Medicare 2026

West Linn's Medicare AEP checklist before Dec. 7

West Linn, Ore. — From October 15 through December 7, people with Medicare across West Linn can review, switch, or drop coverage for the plan year that begins January 1, 2027. It is the one window every fall when nearly every Medicare choice is on the table, and the changes you make now are the ones you will live with next year.

This fall that decision comes with some real shifts worth understanding before you click "enroll" — including another change to the cap on what you pay out of pocket for prescription drugs.

What you can actually do between Oct. 15 and Dec. 7

The Annual Enrollment Period (AEP) is broad. During this window you can:

• Switch from Original Medicare to a Medicare Advantage plan, or the other way around.
• Change from one Medicare Advantage plan to another.
• Join, drop, or switch a stand-alone Part D prescription drug plan.
• Return to Original Medicare and pick up a Part D plan separately.

Whatever you choose takes effect January 1, 2027. According to CMS, if you make more than one change during AEP, the last choice you submit by December 7 is the one that counts.

Why 2027 is not a "set it and forget it" year

Two program-level changes are worth putting on your radar.

First, the Part D out-of-pocket maximum drops to $2,100 for 2026. Once your covered drug costs reach that amount, you pay $0 for covered prescriptions the rest of the year. The Part D deductible also cannot exceed $615.

Second, the old "donut hole" coverage gap is gone. Starting in 2025, Part D has three phases instead of four — deductible, initial coverage, and catastrophic — and that structure carries into 2027.

If prescriptions are a big part of your budget, you can also opt into the Medicare Prescription Payment Plan, which spreads your out-of-pocket drug costs across monthly payments instead of hitting you all at once at the pharmacy counter.

Read your Annual Notice of Change first

By late September, your current Medicare Advantage or Part D plan should have sent you an Annual Notice of Change (ANOC). It spells out what will be different in 2027 — premiums, copays, the drug formulary, the pharmacy and provider networks, and extra benefits.

Before shopping anything else, check three things in your ANOC:

1. Are your regular prescriptions still covered, and in the same tier? 2. Are your doctors and preferred hospitals still in network? 3. Did the premium, deductible, or copays move in a direction that matters to you?

West Linn is in Clackamas County, where the mix of Medicare Advantage and Part D plans available can shift year to year. A plan that fit in 2026 may not fit in 2027 — and vice versa. The 2027 lineup is spelled out in each plan's ANOC and on Medicare.gov's Plan Finder.

A quick income check: IRMAA

If your income is higher, you may pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of standard Part B and Part D premiums. For 2026, IRMAA surcharges begin above $109,000 in income for a single filer (higher thresholds apply for joint filers). Social Security uses your tax return from two years ago to set this, so a big income year in 2024 can affect your 2026 premiums.

How to compare without getting overwhelmed

The most neutral tool is the Plan Finder at Medicare.gov. You enter your ZIP code and your prescriptions, and it shows estimated yearly costs across plans available in Clackamas County. A few tips:

• Enter every drug, including the exact dose and quantity.
• List the pharmacies you actually use — cost-sharing can vary by pharmacy.
• Look at total estimated annual cost, not just the monthly premium.

Star Ratings, published by CMS on a 1-to-5 scale, can also help you gauge member experience and plan performance. They are one data point, not a verdict.

For one-on-one help at no cost, Oregonians can call SHIBA (Senior Health Insurance Benefits Assistance), Oregon's State Health Insurance Assistance Program, or reach 1-800-MEDICARE directly.

If December 7 sneaks past you

You still have options, just fewer of them. From January 1 through March 31, the Medicare Advantage Open Enrollment Period lets people already in a Medicare Advantage plan switch to a different Advantage plan or return to Original Medicare (and add Part D). It does not let someone on Original Medicare jump into an Advantage plan for the first time. Special Enrollment Periods may also apply if you move, lose other coverage, or qualify for Extra Help.