Medicare 2026

Evanston at 65: the seven-month Medicare window that opens before your birthday

EVANSTON, Ill. — For anyone in Evanston approaching 65, a birthday isn't just a birthday. It opens a seven-month window called the Initial Enrollment Period, or IEP — the stretch when most people first sign up for Medicare. Miss it, and you could face lifelong late penalties or a gap in coverage.

A birthday that starts a clock

The good news: the window is generous, the rules are public, and you don't have to figure it out alone.

When your window opens (and closes)

Your Initial Enrollment Period runs for seven months total:

• The three months before your 65th birthday month
• Your birthday month
• The three months after your birthday month

If your birthday falls on the first of the month, Medicare treats you as turning 65 the month before, and your window shifts one month earlier.

Signing up in the three months before your birthday month usually means Part A and Part B coverage start on the first day of your birthday month. Sign up later in the window, and coverage begins the month after you enroll. So the earlier you act inside the window, the smoother the handoff from whatever coverage you have now.

The first steps to take

Here's a simple order of operations for someone in Evanston aging in:

1. Decide about Part A and Part B. Most people get premium-free Part A (hospital) automatically if they or a spouse paid Medicare taxes for at least 10 years. Part B (doctor visits and outpatient care) has a monthly premium. If you're already getting Social Security, you may be enrolled automatically. If not, you sign up through the Social Security Administration at ssa.gov or by calling 1-800-772-1213. 2. Check your current coverage. If you have employer insurance, retiree coverage, COBRA, or VA benefits, the rules for delaying Part B without a penalty vary. Talk to your benefits administrator before making a decision — COBRA and retiree plans do not count as active employer coverage for delaying Part B. 3. Choose how you'll get your Medicare. You can stay with Original Medicare (Parts A and B) and add a standalone Part D drug plan, and often a Medigap supplement. Or you can pick a Medicare Advantage plan (Part C), which bundles hospital, medical, and usually drug coverage through a private insurer. 4. Look at drug coverage. Even if you don't take prescriptions today, enrolling in Part D during your IEP avoids a late-enrollment penalty later.

What's new for 2027

A few program-level facts to keep in mind as you plan:

• Part D out-of-pocket cap: $2,100 for the year. Once you hit that in covered drug costs, you pay $0 for the rest of the year.
• Part D maximum deductible: $615.
• No more donut hole. The coverage gap was eliminated in 2025, and Part D now has three phases instead of four.
• Medicare Prescription Payment Plan. This optional program lets you spread your out-of-pocket drug costs across monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges — the higher Part B and Part D premiums for higher earners — start above $109,000 in income for a single filer in 2026.

Local availability, county by county

Medicare plan choices are set at the county level, not the city level. Evanston is in Cook County, where 11 carriers offer 58 Medicare Advantage plans for 2027, down from 12 carriers and 78 plans in 2026. Six plans are new, 17 are not returning, and nine have been renamed; Clear Spring Health is not offering plans in the county next year. When you compare plans on Medicare.gov, you'll enter your ZIP code, and the site will show you what's available in your county for the coming year.

What if you miss the window?

If you don't sign up during your Initial Enrollment Period and you don't qualify for a Special Enrollment Period (for example, because you had employer coverage), you may have to wait for the General Enrollment Period, January 1 through March 31, with coverage starting the month after you enroll. Late enrollment can also mean a permanent penalty added to your Part B or Part D premium — the longer you wait, the higher it climbs.

Two other dates worth knowing once you're in Medicare:

• Annual Enrollment Period: October 15 – December 7, when anyone with Medicare can change drug or Advantage plans for the next year.
• Medicare Advantage Open Enrollment: January 1 – March 31, when people already in an Advantage plan can switch once.

Where to get personal help in Evanston

Because everyone's situation is different — job coverage, medications, a spouse's plan — the smartest move is to ask questions before you sign anything. Free, unbiased help is available:

• Medicare.gov for plan comparisons and official rules.
• 1-800-MEDICARE (1-800-633-4227), open 24/7.
• Illinois SHIP (Senior Health Insurance Program), the state's free Medicare counseling service, at 1-800-252-8966.
• Social Security Administration at ssa.gov or 1-800-772-1213 to actually enroll.