Medicare 2026

The Bellevue fork at 65: Medigap or Medicare Advantage

Bellevue, Neb. — If you're getting close to 65 in Bellevue, you'll quickly hit a fork in the road. Do you pair Original Medicare with a Medigap policy, or do you go with a Medicare Advantage plan? Both are legitimate paths, but they're built very differently — and understanding how they're put together is more useful than any ranking or ad.

The two structures, side by side

Original Medicare is the traditional, government-run program. Part A covers hospital stays, and Part B covers doctor visits and outpatient care. You can see any provider in the country who accepts Medicare, and there's no network. But Original Medicare doesn't cap what you pay out of pocket in a year, and it doesn't include drug coverage.

That's why most people on Original Medicare add two things:

• A Medigap (Medicare Supplement) policy from a private insurer, which pays some or most of the deductibles and coinsurance Original Medicare leaves behind.
• A stand-alone Part D plan for prescriptions.

Medicare Advantage takes a different approach. A private insurer, approved by Medicare, delivers your Part A and Part B benefits — and almost always your Part D drug coverage — in one bundled plan. These plans typically use networks (HMO or PPO), require referrals or prior authorization for some services, and set their own copays. In exchange, they cap your yearly out-of-pocket costs for medical care and often include extras like dental, vision, or hearing.

What that means day to day

With Original Medicare + Medigap, your card gets you in the door at nearly any doctor or hospital nationwide that takes Medicare. Your monthly costs are more predictable (Part B premium, Medigap premium, Part D premium), and your bills after care tend to be small or nothing. The trade-off: you're paying more in premiums up front, and you manage a few separate pieces.

With Medicare Advantage, premiums are often lower, and everything is packaged together. The trade-off: you generally need to stay in-network, some services require the plan's approval before you get them, and your costs at the point of care can vary more.

Neither structure is "better." They're built for different priorities.

A Bellevue snapshot

Bellevue is in Sarpy County, where Medicare beneficiaries can choose from a range of Medicare Advantage and stand-alone Part D plans offered by multiple carriers each year. Plan availability, networks, and formularies are set at the county level and can change every year, so it's worth checking during the fall Annual Enrollment Period even if you're happy with what you have.

You can see the current list for your ZIP code using the Plan Finder at medicare.gov.

2027 rules that apply to everyone

A few program-level facts affect both paths:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your drug spending hits that amount, you pay nothing more for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that lets you spread your drug costs across the year in monthly payments instead of paying at the pharmacy counter.
• IRMAA surcharges on Part B and Part D begin above $109,000 in income for a single filer (2026).

Timing and the Medigap catch

If you're new to Medicare, pay close attention to your Medigap Open Enrollment Period — the six months that start when you're 65 and enrolled in Part B. During that window, insurers must sell you a Medigap policy at their standard rate regardless of your health. If you try to buy Medigap later, in most states, insurers can look at your health history and can decline you or charge more. That's a structural reason people think carefully before starting on Medicare Advantage and later trying to switch.

Once you're enrolled, you can review and change your Medicare Advantage or Part D coverage during the Annual Enrollment Period (Oct. 15 – Dec. 7). If you're already in a Medicare Advantage plan, you get one more window — Jan. 1 – March 31 — to switch to another Advantage plan or go back to Original Medicare.

How to think it through

A few honest questions help more than any ranking:

• Do you travel often, or split time between states? Original Medicare's nationwide access matters more.
• Do you want the lowest possible surprise bills, and are you willing to pay more in premiums to get there? That points toward Medigap.
• Do you prefer one card, one plan, and extras like dental or vision bundled in? That's Medicare Advantage's design.
• Are your doctors and hospitals in a given Advantage plan's network? Always check before enrolling.

For personalized help, Nebraska's SHIP (State Health Insurance Assistance Program) offers free, unbiased counseling. You can also call 1-800-MEDICARE or visit medicare.gov.