Medicare 2026
Oct. 15 to March 31: Waukegan's Medicare windows
WAUKEGAN, Ill. — When you first sign up for Medicare, you face a fork in the road. One path is Original Medicare, often paired with a Medigap (supplement) policy and a stand-alone Part D drug plan. The other path is Medicare Advantage, a single private plan that bundles your coverage together. They are built differently, and that structure — not any single premium or perk — is what shapes how you use your coverage day to day.
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Key takeaways
- Original Medicare with a Medigap policy uses any provider that takes Medicare nationwide, while Medicare Advantage generally uses a plan network.
- Medigap helps pay the out-of-pocket costs Original Medicare leaves behind; Medicare Advantage instead sets its own copays and a yearly out-of-pocket maximum.
- Drug coverage is separate under Original Medicare (a stand-alone Part D plan) and usually built into a Medicare Advantage plan.
- The Annual Enrollment Period runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31.
Waukegan is in Lake County, where residents can choose either path. Here is how to think it through.
The two structures, side by side
Original Medicare is the federal program: Part A (hospital) and Part B (doctor and outpatient). You can see any doctor, hospital or specialist in the country that accepts Medicare — no network, no referrals. But Original Medicare has no yearly cap on what you might owe, which is why many people add a Medigap policy.
Medicare Advantage (Part C) is different. A private insurer contracts with Medicare to provide your Part A and Part B benefits through their plan. Most Advantage plans use a network (HMO or PPO), often require referrals for specialists, and set their own copays, coinsurance and yearly out-of-pocket maximum.
Where Medigap fits in
Medigap is a supplement — it only works alongside Original Medicare, never with Medicare Advantage. It helps pay things like the Part A hospital deductible, coinsurance, and the 20% Part B share that Original Medicare leaves to you.
Medigap plans are standardized by letter (Plan G, Plan N and so on). That means a Plan G from one insurer covers the same medical costs as a Plan G from another — the differences are price, customer service and extras. In Illinois, your best shot at buying Medigap without medical underwriting is during the six-month Medigap Open Enrollment Period that begins when you're 65 and enrolled in Part B.
How drug coverage works on each path
On the Original Medicare path, you add a stand-alone Part D prescription drug plan.
On the Medicare Advantage path, drug coverage is usually built into the plan (called an MA-PD).
Either way, these program-level rules apply:
- Part D out-of-pocket spending is capped at $2,100 in 2026 and $2,400 in 2027.
- The Part D deductible cannot exceed $615 in 2026 and $700 in 2027.
- The old "donut hole" is gone — Part D now has three phases.
- You can opt into the Medicare Prescription Payment Plan to spread drug costs evenly across the year.
Higher earners may also pay an IRMAA surcharge on Part B and Part D; for 2026, that starts above $109,000 in income for a single filer.
How to think about which path fits
There is no universally "right" answer — the paths solve different problems. A few honest questions help:
- Do you travel or split time out of state? Original Medicare works with any Medicare-accepting provider nationwide. Advantage networks are usually regional.
- Do you have specific doctors or a hospital system you want to keep? Check whether they're in-network on an Advantage plan, or whether they accept Medicare for the Original path.
- How do you feel about trade-offs? Original Medicare + Medigap tends to mean higher monthly premiums but more predictable bills. Advantage tends to mean lower (sometimes no) plan premiums but variable copays as you use care.
- How is your health today, and could you pass medical underwriting later? Switching from Advantage to Medigap after your initial window can be harder in most states.
Key dates to know
- Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, switch or drop Medicare Advantage and Part D plans.
- Jan. 1 – March 31: Medicare Advantage Open Enrollment. If you're already in an Advantage plan, you can switch to another or return to Original Medicare (and pick up a Part D plan).
- Your Medigap Open Enrollment Period: The six months starting when you're 65 and enrolled in Part B — your one guaranteed window to buy any Medigap policy sold in Illinois without health questions.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Lake County
(MA penetration in Lake County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
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The parts of Medicare
Good to know
Frequently asked questions
Can I have both a Medigap policy and a Medicare Advantage plan?
If I start with Medicare Advantage, can I switch to Original Medicare later?
Do I need a separate drug plan on Medicare Advantage?
Where can I get unbiased help in Waukegan?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Waukegan
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This page was last updated: October 7, 2026.