Medicare 2026
Two Ways to Cover Medicare Gaps: Which Path Fits You?
South Brunswick, N.J. — If you're turning 65 soon or helping a parent sort through mail from Medicare, you've probably noticed the choice comes down to two very different structures. One path pairs Original Medicare with a Medigap policy (and usually a separate Part D drug plan). The other bundles your coverage into a single Medicare Advantage plan. They cover the same person, but they work in almost opposite ways — and the difference matters more than the brochures suggest.
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Key takeaways
- Original Medicare plus a Medigap plan uses one federal network and predictable cost-sharing; Medicare Advantage bundles hospital, medical, and usually drug coverage through a private plan with its own network.
- Medigap can be easier to buy during your one-time 6-month Medigap Open Enrollment Period, which starts when you're 65 and enrolled in Part B.
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and the maximum Part D deductible is $615 in 2026 and $700 in 2027. The old coverage gap is gone.
- The Annual Enrollment Period runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31.
South Brunswick is in Middlesex County, where residents pick from a range of Medicare Advantage and Part D options each fall. But before you compare plan names, it helps to understand how the two structures behave.
Two different structures, not just two different prices
Original Medicare is the traditional federal program: Part A covers hospital stays, Part B covers doctors and outpatient care. You can see any provider in the U.S. who accepts Medicare, and there's no network. But Original Medicare alone has no annual out-of-pocket limit, which is why many people add a Medigap policy.
Medicare Advantage (Part C) is different. Private insurers, approved by Medicare, take over your Part A and Part B coverage and typically fold in Part D drug coverage plus extras. These plans usually have networks (HMO or PPO), require referrals or prior authorization for some services, and set their own yearly out-of-pocket maximum.
What Medigap does — and what it doesn't
A Medigap (Medicare Supplement) policy pays some of the costs Original Medicare leaves behind — things like the Part A deductible or the 20% coinsurance under Part B. Medigap does not include drug coverage, so most people who choose this path also enroll in a stand-alone Part D plan.
One important rule: your best window to buy Medigap is the 6-month Medigap Open Enrollment Period that starts the month you're 65 and enrolled in Part B. During that window, insurers can't turn you down or charge more for health reasons. Outside of it, in most states, they can.
How Medicare Advantage bundles things together
With Medicare Advantage, you still have Medicare — but the plan administers it. That means one card, one set of rules, and one out-of-pocket maximum for the year. Many plans include dental, vision, hearing, or fitness benefits that Original Medicare doesn't cover.
The trade-off is the network. If your doctor or preferred hospital isn't in the plan, you may pay more or not be covered at all outside emergencies. Prior authorization is more common. And plans can change each year, so the coverage you have in January may look different next January.
The Part D drug coverage picture for 2027
Whichever path you choose, Part D matters. The annual out-of-pocket cap for covered drugs is $2,100 in 2026 and $2,400 in 2027, and the maximum Part D deductible is $615 in 2026 and $700 in 2027. The old "donut hole" coverage gap was eliminated in 2025, so Part D now has three phases instead of four. There's also the Medicare Prescription Payment Plan, which lets you spread your drug costs across the year in monthly installments instead of paying at the pharmacy counter.
Higher-income beneficiaries pay IRMAA surcharges on Part B and Part D. In 2026, those surcharges start above $109,000 in income for a single filer.
Key dates to remember
The Annual Enrollment Period runs Oct. 15 through Dec. 7, 2026. That's when you can join, switch, or drop a Medicare Advantage or Part D plan for 2027. If you're already in a Medicare Advantage plan, you get a second window — the Medicare Advantage Open Enrollment Period, Jan. 1 through March 31, 2027 — to switch to a different Advantage plan or return to Original Medicare.
Where to get personal help
Plan availability, doctor networks, and drug formularies are personal decisions, and no article should be the last word. For unbiased help in South Brunswick, you can:
- Visit medicare.gov to compare plans available in Middlesex County.
- Call 1-800-MEDICARE (1-800-633-4227), available 24/7.
- Contact New Jersey's State Health Insurance Assistance Program (SHIP), known locally as SHIP/NJ, for free one-on-one counseling.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Middlesex County
(MA penetration in Middlesex County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
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The parts of Medicare
Good to know
Frequently asked questions
Can I switch from Medicare Advantage back to Original Medicare with a Medigap plan?
Do I need a separate drug plan with Medicare Advantage?
What is the $2,100 Part D cap I've been hearing about?
Where can I get help comparing options in South Brunswick?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for South Brunswick
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This page was last updated: September 29, 2026.