Medicare 2026

Two Medicare Paths Compared for Indianapolis Residents

INDIANAPOLIS — If you are weighing Original Medicare with a Medigap policy against a Medicare Advantage plan, the calendar matters as much as the coverage itself. In Marion County, as everywhere else, a few key dates control which door stays open to you — and which one can quietly close.

This piece focuses on the timing side of that choice: the enrollment windows, what happens if you miss one, and how the deadlines for Original Medicare, Medigap, and Medicare Advantage interact.

The structural difference, in one minute

Original Medicare is the federal program — Part A (hospital) and Part B (outpatient). Most people pair it with a stand-alone Part D drug plan and a Medigap (Medicare Supplement) policy that helps pay the out-of-pocket costs Original Medicare leaves behind. You can see any provider in the country that accepts Medicare.

Medicare Advantage (Part C) is different in structure. A private insurer is paid by Medicare to deliver your Part A and Part B benefits, usually with Part D and extras bundled in. Plans typically use provider networks and prior authorization, and costs and rules are set by the plan.

The choice between these two paths is not just about benefits today. It is about which path you can still get onto years from now — and that is where the dates come in.

The Medigap window most people only get once

The single most important date for anyone considering the Original Medicare + Medigap path is the start of the Medigap Open Enrollment Period. It begins the month you are 65 and enrolled in Part B, and it lasts six months.

During those six months, Medigap insurers in Indiana must sell you any policy they offer at their standard price, no matter your health history. Once that window closes, insurers can, in most cases, ask health questions and decide whether to offer you a policy and at what price. There are limited "guaranteed issue" situations later on, but they are narrower than many people expect.

That is why a decision that feels like "Advantage now, Medigap later" is really a decision that depends on whether a Medigap insurer will accept you later.

The Annual Enrollment Period: October 15 – December 7

This is the fall window most people know. From October 15 through December 7 each year, you can:

• Switch from Original Medicare to a Medicare Advantage plan, or the reverse.
• Switch from one Medicare Advantage plan to another.
• Join, switch, or drop a Part D drug plan.

Changes made during this window take effect January 1. If you do nothing, your current coverage generally rolls into next year with whatever benefit and cost changes your plan has announced in its Annual Notice of Change.

Important: this window controls Advantage and Part D. It does not guarantee you a Medigap policy. Applying for Medigap in the fall does not override an insurer's right to underwrite you.

The Medicare Advantage Open Enrollment Period: January 1 – March 31

If you are already in a Medicare Advantage plan on January 1, you get one more chance to change your mind. Between January 1 and March 31 you can:

• Switch to a different Medicare Advantage plan, or
• Drop Advantage and return to Original Medicare (and pick up a Part D plan).

This window is only for people already in Advantage. It is not a second AEP for everyone. And again, dropping Advantage to return to Original Medicare does not automatically give you a Medigap policy — you may need to answer health questions to get one.

What happens if you miss a window

Missing the Medigap Open Enrollment Period is the one that tends to sting most, because there is no annual do-over. Missing the AEP usually means waiting until the next October 15, unless you qualify for a Special Enrollment Period — for example, a move out of your plan's service area, loss of employer coverage, or a change in Medicaid status.

Missing your initial Part B enrollment around age 65 is a separate problem: it can cause a lifelong Part B late-enrollment penalty and can push back when your Medigap open window even begins. If you are still working past 65 with employer coverage, check with Social Security or your local SHIP before assuming you can delay.

A few 2026 and 2027 numbers worth knowing

These are program-level facts from Medicare, and they apply regardless of which path you choose:

• Part D has a $2,100 annual out-of-pocket cap in 2026 and a $2,400 cap in 2027.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old coverage gap ("donut hole") was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments.
• IRMAA surcharges on Part B and Part D begin above $109,000 in income for a single filer in 2026.