart within the same calendar year.

That last point surprises people. Two separate hospitalizations more than 60 days apart mean the deductible applies twice.

Part B: the premium everyone pays

The standard 2026 Part B premium is $202.90 a month, with an annual deductible of $283. After the deductible, Original Medicare generally pays 80% of approved costs and you pay the remaining 20%, with no annual ceiling.

Higher-income beneficiaries pay more than the standard premium through IRMAA, which begins above $109,000 for single filers and $218,000 for joint filers.

Part D and the new drug cap

Part D premiums vary by plan. The maximum allowable deductible in 2026 is $615, and out-of-pocket drug spending is capped at $2,100 for the year.

That cap is the meaningful number for anyone on expensive medication, because it converts an open-ended risk into a known maximum.

What the total actually looks like

A typical Texas retiree choosing Original Medicare with a Medigap policy and a Part D plan is generally looking at the Part B premium plus a Medigap premium plus a Part D premium each month, with very little variable cost after that.

Someone choosing a $0-premium Medicare Advantage plan pays the Part B premium and little else monthly, but takes on copays as they use care. Over a healthy year the second is cheaper. Over a heavy year the first often is. Comparing them honestly means estimating your own use, not comparing premiums.

What drives the difference between two Texas retirees

Two people the same age in the same Texas county can pay very different totals for Medicare, and the drivers are rarely the ones people expect. Income determines whether IRMAA applies. Prescriptions determine whether Part D is a rounding error or the largest line. Health status determines whether an Advantage plan's copays stay small or accumulate.

Geography matters too: Medigap premiums are rated by area within Texas, and Medicare Advantage plan availability differs between Harris, Dallas, Bexar and Tarrant counties and the rural counties of West Texas and the Panhandle, which changes what is even on the menu before cost enters the picture.

Cost questions people ask

Is a $0-premium plan really $0? No. You still pay the Part B premium, and you pay copays as you use care up to the plan's out-of-pocket maximum. The $0 refers only to the plan's own premium.

Does Medicare cover long-term care? Generally no. Medicare covers limited skilled nursing after a qualifying hospital stay, not custodial long-term care. This is one of the largest and most common misunderstandings about what Medicare is for.

Do dental and vision come with Medicare? Not with Original Medicare. Many Advantage plans include limited dental and vision, with annual caps that are worth reading closely before treating them as equivalent to standalone coverage.