Medicare 2026

Medicare's 7-Month Initial Enrollment Window in Happy Valley

HAPPY VALLEY, Ore. — If a 65th birthday is on the horizon at your house, there's one Medicare date to circle before any other: the start of your Initial Enrollment Period. It's a seven-month window built around your birthday month, and using it well can spare you late penalties, coverage gaps, and a lot of second-guessing later.

Turning 65 in Happy Valley: The Enrollment Window That Sets the Tone

Here in Happy Valley — tucked into Clackamas County just southeast of Portland — thousands of neighbors cross this milestone each year. The rules are the same nationwide, but knowing where to turn locally makes the paperwork feel a lot less daunting.

What the Initial Enrollment Period Actually Is

Your Initial Enrollment Period (IEP) is a seven-month stretch:

• The three months before the month you turn 65
• The month you turn 65
• The three months after your birthday month

During this window you can sign up for Medicare Part A (hospital), Part B (medical), and — if you want drug coverage — a Part D plan or a Medicare Advantage plan that includes drugs.

Here's the timing detail people miss: if you enroll before your birthday month, coverage generally starts the first day of your birthday month. If you enroll during or after, coverage can be delayed. Signing up early is almost always the smoother path.

First Steps: What to Do Before You Enroll

A little prep makes the enrollment itself simple:

1. Decide about Part A and Part B. Most people get Part A premium-free based on their (or a spouse's) work history. Part B has a standard monthly premium. 2. Check your current coverage. Still working? Covered by a spouse's employer plan? Retiree coverage? Veterans benefits? Each situation changes what you should do — and when. 3. Think about drug coverage. Even if you don't take prescriptions today, going without "creditable" drug coverage can trigger a lifelong Part D late-enrollment penalty. 4. Look at your income. Higher-income households may owe an IRMAA surcharge on Part B and Part D. For 2026, IRMAA begins above $109,000 for a single filer.

How to Sign Up

You have three ways to enroll in Medicare:

• Online at ssa.gov/medicare
• By phone with Social Security at 1-800-772-1213
• In person at a Social Security office (appointments recommended)

If you're already receiving Social Security benefits before 65, you'll typically be enrolled in Parts A and B automatically. Everyone else needs to sign up.

What's New for 2027 (and Why It Matters at 65)

A few program-level updates 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 on covered drugs, you pay nothing more for covered drugs the rest of the year.
• Part D deductible: up to $615 maximum in 2026, rising to $700 in 2027.
• The old "donut hole" is gone as of 2025 — Part D now has three simpler phases.
• Medicare Prescription Payment Plan: an optional program that lets you spread drug costs across the year in monthly payments instead of paying big amounts at the pharmacy counter.

These are program rules — they apply the same in Happy Valley as anywhere else — but they can shape which type of coverage feels right for you.

The Local Picture in Clackamas County

Happy Valley is in Clackamas County, where Medicare beneficiaries generally have a broad menu of stand-alone Part D plans and Medicare Advantage plans to compare. Plan availability, provider networks, and pharmacy access are set at the county level, so two neighbors on the same street see the same options — but the "right" choice depends on your doctors, your medications, and how you like to get care.

You can compare plans side by side using Medicare's official Plan Finder at medicare.gov/plan-compare.

Where to Get Unbiased Help

You don't have to figure this out alone, and you don't have to talk to a salesperson to get answers.

• SHIBA (Oregon's SHIP): free, unbiased Medicare counseling from trained volunteers. Call 1-800-722-4134 or visit shiba.oregon.gov.
• Medicare: 1-800-MEDICARE (1-800-633-4227), 24/7.
• Social Security: 1-800-772-1213 for enrollment questions.

Key Dates to Remember After You're Enrolled

• Annual Enrollment Period: October 15 – December 7 each year. You can join, switch, or drop Medicare Advantage and Part D plans.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in a Medicare Advantage plan, you get one more chance to change it or return to Original Medicare.