Medicare 2026

Two Ways to Get Medicare Coverage in Deltona

In Deltona, turning 65 often brings the same question: should you stick with Original Medicare and add a Medigap policy, or take the Medicare Advantage route? Both are legal, both are common, and both are built on the same federal program — but they are structured very differently, and that structure shapes how you see a doctor, how you pay, and what happens when you travel.

Here is a plain-language look at how the two paths compare, using the rules in place for 2027.

The two structures, side by side

Original Medicare + Medigap is the older, government-run path. Part A covers hospital stays, Part B covers doctor visits and outpatient care, and both are administered directly by Medicare. Because Original Medicare leaves gaps — deductibles, the 20% coinsurance on Part B, and no yearly out-of-pocket limit — many people add a Medigap (Medicare Supplement) policy from a private insurer to help pay those leftover costs. Prescription drugs are handled through a separate standalone Part D plan.

Medicare Advantage (Part C) bundles Part A, Part B, and usually Part D into a single plan run by a private insurer that Medicare has approved. You still have Medicare, but the private plan manages your care day to day, often through a network of doctors and hospitals. Many Advantage plans also include extras like dental or vision.

The key structural difference: with Original Medicare + Medigap, you have one government program plus one or two private policies filling in gaps. With Medicare Advantage, one private plan is doing most of the work under Medicare's rules.

How you see a doctor

Under Original Medicare, you can go to any provider in the country that accepts Medicare — no network, no referrals. That flexibility is why many retirees who split time between Deltona and family up north lean toward this path.

Medicare Advantage plans usually use provider networks (HMO or PPO). Care inside the network is generally covered; care outside may cost more or require prior approval. Referrals to specialists may also be required.

How the costs are structured

With Original Medicare, you pay the Part B premium plus, if you buy one, a Medigap premium and a Part D premium. In exchange, your out-of-pocket exposure at the doctor's office is usually very predictable.

With Medicare Advantage, premiums vary by plan, but you still owe the Part B premium. Instead of a Medigap policy, the plan itself sets copays and has a yearly out-of-pocket maximum for medical services.

For drugs, the rules are the same either way: Part D has an annual out-of-pocket cap of $2,100 in 2026 and $2,400 in 2027, with a maximum deductible of $615 in 2026 and $700 in 2027. The old coverage gap — the "donut hole" — was eliminated in 2025, so Part D now has three phases instead of four. If monthly drug costs are a strain, the Medicare Prescription Payment Plan lets you spread them across the year.

Higher-income enrollees should also know IRMAA surcharges on Part B and Part D begin above $109,000 in income for a single filer in 2026.

What this looks like in Deltona

Deltona is in Volusia County, where both paths are available. Volusia County residents can choose Original Medicare (with or without a Medigap policy and a standalone Part D plan) or pick from the Medicare Advantage plans offered locally by private carriers. The specific plans and carriers change each year, which is why the fall shopping window matters.

Timing: the dates that decide your year

• Annual Enrollment Period: October 15 – December 7. This is when anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you are already in an Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare.

One important note about Medigap: in most states, including Florida, the strongest right to buy a Medigap policy without medical underwriting is during the six-month window that opens when you first enroll in Part B at age 65 or older. If you choose Advantage first and want to switch to Original Medicare + Medigap later, insurers may be allowed to consider your health history. That is a structural detail worth understanding before you pick a path.