Whether you are registered for Medicare, you’re not registered but eligible (age 65 or older), or you’re already receiving Medicare benefits but you’re thinking about changing your plan, you need to know that the current enrollment period for Medicare coverage in 2026 runs from October 15, 2025, to December 7, 2025. During this period, you have the opportunity to enroll or make changes to your plan for 2026, and the chance won’t come again until next October.
Most of us will recall that Medicare has different parts, often referred to as “Medicare Part A,” “Medicare Part B,” and so on. Each of the parts covers different aspects of your medical needs, and it’s important that they work together in a way that’s best for your individual situation. So, let’s go over some basics.
Medicare Part A covers most hospital charges including inpatient care, skilled nursing care in a nursing home or skilled nursing facility (as long as it’s not custodial or long-term care) and some home healthcare costs. This part of Medicare is free for most of those who qualify, but there are deductibles and co-pays that are out-of-pocket.
Medicare Part B covers “medically necessary and preventive services” such as doctor visits, durable medical equipment (like walkers and wheelchairs), and drugs for certain conditions. Medicare Parts A and B are sometimes referred to as “original Medicare.” Keep in mind that Part B requires a monthly premium that is estimated to start at $206.50 for 2026 but could be more, depending on your income. While the premium amounts won’t be finalized until later this fall, the modified adjusted gross income (MAGI) brackets that determine how much your premium will be adjusted (your income-related monthly adjustment amount, or IRMAA) and related premiums are estimated to be as follows:
- Single taxpayer—Up to $109,000, $206.50; $109,001–137,000, $289.10; $137,001–171,000, $413.00; $171,001–205,000, $536.90; $205,001–500,000, $660.80; $500,000+, $702.10
- Married filing jointly—Up to $218,000, $206.50; $218,001–274,000, $289.10; $274,001–342,000, $413.00; $342,001–410,000, $536.90; $410,001–750,000, $660.80; $750,000+, $702.10
Medicare Part C, sometimes called “Medicare Advantage,” provides the same coverages as Parts A and B, but works through approved private insurance companies. To enroll in Part C, you must already be enrolled in Parts A and B and live in an area covered by your chosen Part C provider. One difference between Medicare Advantage and original Medicare is that Medicare Advantage typically requires you to use doctors and other providers who are members of a particular network; original Medicare has no such network requirements.
Medicare Part D is for those who want coverage for a wider range of prescription drugs. Part D plans cover a wider range of medications than Part B, but not every drug is covered. If you have a particular prescription that you must take, you should make sure that it is included in your Part D coverage. Remember: “D” for “drugs.”
If you aren’t yet receiving Medicare benefits and you are eligible, it’s important to enroll before December 7 in order to avoid a penalty for the months you could have had coverage but didn’t. The exception to this rule is if you are 65 or older and otherwise eligible, but you are covered by an employer plan through your employer or your spouse’s employer. But if you are 65 or older and no longer have access to medical insurance through an employer plan, you should definitely enroll, both to cover medical costs and to avoid a penalty.
Remember, if you have questions about Medicare coverage, Medicare Advantage, or any other aspect of your retirement planning, Mathis Wealth Management is here to help. And for more information about planning your retirement, please visit our website and read our article, “Your Social Security Checklist.”
