Medicare 2026

What Butte residents can change during Medicare AEP

BUTTE, Mont. — The clock is running on Medicare's biggest decision window of the year. From October 15 through December 7, 2026, people with Medicare can review, switch, or drop coverage for 2027 — and the changes they make now will shape what they pay and which doctors they see starting January 1.

This year's window matters. The Part D out-of-pocket cap rises from $2,100 in 2026 to $2,400 in 2027, and plan sponsors have adjusted formularies, pharmacy networks, and premiums heading into the new year. That makes reading your Annual Notice of Change (ANOC) — the letter your current plan mailed in late September — the single most useful thing you can do this month.

What you can actually do between Oct. 15 and Dec. 7

The Annual Enrollment Period (AEP) is the one time each year almost anyone with Medicare can make coverage changes without needing a special qualifying event. 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 separately.

Whatever you choose takes effect January 1, 2027. If you do nothing, your current plan generally rolls over — but the plan itself may not look the same next year, which is why reading your ANOC matters.

What's new for 2027

A few program-level changes are worth knowing before you compare plans:

• $2,400 Part D cap. Once your out-of-pocket spending on covered drugs hits $2,400 in 2027, you pay nothing for covered prescriptions the rest of the year.
• $700 Part D deductible ceiling. No stand-alone or Advantage-included Part D plan can charge a deductible higher than $700 in 2027.
• No more donut hole. The old coverage-gap phase was eliminated in 2025, leaving three simpler phases: deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan. This optional program lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.
• IRMAA thresholds. Higher-income beneficiaries pay extra for Parts B and D. In 2026, these surcharges begin above $109,000 in income for a single filer.

How to compare coverage without getting overwhelmed

You don't have to read every plan brochure in the mail. A short checklist covers most of what matters:

1. Pull your ANOC. It shows what's changing in your current plan — premium, drugs covered, network, cost-sharing. 2. List your prescriptions. Include dose and frequency. Formularies change every year. 3. List your doctors and preferred pharmacies. Networks change too. 4. Use the Plan Finder at medicare.gov. You can enter your drugs and pharmacy and see 2027 plans side by side. 5. Confirm the ZIP code. Butte is in Silver Bow County, where Medicare plan availability is determined at the county level. Always verify a plan serves your specific address.

Where to get free, unbiased help in Butte

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

• Montana SHIP (State Health Insurance Assistance Program): Free one-on-one counseling from trained volunteers with no ties to any insurer. Call 1-800-551-3191.
• Medicare.gov: The official Plan Finder, drug pricing tool, and enrollment portal.
• 1-800-MEDICARE (1-800-633-4227): Available 24/7, including help in Spanish and other languages.
• Area Agency on Aging: Local staff who often work alongside SHIP counselors.

What happens if you miss December 7

If December 7 passes and you didn't make a change, your current coverage generally continues into 2027 with whatever adjustments your plan spelled out in the ANOC. But your next chance to switch is limited:

• Medicare Advantage Open Enrollment (Jan. 1 – March 31, 2027): If you're already in a Medicare Advantage plan, you can switch to a different Advantage plan once, or drop back to Original Medicare and add a Part D plan.
• Special Enrollment Periods: Certain life events — moving, losing other coverage, qualifying for Extra Help — can open a shorter window outside AEP.

Original Medicare enrollees who want to add a Part D plan for the first time generally can't do so again until the next AEP, so it's worth acting now if drug coverage is on your mind.