Medicare 2026

Turning 65 in Franklin Township? Don't Miss This Window

# Turning 65 in Franklin Township? Don't Miss This…

FRANKLIN TOWNSHIP, N.J. — If a 65th birthday is on the calendar this year, so is one of the most important deadlines of your adult life: your Initial Enrollment Period for Medicare. Miss it, and you could face lifelong late-enrollment penalties and a gap in coverage. Hit it, and the transition from working-age insurance to Medicare can be surprisingly smooth.

Here's what Franklin Township residents need to know to get started on the right foot.

What the Initial Enrollment Period actually is

Your IEP is a seven-month window built around your 65th birthday. It includes the three months before your birthday month, your birthday month, and the three months after. For example, if you turn 65 in June, your IEP runs from March 1 through September 30.

This is when you can first sign up for Medicare Part A (hospital) and Part B (medical) without a late penalty. You can also join a Medicare Advantage plan (Part C) or a stand-alone Part D drug plan during this same window, if you want that kind of coverage.

Signing up in the three months before your birthday month is the smart move — it lets your coverage start the first day of your birthday month, with no gap.

First steps for Franklin Township residents

Before your IEP begins, take a little time to get organized. Here's a simple checklist:

1. Check whether you'll be enrolled automatically. If you're already collecting Social Security benefits, you'll usually be signed up for Parts A and B automatically, and your red, white and blue Medicare card will arrive in the mail about three months before you turn 65. 2. If you're not on Social Security yet, you must sign up yourself through the Social Security Administration at ssa.gov or by calling 1-800-772-1213. 3. Look at your current coverage. If you or your spouse is still working and covered by a large employer's group health plan, you may be able to delay Part B without penalty. Check with your HR department in writing. 4. Make a list of your prescriptions, doctors and preferred hospitals. You'll need these when comparing drug or Medicare Advantage plans.

Understanding your choices

Once you have Original Medicare (Parts A and B), you have a decision to make. Broadly speaking, people choose between two paths:

• Original Medicare, often paired with a stand-alone Part D drug plan and, for many people, a Medigap (supplement) policy that helps with out-of-pocket costs.
• A Medicare Advantage plan (Part C), which is an all-in-one alternative offered by private insurers approved by Medicare. These plans usually include drug coverage and may include extras.

Franklin Township is in Somerset County, where residents typically have a wide range of Medicare Advantage and Part D plans to compare. Availability and specifics are set at the county level, so what your neighbor in another town enrolled in may not be identical to what's offered here.

Neither path is "better" in the abstract — the right choice depends on your health, your prescriptions, your doctors, your budget, and how you like to handle paperwork.

Watch these numbers for 2026 and 2027

A few program-wide figures are worth knowing as you plan:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once you hit that ceiling in covered drug costs, you pay nothing more for covered drugs for the rest of the calendar year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• The coverage gap (or "donut hole") is gone as of 2025. Part D now has three payment phases instead of four.
• Medicare Prescription Payment Plan: an optional program that lets you spread your yearly drug costs across monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA: higher-income beneficiaries pay an income-related surcharge on Part B and Part D premiums. For a single filer in 2026, this begins above $109,000 in income (based on your tax return from two years earlier).

What happens if you miss your window

If you don't enroll in Part B during your IEP and don't qualify for a Special Enrollment Period (for example, because you had employer coverage), you may have to wait for the General Enrollment Period (January 1 – March 31) and could owe a lifetime Part B late penalty. Part D has its own late-enrollment penalty as well.

After your IEP, you'll hear about two other windows every year:

• Annual Enrollment Period: October 15 – December 7, when you can change your Medicare Advantage or Part D plan.
• Medicare Advantage Open Enrollment: January 1 – March 31, when people already in a Medicare Advantage plan can switch once.

Where to get unbiased help

You don't have to figure this out alone, and you don't have to buy anything to get answers. Free, unbiased help is available:

• medicare.gov — the official site, with a plan-finder tool.
• 1-800-MEDICARE (1-800-633-4227) — 24/7 phone help.
• SHIP-NJ, New Jersey's State Health Insurance Assistance Program, offers one-on-one counseling from trained volunteers. In Somerset County, you can reach SHIP through the county Office on Aging.