Medicare 2026

The Medicare Fork in the Road Every Beckley Retiree Faces

When you first sign up for Medicare, you reach a fork in the road. One path keeps you on Original Medicare and lets you add a Medigap policy to help with what Medicare doesn't pay. The other path moves your coverage over to a Medicare Advantage plan, run by a private insurer. Both paths are legitimate. They just work very differently — and in Beckley, where most retirees are weighing this decision at their kitchen table, the difference is worth understanding before you sign anything.

Two structures, not two flavors

Original Medicare is the federal program — Part A (hospital) and Part B (doctor and outpatient). You can see any provider in the country who accepts Medicare, and there are no networks or referrals. But Original Medicare has no annual out-of-pocket limit, so most people add either a Medigap (Medicare Supplement) policy, a Part D drug plan, or both.

Medicare Advantage (Part C) is different. A private insurer, approved by Medicare, takes over your Part A and Part B coverage and usually bundles in Part D drug coverage. These plans typically use networks — HMOs, PPOs, or similar — and often include extras Original Medicare doesn't cover, like routine dental or vision. In exchange, you generally follow the plan's rules on which doctors to see and when prior approval is needed.

What Medigap actually does

Medigap is not a replacement for Medicare. It sits on top of Original Medicare and helps pay the deductibles, coinsurance, and copays that Part A and Part B leave behind. Medigap plans are standardized by letter (Plan G, Plan N, and so on), so a Plan G from one company covers the same medical costs as a Plan G from another — the price is what varies.

One important detail: Medigap does not include prescription drug coverage. If you go the Original Medicare + Medigap route, you'll usually add a stand-alone Part D plan for medications.

What to know about the local picture

Beckley is in Raleigh County, and plan availability is set at the county level by the Centers for Medicare & Medicaid Services. That means the Medicare Advantage and Part D plans offered to a Beckley resident are the same ones offered across Raleigh County. Medigap options, on the other hand, are regulated by the state of West Virginia and are generally available anywhere in the state, though pricing can differ by ZIP code and age.

To see the current plans available in your county, use the Plan Finder tool at medicare.gov or call 1-800-MEDICARE.

The 2027 rules that apply either way

A few program-level facts apply no matter which path you take:

• Part D prescription drug costs are capped at $2,100 out of pocket in 2026. This cap applies to any Part D plan, whether it's stand-alone or built into a Medicare Advantage plan.
• The Part D deductible cannot exceed $615 in 2026.
• The old "donut hole" coverage gap was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments instead of paying all at once at the pharmacy.
• IRMAA — the income-related surcharge on Part B and Part D — begins above $109,000 in income for a single filer in 2026.

When you can switch

The Annual Enrollment Period runs October 15 through December 7 every year. During that window, anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan for the following year.

The Medicare Advantage Open Enrollment Period runs January 1 through March 31. If you're already in a Medicare Advantage plan, you can switch to a different one or return to Original Medicare during this window.

Medigap has its own timing. The best time to buy is during your six-month Medigap Open Enrollment Period, which starts when you're 65 and enrolled in Part B. During that window, insurers can't turn you down or charge more for health reasons. After that, medical underwriting may apply in most states, including West Virginia.

Where to get unbiased help

If you want to talk it through with someone who isn't selling anything, West Virginia's State Health Insurance Assistance Program (SHIP) offers free one-on-one Medicare counseling. It's a good stop before you decide which path fits your health, your doctors, and your budget.