Medicare 2026

Two Medicare Structures Easley Residents Can Choose From

EASLEY, S.C. — If you're turning 65 in Easley, or helping a parent sort through the mail piling up before the December 7 deadline, one question tends to sit at the center of everything: should you stick with Original Medicare and add a Medigap policy, or go with a Medicare Advantage plan?

They are two different roads. Both are legitimate. But they are built differently, and understanding that difference upfront can save you a lot of second-guessing later.

Two structures, not two flavors

Original Medicare is the federal program itself — Part A (hospital) and Part B (doctor and outpatient). You can use it with almost any provider in the country that accepts Medicare, and there's no network. It doesn't cover everything, though. There's no cap on your yearly out-of-pocket costs, and it doesn't include prescription drugs.

That's where the add-ons come in. Many people on Original Medicare pair it with a standalone Part D drug plan and a Medigap policy (also called Medicare Supplement Insurance) to help pay the deductibles and coinsurance Medicare leaves behind.

Medicare Advantage (Part C) is a different structure. It's private insurance approved by Medicare that replaces the way you receive your benefits. You still have Medicare, but the plan administers it — usually through a network of doctors and hospitals, often with prescription drug coverage built in, and often with extras like dental or vision. Advantage plans must have a yearly out-of-pocket maximum for medical care.

What Medigap does — and what it doesn't

Medigap only works alongside Original Medicare. It cannot be used with a Medicare Advantage plan. Its job is to fill in the "gaps" — the Part A deductible, Part B coinsurance, and so on, depending on which lettered plan you pick (Plan G and Plan N are common examples).

One important timing point: when you first enroll in Part B at 65, you have a six-month Medigap Open Enrollment window where insurers must sell you a policy regardless of your health. Miss that window, and in most states — South Carolina included — insurers can use medical underwriting. That's a detail worth understanding before you make your first move.

What Medicare Advantage does differently

Advantage plans bundle your coverage. Most include Part D drug coverage, which means one card, one plan, one set of rules. In return, you generally agree to use the plan's network and follow its referral or prior authorization rules.

Easley is in Pickens County, where residents typically have a range of Medicare Advantage plans and standalone Part D plans available during Annual Enrollment. Availability is set at the county level, so a plan offered in Pickens County may not be offered a county over. You can see the 2027 options for your ZIP code using the Plan Finder at medicare.gov once the new lineup is loaded, and your current plan's ANOC will describe any changes for next year.

2026 and 2027 numbers worth knowing

A few program-level changes affect both paths:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your drug spending hits that ceiling, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 for 2026 and $700 for 2027.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that lets you spread your drug costs across the calendar year in monthly payments instead of paying at the pharmacy counter.
• IRMAA: higher-income beneficiaries pay a surcharge on Part B and Part D premiums. In 2026, that begins above $109,000 in income for a single filer.

These rules apply whether you choose Original Medicare with a Part D plan or a Medicare Advantage plan that includes drug coverage.

Deadlines to circle

• Annual Enrollment Period: October 15 – December 7. This is when anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in an Advantage plan, you get one chance to switch to a different Advantage plan or return to Original Medicare.

Switching from Medicare Advantage back to Original Medicare and then buying a Medigap policy is where people sometimes get surprised — outside your initial Medigap window, insurers may underwrite. If that path matters to you, it's worth asking questions before you commit.