Medicare 2026

What the Medicare Enrollment Window Covers in Central Point

# Turning 65 in Central Point? Your first Medicare decisions, step by…

CENTRAL POINT, Ore. — If your 65th birthday is on the horizon, you're about to make a set of decisions that will shape your health coverage for years. The good news: Medicare's rules for new enrollees are the same across the country, and once you understand the timeline, the first steps are pretty manageable.

Here's what to know if you live in Central Point and you're approaching that milestone.

Your seven-month window

Medicare calls it the Initial Enrollment Period, or IEP. It runs for seven months total: the three months before the month you turn 65, your birthday month itself, and the three months after.

That means if your birthday is in June, your IEP starts March 1 and ends September 30. Signing up in the first three months usually gives you the smoothest start, because your coverage can begin on the first day of your birthday month.

Wait until your birthday month or later, and your coverage start date gets pushed back. That delay is one of the most common — and most avoidable — mistakes new enrollees make.

Are you enrolled automatically?

If you're already collecting Social Security benefits before you turn 65, you'll typically be enrolled in Part A (hospital) and Part B (medical) automatically. Your red, white and blue Medicare card should arrive in the mail about three months before your birthday.

If you're not yet drawing Social Security — which is more common now that full retirement age is 67 — you need to sign up yourself through the Social Security Administration at ssa.gov or by calling 1-800-772-1213.

If you're still working at 65 and have solid coverage through a large employer, you may be able to delay Part B without a penalty. Check with your HR department and Medicare before you make that call, because the rules depend on the size of the employer.

The Part A / Part B / Part D basics

Original Medicare has two parts:

• Part A covers hospital stays, skilled nursing, hospice, and some home health. Most people pay no premium because they or a spouse paid Medicare taxes while working.
• Part B covers doctor visits, outpatient care, preventive services, and durable medical equipment. It has a monthly premium set each year by Medicare.

Then there's Part D, which covers prescription drugs. The Part D annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and the maximum deductible a plan can charge is $615 in 2026 and $700 in 2027. The old "donut hole" coverage gap was eliminated in 2025, so Part D now has just three phases.

If drug costs hit hard early in the year, ask about the Medicare Prescription Payment Plan. It lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying big lump sums at the pharmacy counter.

Original Medicare or Medicare Advantage?

At 65, you'll choose between two paths:

1. Original Medicare (Parts A and B), usually paired with a stand-alone Part D drug plan, and often with a Medigap (Medicare Supplement) policy that helps cover deductibles and coinsurance. 2. Medicare Advantage (Part C), a private plan that bundles Parts A, B, and usually D, often with additional benefits and a set network of providers.

Central Point is in Jackson County, where a range of Medicare Advantage and Part D plans are offered by different carriers. Availability, networks, and drug formularies are set at the county level, so what a friend has in Portland or Bend may not be offered here.

Compare plans at medicare.gov's Plan Finder, where you can enter your ZIP code, your prescriptions, and your preferred doctors or pharmacies.

Watch out for IRMAA

If your income is higher than average, you may pay more for Part B and Part D through an added charge called IRMAA (Income-Related Monthly Adjustment Amount). For 2026, IRMAA kicks in when a single filer's income is above $109,000 (the threshold is higher for joint filers). Medicare looks at your tax return from two years earlier to make this decision.

If your income has dropped since then — due to retirement, for example — you can appeal.

Missing the window costs you

Skip your Initial Enrollment Period without other qualifying coverage, and you can face lifelong late-enrollment penalties for Part B and Part D. You'd also likely have to wait for the General Enrollment Period (January 1 – March 31) to sign up, with coverage starting the month after enrollment.

Two other dates worth remembering once you're enrolled:

• Annual Enrollment Period: October 15 – December 7, when anyone with Medicare can switch plans for the following year.
• Medicare Advantage Open Enrollment Period: January 1 – March 31, when people already in an Advantage plan can switch once.

Where to get local help

You don't have to figure this out alone. Free, unbiased counseling is available through Oregon's State Health Insurance Assistance Program (SHIP), known locally as SHIBA (Senior Health Insurance Benefits Assistance). SHIBA counselors don't sell plans and don't earn commissions.

• Medicare: medicare.gov or 1-800-MEDICARE (1-800-633-4227)
• Social Security (to enroll): ssa.gov or 1-800-772-1213
• Oregon SHIBA: 1-800-722-4134