Medicare Ups Stakes: $200 Minimum for Judge Hearings in 2026
Published Date: 12/4/2025
Notice
Summary
Starting January 1, 2026, Medicare is raising the minimum dollar amounts needed to appeal decisions. If you want a hearing with an Administrative Law Judge, your dispute must be at least $200, and for judicial review, it’s $1,960. This change affects anyone dealing with Medicare Part A, B, C, or D appeals and helps keep up with rising medical costs.
Analyzed Economic Effects
2 provisions identified: 0 benefits, 2 costs, 0 mixed.
Higher ALJ Hearing Dollar Threshold
You will need at least $200 in dispute to get a hearing with an Administrative Law Judge for Medicare appeals starting January 1, 2026. This raises the ALJ threshold from $190 for CY 2025 to $200 for CY 2026 and applies to Medicare Parts A, B, C (Medicare Advantage), and D appeals.
Raised Judicial Review Threshold
You must have at least $1,960 in dispute to seek judicial review of a Medicare appeal starting January 1, 2026. This raises the judicial-review threshold from $1,900 for CY 2025 to $1,960 for CY 2026 and applies to Medicare Parts A, B, C (Medicare Advantage), and D appeals.
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