Founder and CEO of Texas Medicare Advisors - Medicare Expert | Guides clients of financial advisors into Medicare | And referral Partner for Insurance Professionals, CPA's & HR Directors
- Jason Fisher
- Jason Fisher
- Jason Fisher
- Jason Fisher
Texas seniors are seeing a notable shift in their healthcare expenses this year as several major federal updates officially take effect. The most visible change for many residents is the standard Medicare Part B monthly premium, which has increased to $202.90 for 2026. This mark represents the first time in the history of the program that the standard premium has exceeded the two hundred dollar threshold, creating a new financial reality for those living on fixed Social Security incomes across the state.
Understanding the rise in Part B and Part A costs
The increase in Part B premiums is accompanied by a rise in the annual medical deductible, which now stands at two hundred and eighty-three dollars for the 2026 calendar year. These adjustments are primarily driven by the rising costs of outpatient care and the increased utilization of medical services nationwide. Furthermore, for the small percentage of Texans who pay for Part A coverage, premiums have risen to five hundred and sixty-five dollars per month, while the inpatient hospital deductible has increased to one thousand seven hundred and thirty-six dollars per benefit period.
The Silver Lining of the New Prescription Drug Cap
While monthly premiums are rising, a significant new protection has arrived to help stabilize the budgets of Texans with high medication costs. For the first time, Medicare Part D and Medicare Advantage plans now feature a maximum out-of-pocket cap of two thousand one hundred dollars for covered prescription drugs. This means that once a beneficiary spends this amount on their medications in 2026, they will pay nothing for their covered prescriptions for the remainder of the year. This change provides much-needed financial predictability for residents managing chronic conditions like diabetes or heart disease.
New prior authorization rules impacting Texas specifically
Texas has been selected as one of only six states to participate in the new Wasteful and Inappropriate Service Reduction pilot program starting in 2026. This federal initiative introduces new prior authorization requirements for certain medical services and equipment within Original Medicare that were previously not subject to such scrutiny. While the goal of the program is to reduce unnecessary spending and medical waste, Texas residents need to work closely with their healthcare providers to ensure that all necessary paperwork is submitted early to avoid any delays in receiving care.
Strategic budgeting for the year ahead
With the Social Security cost-of-living adjustment for 2026 estimated at two point eight percent, many Texans will find that their increased benefit checks are largely offset by these higher Medicare premiums. Reviewing your current supplemental coverage or considering a switch to a more cost-effective Medicare Advantage plan may be necessary to maintain your desired standard of living. Consulting with a local advisor can provide clarity on which plans in your specific Texas county offer the best balance of low premiums and robust benefits to counter these rising costs.