Medicare 2026

The Dec. 7 Medicare deadline facing Lafayette shoppers

LAFAYETTE, La. — Every fall, Medicare shoppers in Acadiana wrestle with the same fork in the road: stick with Original Medicare and add a Medigap policy, or move to a Medicare Advantage plan. The two paths are built very differently, and understanding that structure — before the Annual Enrollment Period closes Dec. 7 — is the single most useful thing you can do for yourself this season.

Two different structures, not two versions of the same thing

Original Medicare is the traditional, federally run program. Part A covers hospital stays and Part B covers doctor visits and outpatient care. You can go to almost any doctor or hospital in the country that accepts Medicare, and there is no network.

Medicare Advantage, sometimes called Part C, is offered by private insurance companies approved by Medicare. When you enroll in an Advantage plan, you still have Medicare — but the plan takes over how your Part A and Part B benefits are delivered. Most Advantage plans use provider networks (HMO or PPO), and most include Part D drug coverage and extras like dental or vision built in.

That is the core structural difference. One is a government program you can add pieces to. The other is a private plan that bundles the pieces for you.

Where Medigap fits in

Medigap — also called Medicare Supplement Insurance — is sold by private insurers, but it is only designed to work with Original Medicare. It helps pay some of the out-of-pocket costs Original Medicare leaves behind, like coinsurance and deductibles.

Two things trip people up:

• You cannot use Medigap with a Medicare Advantage plan. It is one path or the other.
• Medigap does not include drug coverage. If you choose Original Medicare + Medigap, you typically add a stand-alone Part D plan for prescriptions.

There is also a timing issue worth knowing. In most states, you have a one-time federal Medigap open enrollment window when you first sign up for Part B. Outside that window, insurers in many states can use medical underwriting, meaning your health history can affect whether you qualify or what you pay. Louisiana rules can differ, so this is a good question for the state SHIP counselor (see below).

How you pay is different, too

With Original Medicare + Medigap + a Part D plan, you generally pay:

• Your Part B premium
• A Medigap premium
• A Part D premium

In return, your costs at the point of care are more predictable, because Medigap picks up much of what Medicare does not.

With Medicare Advantage, you still pay your Part B premium, plus whatever the Advantage plan charges. Costs at the doctor or hospital come as copays and coinsurance up to the plan's annual out-of-pocket maximum. The tradeoff is often a lower monthly cost in exchange for paying more as you use services, and staying inside a network.

Neither structure is automatically cheaper. It depends on your health, the providers you want to see, and the drugs you take.

2027 rules that apply either way

A few program-level facts from Medicare apply no matter which path you choose:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your drug spending hits that ceiling, you pay $0 for covered drugs the rest of the year.
• The Part D deductible can be no higher than $615 in 2026.
• The old coverage gap (“donut hole”) is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges on Part B and Part D begin above $109,000 in income for a single filer in 2026.

What Lafayette shoppers should check locally

Lafayette is in Lafayette Parish, where Medicare beneficiaries typically have a wide range of Medicare Advantage and stand-alone Part D plans to compare. The exact number changes every year, and CMS publishes it in the official Medicare Plan Finder at medicare.gov.

Because Advantage plans use networks, the most important local question is not how many plans exist — it is which plans include your doctors, your preferred hospital system in Acadiana, and your regular pharmacy. With Original Medicare, that question largely goes away, but you take on the Medigap and Part D shopping instead.

Deadlines to keep on the fridge

• Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan for coverage starting Jan. 1.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment. If you are already in an Advantage plan, you get one chance to switch to a different Advantage plan or return to Original Medicare (and pick up a Part D plan).

Missing these windows usually means waiting a full year, unless you qualify for a Special Enrollment Period.