Medicare 2026

Caldwell first steps for Medicare at the 7-month mark

# Turning 65 in Caldwell? Don't Miss Your 7-Month…

CALDWELL, Idaho — If you're approaching your 65th birthday, one of the most important dates on your calendar isn't the party — it's your Initial Enrollment Period for Medicare. Miss it, and you could face lifelong late penalties or a gap in coverage. Get it right, and you'll start Medicare on solid footing.

Here's what people aging into Medicare in Caldwell need to know, step by step.

What the Initial Enrollment Period actually is

Your IEP is a 7-month window built around your 65th birthday. It includes the three months before your birthday month, your birthday month itself, and the three months after. So if you turn 65 in June, your window runs from March 1 through September 30.

During this window, you can sign up for Original Medicare (Part A and Part B), and you can also pick up a Medicare Advantage plan (Part C) or a stand-alone Part D drug plan if you want one. This is also your first chance to buy a Medigap (Medicare Supplement) policy with the strongest federal protections against being turned down for health reasons.

First steps: what to do 3–6 months before your birthday

Start early. A few months out, sit down and take stock of:

• Whether you're getting Social Security already. If you are, you'll usually be enrolled in Part A and Part B automatically. If you're not, you'll need to sign up yourself at ssa.gov or by calling Social Security.
• Your current health coverage. Employer coverage, retiree plans, COBRA, and VA benefits all interact with Medicare differently. Some let you delay Part B without penalty; others don't.
• Your prescriptions. Make a written list of every drug and dose. You'll need this to compare Part D or Medicare Advantage drug coverage.
• Your doctors. If you want to stay with them, you'll want to know whether they take Original Medicare or specific Advantage plan networks.

Signing up: Part A, Part B, and beyond

Most people get Part A (hospital insurance) premium-free based on their work history. Part B (doctor and outpatient care) has a monthly premium set by Medicare each year.

If you're not automatically enrolled, you apply through Social Security — online, by phone, or at a local office. Once you have Original Medicare, you decide whether to:

• Stay with Original Medicare and add a stand-alone Part D drug plan, often paired with a Medigap policy, or
• Choose a Medicare Advantage plan, which bundles Parts A, B, and usually D through a private insurer.

Caldwell is in Canyon County, where a range of Medicare Advantage and Part D plans are offered each year. The exact number changes annually, and you can see the current list on medicare.gov's Plan Finder using your ZIP code.

Watch out for late-enrollment penalties

This is where people get burned. If you don't sign up for Part B when you're first eligible — and you don't have other coverage that qualifies — you can owe a Part B late penalty that stays with you for as long as you have Medicare.

Part D has its own late penalty if you go 63 days or more without "creditable" drug coverage after becoming eligible. "Creditable" means coverage Medicare considers at least as good as a standard Part D plan. Your employer or union plan should send you a notice each year telling you whether your drug coverage counts.

2026 and 2027 numbers worth knowing

A few program-wide figures apply no matter which plan you pick:

• The Part D out-of-pocket cap for 2026 is $2,100. Once you hit it, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible for 2026 is $615.
• The old "donut hole" coverage gap was eliminated in 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs into monthly payments across the year, at no extra charge.
• IRMAA — higher-income surcharges on Part B and Part D — starts above $109,000 in income for single filers in 2026 (based on your 2024 tax return).

Dates to circle after your IEP ends

Once you're in Medicare, two annual windows matter most:

• Annual Enrollment Period: October 15 – December 7, 2026. You can join, switch, or drop a Medicare Advantage or Part D plan for 2027.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in an Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare.

Where to get free, unbiased help in Caldwell

You don't have to figure this out alone, and you don't have to rely on a sales call.

• Medicare.gov — the official site for enrollment, Plan Finder, and rules.
• 1-800-MEDICARE (1-800-633-4227) — 24/7 help from Medicare directly.
• Idaho SHIBA (Senior Health Insurance Benefits Advisors) — Idaho's State Health Insurance Assistance Program offers free, one-on-one Medicare counseling to Caldwell-area residents. They don't sell plans.
• Social Security Administration (ssa.gov or 1-800-772-1213) — for enrolling in Part A and Part B.