Medicare 2026

Turning 65 in Everett? Your Medicare Enrollment Playbook

Turning 65 in Everett is a milestone — and it comes with a Medicare deadline you don't want to miss. Your Initial Enrollment Period (IEP) is a seven-month window built around your 65th birthday, and the choices you make during it can shape your coverage and costs for years. Here's how to walk through it calmly, step by step.

Step 1: Know your seven-month window

Your Initial Enrollment Period is seven months long. It starts three months before the month you turn 65, includes your birthday month, and ends three months after. If you sign up in the first three months, your Medicare coverage can start on the first day of your birthday month. Wait until later, and your start date is pushed back.

If you're already getting Social Security benefits when you turn 65, you'll be enrolled in Part A and Part B automatically. If you're not, you'll need to sign up yourself through the Social Security Administration at ssa.gov or by calling 1-800-772-1213.

Step 2: Understand the parts of Medicare

Medicare has a few moving pieces, and it helps to know what each one does before you make a choice:

• Part A covers hospital stays, skilled nursing, and some home health care. Most people pay no premium for Part A.
• Part B covers doctor visits, outpatient care, and preventive services. It has a monthly premium.
• Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare, offered by private insurers.
• Part D covers prescription drugs, either as a stand-alone plan or built into a Medicare Advantage plan.
• Medigap (Medicare Supplement) helps pay some of the out-of-pocket costs of Original Medicare.

You'll generally choose one path: Original Medicare (often paired with a Medigap policy and a stand-alone Part D plan) or a Medicare Advantage plan. Both are valid — the right fit depends on your doctors, medications, and budget.

Step 3: Look at what's available around Everett

Everett is in Middlesex County, where Medicare Advantage and Part D plan availability is set at the county level. That means every Everett resident sees the same menu of plans as neighbors in Malden, Medford, and Cambridge. When you're ready to compare, the plan finder at medicare.gov lets you filter by ZIP code, enter your prescriptions, and see which plans include your doctors.

Because plan details change every year, it's worth reviewing options during the Annual Enrollment Period (October 15 – December 7) even after you're settled in.

Step 4: Know the 2027 drug coverage rules

Part D got simpler in recent years. For 2027:

• Your out-of-pocket spending on covered drugs is capped at $2,400 for the year.
• The plan deductible can't be higher than $700.
• The old "donut hole" coverage gap is eliminated — there are now three phases instead of four.
• You can opt into the Medicare Prescription Payment Plan, which spreads your drug costs into monthly payments instead of paying a large amount at the pharmacy counter.

If your income is above $109,000 as a single filer (based on your tax return from two years ago), you may pay an IRMAA surcharge on top of your Part B and Part D premiums.

Step 5: Don't skip enrollment — the penalties last

If you don't sign up for Part B when you're first eligible and you don't have other qualifying coverage (like from a current employer), you can face a late enrollment penalty that lasts as long as you have Medicare. The same goes for Part D if you go 63 days or more without creditable drug coverage. This is one of the most common — and costly — mistakes at 65.

If you're still working and covered by an employer plan, ask your HR department whether that coverage is "creditable" for Medicare purposes before you delay enrollment.

Step 6: Get free, local help before you decide

You don't have to figure this out alone, and you don't have to talk to a salesperson to get answers. In Massachusetts, the SHIP program is called SHINE (Serving the Health Insurance Needs of Everyone). SHINE counselors are trained volunteers who give free, unbiased help. You can reach SHINE by calling 1-800-AGE-INFO (1-800-243-4636) or visiting mass.gov/shine.