Medicare 2026

Medigap Letter Plans Explained for Hartford Medicare

HARTFORD, Conn. — If you're turning 65 in Hartford, or helping a parent sort through Medicare mail, you've probably run into the same fork in the road: should you stick with Original Medicare and add a Medigap policy, or go with a Medicare Advantage plan? They both cover you, but they're built very differently — and understanding that difference up front can save you from a frustrating switch later.

The two structures, in plain English

Original Medicare is the federal program itself — Part A (hospital) and Part B (doctor and outpatient). You can see any doctor or hospital in the country that accepts Medicare, and you don't need referrals. But Original Medicare alone has no out-of-pocket maximum, so many people pair it with a Medigap (Medicare Supplement) policy sold by a private insurer. Medigap helps pay the deductibles and coinsurance Original Medicare leaves behind. You'd also typically add a stand-alone Part D drug plan.

Medicare Advantage (Part C) is different. It's a private plan that replaces the way you get your Part A and Part B benefits. The insurer manages your care, usually through an HMO or PPO network, and most Advantage plans bundle in Part D drug coverage plus extras like dental or vision. Advantage plans must cap your yearly out-of-pocket costs for Part A and B services.

Neither structure is "better." They're trade-offs — and the right fit depends on your doctors, your prescriptions, your travel habits, and your budget.

Provider access and referrals

With Original Medicare, your card is accepted almost anywhere in the U.S. that takes Medicare. That flexibility matters if you split time between Connecticut and another state, or if you want to keep the option of a specialist at a hospital system outside your immediate area.

Medicare Advantage plans generally build a network. HMOs usually require you to stay in-network and get referrals for specialists. PPOs are looser but still charge more out-of-network. Before you enroll in any Advantage plan, check that your current doctors — and the Hartford-area hospitals you'd want to use — are in that plan's network for the coming year. Networks can change annually.

How costs are structured

Under Original Medicare + Medigap, you'll typically pay:

• The Part B premium (everyone pays this),
• A Medigap premium to the private insurer,
• A Part D premium for drug coverage,
• Small or no cost-sharing at the point of care, depending on which Medigap plan you choose.

Under Medicare Advantage, you'll typically pay:

• The Part B premium,
• Possibly an additional plan premium (some are lower, some higher),
• Copays and coinsurance as you use services, up to the plan's annual out-of-pocket maximum.

We can't quote specific plan prices here, but the shape of the math is different: Medigap trades higher monthly premiums for more predictable costs when you actually need care. Advantage trades lower premiums for more variable cost-sharing as you use services.

Drug coverage and the 2027 rules

If you go with Original Medicare, you'll almost always want a stand-alone Part D plan. Most Medicare Advantage plans include drug coverage already.

Either way, the same Part D rules apply in 2027:

• The out-of-pocket cap on covered drugs is $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old "donut hole" coverage gap is gone — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.

Higher-income enrollees also pay an IRMAA surcharge on Part B and Part D. For 2026, IRMAA begins above $109,000 in income for a single filer.

The Medigap timing trap

This is the mistake worth flagging. When you first enroll in Part B at 65, you get a six-month Medigap Open Enrollment window during which insurers must sell you any Medigap policy they offer, at their best available rate, regardless of your health.

After that window closes, in most states insurers can use medical underwriting — meaning they can charge more or decline you based on health history. Connecticut has some of the strongest Medigap consumer protections in the country, but rules and pricing still vary by carrier. If you start on Medicare Advantage and later decide you'd rather switch to Original Medicare + Medigap, getting a Medigap policy may not be automatic. Know that going in.

Plan availability in the Hartford area

Hartford is in Hartford County, where Medicare plan availability is set at the county level by CMS. Every year, a range of Medicare Advantage plans and stand-alone Part D plans are offered by multiple carriers in the county, and the exact lineup changes each fall. The best place to see the current-year options for your ZIP code is the Plan Finder at medicare.gov.

When you can enroll or switch

• Initial Enrollment Period: the seven months around your 65th birthday.
• Annual Enrollment Period (AEP): Oct. 15 – Dec. 7. You can join, drop, or switch Medicare Advantage and Part D plans for coverage starting Jan. 1.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in an Advantage plan, you can switch to a different Advantage plan or return to Original Medicare (and pick up a Part D plan) once during this window.

Special Enrollment Periods can also apply if you move, lose other coverage, or qualify for Extra Help.