Medicare 2026

Before Your 65th Birthday in Reno: Medicare Steps

RENO, Nev. — If your 65th birthday is on the horizon, a quiet countdown has already started. Medicare gives most people a seven-month Initial Enrollment Period to sign up, and missing it can mean late penalties that stick around for years. Here is what Reno-area readers need to know before that window closes.

The seven-month window, explained

Your Initial Enrollment Period (IEP) is built around your 65th birthday. It begins three months before the month you turn 65, includes your birthday month, and runs three months after. That is seven months total to enroll in Original Medicare — Part A (hospital) and Part B (medical).

If you sign up in the three months before your birthday month, your coverage generally starts on the first day of your birthday month. If you wait until your birthday month or later, your start date gets pushed back.

What if you're still working?

Many people in the Reno area keep working past 65, and that changes the math. If you have qualifying health coverage through a current employer (yours or your spouse's), you may be able to delay Part B without a penalty. When that job-based coverage ends, you get a Special Enrollment Period to sign up.

Retiree coverage, COBRA, and marketplace plans do not count as “qualifying” for this purpose. If you are unsure how your coverage fits, call your benefits administrator before your birthday month.

Part D and the numbers to know for 2027

Prescription drug coverage — Part D — has its own enrollment rules, and skipping it when you first become eligible can also lead to a lifelong penalty if you go 63 days or more without creditable drug coverage.

Medicare has set some program-wide figures worth knowing:

• The Part D out-of-pocket cap is $2,100.
• The Part D maximum deductible is $615.
• The old coverage gap, or “donut hole,” is gone as of 2025; Part D now has three phases.
• A new Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments if you choose.
• Higher-income enrollees pay IRMAA surcharges, which begin above $109,000 in income for single filers in 2026.

Original Medicare or Medicare Advantage?

Once you have Part A and Part B, you have a choice. You can stay with Original Medicare and consider adding a standalone Part D drug plan and possibly a Medigap supplement. Or you can enroll in a Medicare Advantage plan (Part C), which bundles hospital, medical, and usually drug coverage through a private insurer.

Reno is in Washoe County, where multiple Medicare Advantage and Part D plans are offered each year. Availability, networks, and benefits change annually, so it is worth comparing options during enrollment — not just at 65, but every fall.

Key dates after your IEP

Once your Initial Enrollment Period ends, two annual windows matter most:

• Annual Enrollment Period: Oct. 15 – Dec. 7. You can join, switch, or drop a Medicare Advantage or Part D plan.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in an Advantage plan, you can switch once to another Advantage plan or return to Original Medicare.

Mark them on your calendar the same way you mark your birthday.

Where to get unbiased help

You do not have to figure this out alone. Nevada's SHIP (State Health Insurance Assistance Program) offers free, one-on-one counseling with trained volunteers who do not sell insurance. You can also call 1-800-MEDICARE (1-800-633-4227) around the clock, or use the plan finder at medicare.gov.