Medicare Cost Estimator — 2026
Enter the client's expected annual healthcare usage to compare estimated out-of-pocket costs
across the three main Medicare coverage types.
/ yr
/ yr
/ yr
/ yr
/ yr
/ yr
/ yr
/ yr
Avg billed ~$1,000/ride
/ yr
Avg billed $12,000–$25,000
drugs/mo
drugs/mo
Most drug deductibles apply to Tier 3+ only — Tier 1 & 2 generics and preferred brands typically go straight to copay, though some plans may apply the deductible to all tiers. Deductible defaults: $480/yr for Original Medicare & Supplement stand-alone Part D plans, $300/yr for Medicare Advantage (2026 range: $150–$615). Adjust in “Edit Cost Assumptions” below.
/ yr
Avg drug cost ~$800/injection
/ yr
Avg ~$2,000/session; 20% patient share on Original Medicare
/ yr
Avg facility charge ~$3,500 per procedure
/ yr
Avg ~$150 allowed per visit
/ yr
Covered at 100% if criteria met; MA may require prior auth
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Edit Cost Assumptions
Click to expand and override any default value
Cost Estimate Disclaimer: These figures are rough estimates based on 2026 official Medicare cost-sharing data and national average costs. For general educational purposes only — not a quote, guarantee of benefits, or enrollment advice. Drug deductible applies to Tier 3+ only; Tier 1–2 drugs go straight to copay. Where individual costs exceed the Medicare Advantage out-of-pocket maximum, the full estimated cost is shown for reference but only the capped amount is counted in the total. Actual costs vary by plan, provider, location, and health needs. Always review a plan’s Evidence of Coverage (EOC) and Summary of Benefits before enrolling.