Medicare 2026

Your Portland Medicare Checklist Before December 7

PORTLAND, Maine — The clock is ticking on Medicare's Annual Enrollment Period. From now through December 7, people with Medicare can review their coverage and make changes that will take effect January 1, 2027. Miss the date, and most of your options close until next fall.

Here's what Portland-area readers can actually do during this window — and why 2027 brings some real reasons to look twice at your drug coverage.

What you can actually do between now and December 7

The Annual Enrollment Period (AEP) is the one time of year almost everyone with Medicare can make changes. During this window, you can:

• Switch from Original Medicare to a Medicare Advantage plan, or the other way around.
• Change from one Medicare Advantage plan to another.
• Join, drop, or switch a stand-alone Part D prescription drug plan.
• Return to Original Medicare and pick up a Part D plan.

Whichever change you make, coverage starts January 1, 2027. After December 7, your choices narrow sharply — people already in a Medicare Advantage plan get one more chance to switch during the Medicare Advantage Open Enrollment Period (January 1 – March 31), but Part D changes generally have to wait.

Why 2027 is worth a fresh look

Even if you like your current coverage, the rules underneath Part D are still shifting. A few things to know:

• The out-of-pocket cap. Your out-of-pocket spending on covered Part D drugs is capped at $2,100 in 2026 and $2,400 in 2027. Once you hit it, you pay nothing for covered prescriptions the rest of the year.
• The deductible ceiling. No Part D plan can charge a deductible higher than $615 in 2026 or $700 in 2027.
• No more donut hole. The old coverage gap was eliminated in 2025, so Part D now moves through three phases instead of four.
• Monthly smoothing. The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly payments instead of paying a big bill at the pharmacy counter. It's optional, and you can ask your plan to enroll you.

If you take expensive medications, these changes can affect how you compare plans for 2027 versus what you have now.

A Portland-specific note on availability

Medicare plan choices aren't set city-by-city. Portland sits in Cumberland County, and that's the level at which Medicare Advantage and Part D plan availability is determined. When you use the Plan Finder at medicare.gov, you'll enter your ZIP code, and it will show you every plan available in your county.

That matters because a neighbor across the state line — or even across the county line in York or Sagadahoc — may see a different lineup than you do.

Read your Annual Notice of Change

If you're already in a Medicare Advantage or Part D plan, you should have received an Annual Notice of Change (ANOC) by late September. This letter spells out what's different about your plan for 2027 — premiums, copays, the drug list (formulary), the pharmacy network, and which doctors and hospitals are in-network.

Even small changes can add up. A drug moving to a higher pricing tier, or a pharmacy leaving the network, can quietly reshape what you pay in 2027. If you can't find your ANOC, call your plan and ask for it.

Watch for higher-income surcharges

If your income is above $109,000 as a single filer (or $218,000 filing jointly) based on your 2024 tax return, you'll pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of your standard Part B and Part D premiums in 2026. Social Security notifies you by mail. If your income has dropped due to a life event — retirement, loss of a spouse, divorce — you can appeal.

Where to get unbiased help in Maine

You don't have to figure this out alone, and you don't have to talk to a salesperson to get answers.

• Medicare Plan Finder at medicare.gov lets you compare plans in Cumberland County side by side, using your own drug list.
• 1-800-MEDICARE (1-800-633-4227) is open 24/7.
• Maine's SHIP — the State Health Insurance Assistance Program — offers free, one-on-one counseling from trained volunteers who don't sell insurance. You can reach them through the Maine Bureau of Insurance or by calling 1-877-353-3771.