Medicare 2026

Pennsylvania SHIP and Licensed Agents for Pottstown Medicare

POTTSTOWN, Pa. — If you live in the Pottstown area and Medicare is making your head spin, you are not alone. Between mailers, TV ads, and phone calls, it can feel like everyone is trying to sell you something. The good news: there are places right here in Pennsylvania where you can get straight answers — some free, some from licensed agents — without pressure.

Here is a plain-language guide to who does what, and how to find help you can trust.

Start With PA MEDI — Pennsylvania's SHIP

Every state has a State Health Insurance Assistance Program (SHIP). In Pennsylvania, it is called PA MEDI (Pennsylvania Medicare Education and Decision Insight).

PA MEDI counselors are trained volunteers and staff who do not sell insurance. They do not earn commissions. Their only job is to help you understand your Medicare choices and make a decision that fits your life.

They can help you:

• Compare Original Medicare, Medicare Advantage, and Part D drug plans
• Understand what Medigap (Medicare Supplement) policies do
• Apply for programs that help pay Medicare costs, like Extra Help or a Medicare Savings Program
• Sort out billing problems, denials, or appeals
• Review a plan's coverage before you enroll

How to reach PA MEDI: Call 1-800-783-7067, Monday through Friday. You can also visit aging.pa.gov and search for "PA MEDI" to find your local counselor. In Pottstown, services are coordinated through the Montgomery County Office of Senior Services.

When a Licensed Agent Makes Sense

Licensed insurance agents and brokers can also help you enroll in Medicare Advantage, Part D, or Medigap plans. Unlike PA MEDI, agents are paid by the insurance companies whose plans they sell.

That is not a bad thing — many agents are knowledgeable and helpful — but it does mean you should ask a few questions before you sit down with one:

• Which carriers do you represent? An "independent" agent works with several companies. A "captive" agent works with just one.
• Are you licensed in Pennsylvania? You can verify this at the Pennsylvania Insurance Department website.
• Will you help me later if I have a claim or billing issue? A good agent stays with you after enrollment.

If an agent pressures you to decide on the spot, or tells you a specific plan is "the best," that's a red flag. No single plan is best for everyone.

What the Local Landscape Looks Like

Medicare Advantage and Part D plans are set at the county level. Pottstown sits in Montgomery County, where 91 Medicare Advantage plans were available for 2026, offered by 12 carriers. With more than 163,000 residents age 65 and older in the county, that is a lot of options to sift through — which is exactly why unbiased help matters. The 2027 lineup is listed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder.

Whether you talk to PA MEDI or a licensed agent, ask them to walk you through how each option handles the doctors and hospitals you already use, and the medications you already take.

Numbers Worth Knowing for 2026 and 2027

Before any meeting, it helps to know a few facts that apply nationwide:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your covered drug costs hit that amount, you pay nothing for the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• The old "donut hole" is gone. 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 installments.
• IRMAA (higher Part B and D premiums) starts above $109,000 in income for a single filer.

Key Dates to Circle

• Annual Enrollment Period: October 15 – December 7. This is when most people compare and switch Medicare Advantage or Part D plans.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you are already in a Medicare Advantage plan and want to change or drop it, this window is your second chance.

Missing these dates can lock you into a plan for the year, so mark them now.