Medicare 2026

Medicare Advantage vs Medigap structure in Montgomery

In Montgomery, Alabama, one of the biggest decisions a person nearing 65 faces isn't which plan to pick — it's which kind of coverage to build around. Original Medicare paired with a Medigap policy and Medicare Advantage are two very different structures, and understanding how they work is the first step toward a choice you can live with.

Key takeaways

• Original Medicare is the federal program (Parts A and B); Medigap and Part D are separate policies that fill in gaps around it.
• Medicare Advantage (Part C) is private coverage that replaces how you get Parts A and B, and usually bundles drug coverage and network rules.
• In 2026, Part D has a $2,100 out-of-pocket cap and a maximum $615 deductible; in 2027, the cap is $2,400 and the maximum deductible is $700. The coverage gap is gone.
• The Annual Enrollment Period runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31.

Two different structures, not just two different prices

Original Medicare is run directly by the federal government. It has two parts: Part A (hospital) and Part B (doctor and outpatient). You can see any provider in the country that accepts Medicare, and there are no networks. But Original Medicare alone doesn't cap what you pay out of pocket, and it doesn't include prescription drugs.

That's where the add-ons come in. A Medigap (Medicare Supplement) policy is sold by a private insurer and pays some of the costs Original Medicare leaves behind — things like coinsurance and deductibles. A stand-alone Part D plan handles prescriptions. Put together, you're stacking three pieces: Original Medicare + Medigap + Part D.

Medicare Advantage takes a different approach. A private insurer contracts with Medicare to deliver your Part A and Part B benefits in one package, usually with Part D built in and often with extras Original Medicare doesn't cover. In exchange, plans typically use provider networks and require referrals or prior authorization for some services. Advantage plans must cap your annual out-of-pocket spending on Part A and B services.

What that means in practice

The trade-off usually comes down to flexibility versus simplicity.

With Original Medicare + Medigap, you get broad provider access nationwide and predictable cost-sharing, but you're paying premiums for more than one policy and managing drug coverage separately.

With Medicare Advantage, you generally have one card, one plan to deal with, and often added benefits — but you're working within a network and following the plan's rules for approvals.

Neither structure is universally better. It depends on your doctors, your prescriptions, how often you travel, and how you feel about paperwork versus network rules.

The local picture in Montgomery

Montgomery is in Montgomery County, where Medicare plan availability is set at the county level. That means the specific Medicare Advantage and Part D options a Montgomery resident can choose from are determined by the county, not the city. For 2027, Montgomery County has 67 Medicare Advantage plans from 8 carriers, with 15 new plans, 4 not returning, and 6 renamed; 17 continuing plans change something in their terms, so the ANOC is worth a careful read. You can see the full lineup by entering your ZIP code at Medicare.gov's plan finder.

Original Medicare and Medigap, on the other hand, aren't tied to plan menus the same way. Original Medicare is the same nationwide, and Medigap policies are standardized by letter (Plan G, Plan N, and so on), though Alabama has its own rules about when you can enroll and whether insurers can consider your health.

Part D figures for 2026 and 2027

A few program-level figures apply no matter which path you choose:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your drug spending reaches that limit, you pay nothing more for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• Coverage gap ("donut hole"): eliminated as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional way to spread drug costs into monthly payments instead of paying at the pharmacy counter.
• IRMAA: higher-income surcharges on Part B and Part D premiums start above $109,000 for a single filer in 2026.

Enrollment windows to circle

• Annual Enrollment Period: Oct. 15 – Dec. 7. You can join, switch, or drop a Medicare Advantage or Part D plan for coverage starting Jan. 1.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in an Advantage plan, you get one chance to switch to a different Advantage plan or return to Original Medicare.
• Medigap: the strongest federal protections apply during your six-month Medigap Open Enrollment Period, which starts when you're 65 and enrolled in Part B. Outside that window, insurers in most states can consider your health history.

How to think it through

Start with your doctors and hospitals — are they in the networks of the Advantage plans available in Montgomery County, or would Original Medicare's open access matter more? Then look at your prescriptions and how each option covers them. Finally, weigh the monthly premium math against the risk of larger bills if something serious comes up.

If any of that feels overwhelming, you don't have to sort it out alone.