Medicare 2026

CLAIM and licensed agents: Medicare help in University City

If you live in University City and Medicare has you feeling turned around, you are not alone. Between mailers, TV ads, and phone calls, it is hard to know who is actually on your side. The good news: there are two solid places to start locally — Missouri's State Health Insurance Assistance Program (SHIP), called CLAIM here, and licensed insurance agencies that work with Medicare plans. Each has a different role, and knowing the difference can save you a lot of stress.

Straight answers, close to home

University City sits in St. Louis County, which is home to nearly 190,000 people age 65 and over. That means there are plenty of neighbors asking the same questions you are — and plenty of help to go around.

Start with CLAIM, Missouri's SHIP

SHIP stands for State Health Insurance Assistance Program. Every state has one, and Missouri's is called CLAIM (Community Leaders Assisting the Insured of Missouri). SHIP counselors are trained volunteers and staff who give free, unbiased, one-on-one help with Medicare. They do not sell insurance and they do not earn commissions.

CLAIM can help you:

• Understand the difference between Original Medicare, Medicare Advantage, Medigap, and Part D drug plans.
• Compare your current coverage during Open Enrollment.
• Check if you qualify for programs that help pay premiums or drug costs, like Extra Help or a Medicare Savings Program.
• Sort out a billing problem or an appeal.

You can reach CLAIM at 1-800-390-3330 or visit missouriclaim.org to find a counselor near University City. Appointments fill up fast between October 15 and December 7, so call early if you can.

When a licensed agent makes sense

Licensed insurance agents and agencies also help people pick Medicare plans — and their help is usually free to you because they are paid by insurance companies. A good agent can walk you through the plans they are appointed to sell, check whether your doctors and prescriptions are covered, and handle the paperwork.

A few things to keep in mind:

• Agents can only discuss the plans and carriers they are contracted with. That means no single agent sees every option on the market.
• Before any sales meeting, an agent should have you sign a Scope of Appointment form. That is a normal CMS requirement, not a red flag.
• You are never obligated to enroll. If you feel pressured, walk away.

If you prefer to shop on your own, medicare.gov/plan-compare shows every plan available in your ZIP code, side by side.

What the local landscape looks like

St. Louis County had 80 Medicare Advantage plans available for 2026, offered by 11 carriers. That is a lot to sort through, which is exactly why free help matters. The 2027 lineup shows up in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. Stand-alone Part D drug plans are sold statewide rather than by county, so you will see those options through Plan Finder or your SHIP counselor as well.

Availability and details change every year, so it is worth a fresh look each fall — even if you liked your plan last year.

Key program numbers worth knowing

Whether you talk to CLAIM, an agent, or Medicare directly, these program-level figures for 2026 are useful to have in your back pocket:

• $2,100 in 2026 and $2,400 in 2027 — the annual out-of-pocket cap on Part D prescription drug costs.
• $615 in 2026 and $700 in 2027 — the maximum Part D deductible a plan can charge.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three payment phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs over monthly installments instead of paying at the pharmacy counter.
• IRMAA surcharges on Part B and Part D premiums begin above $109,000 in income for a single filer in 2026.

Deadlines to circle

• October 15 – December 7, 2026: Annual Enrollment Period. Join, switch, or drop a Medicare Advantage or Part D plan for 2027.
• January 1 – March 31: Medicare Advantage Open Enrollment. If you are already in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare.

Miss a deadline and you may have to wait a full year, so put these on the calendar.