Medicare 2026

Your Medicare AEP Checklist: What Cedar Falls Can Do by Dec. 7

CEDAR FALLS, Iowa — Medicare's Annual Enrollment Period opens Oct. 15 and closes Dec. 7, giving people with Medicare a seven-week window to review their coverage for 2027 and make changes that take effect Jan. 1. It's the one time each year almost anyone on Medicare can switch how they get their benefits — and for a lot of folks in the Cedar Valley, it's the easiest chance to fix a plan that no longer fits.

This fall's window also lands alongside continuing program-level changes, including the Part D out-of-pocket cap, which is $2,100 in 2026 and rises to $2,400 in 2027. That makes the review worth doing even if you like your current plan.

What you can actually change during AEP

The Annual Enrollment Period — sometimes called the fall open enrollment or AEP — is broader than people realize. Between Oct. 15 and Dec. 7, you can:

• Switch from Original Medicare (Parts A and B) to a Medicare Advantage plan, or the other way around.
• Change from one Medicare Advantage plan to another.
• Join a stand-alone Part D prescription drug plan, drop one, or switch to a different one.
• Add drug coverage if you have Original Medicare and don't currently have Part D.

Whatever you choose during AEP starts Jan. 1, 2027. If you make more than one change, the last choice you make before Dec. 7 is the one that sticks.

Why this fall's review matters more than usual

Even if your plan card looks the same, the rules underneath it are shifting. Medicare's Part D annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. The maximum Part D deductible is $615 in 2026 and $700 in 2027, though many plans set theirs lower. The old "donut hole" coverage gap was eliminated in 2025, so Part D now has three phases instead of four.

There's also the Medicare Prescription Payment Plan, an optional program that lets you spread your drug costs across the calendar year in monthly payments instead of paying a large amount at the pharmacy counter. It doesn't lower your total cost, but it can smooth out the timing.

Higher-income beneficiaries should also know the IRMAA income thresholds — the surcharges that get added to Part B and Part D premiums — start above $109,000 for a single filer in 2026.

What to check before you pick

Every fall, plans send out an Annual Notice of Change (usually arriving in September). It spells out what's different for the coming year: the premium, the drug list (formulary), the pharmacy network, the provider network, and cost-sharing. Read it, even if it looks like junk mail.

A few practical things to look at before Dec. 7:

• Are your prescriptions still covered, and at the same tier?
• Are your doctors and preferred hospitals still in the plan's network?
• Did the plan's rules for referrals or prior authorization change?
• If you travel or spend time out of state, how does the plan handle care away from home?

Cedar Falls plan choices and where to get help

Cedar Falls is in Black Hawk County, where Medicare beneficiaries typically have a wide range of Medicare Advantage and stand-alone Part D options to compare. The exact number of plans available in the county changes each year as carriers file new offerings with CMS, and it's easy to check your own ZIP code using the Plan Finder at medicare.gov.

For personalized, unbiased guidance, Iowa's SHIIP (Senior Health Insurance Information Program) has trained counselors who can sit down with you at no cost and walk through your options. You can also call 1-800-MEDICARE (1-800-633-4227), which is staffed 24/7.

A quick word on scam-proofing your AEP

The weeks before Dec. 7 are also peak season for aggressive sales calls, misleading TV ads and door-knockers. Medicare will not call, text or come to your door to sell you a plan. If someone pressures you to decide today, that's your cue to hang up and call SHIIP or 1-800-MEDICARE instead.