Medicare 2026

Why the Medicare path matters before plan names in Green Bay

In Green Bay, one of the first big Medicare decisions has nothing to do with a specific plan name. It's a structural choice: do you want Original Medicare paired with a Medigap policy, or do you want a Medicare Advantage plan? The two paths cover the same person, but they're built very differently — and switching later isn't always easy.

Two different structures, not two flavors of the same thing

Original Medicare is the federal program: Part A (hospital) and Part B (doctor and outpatient). You can see any provider in the country that accepts Medicare, and there's no network. But Original Medicare alone has deductibles, coinsurance, and no yearly cap on what you can spend.

That's where Medigap (also called Medicare Supplement Insurance) comes in. A Medigap policy is sold by a private company and helps pay the out-of-pocket costs Original Medicare leaves behind. Medigap does not include prescription drug coverage, so most people on this path also add a stand-alone Part D plan.

Medicare Advantage (Part C) is a different setup. It's a private plan that replaces the way you get your Original Medicare benefits. It usually bundles Part A, Part B, and Part D together, and it may include extras. In exchange, you generally use the plan's network of doctors and hospitals, and the plan sets rules like prior authorization and referrals.

What each path tends to feel like day to day

With Original Medicare + Medigap + a Part D plan, you're typically juggling three cards, but you have wide provider freedom and predictable cost-sharing. There's no network to worry about as long as the provider accepts Medicare.

With Medicare Advantage, you have one card and one plan to deal with. Costs, rules, and extra benefits vary by plan, and every Advantage plan must include a yearly out-of-pocket maximum for Part A and B services. The trade-off is that you'll usually need to stay in-network and follow the plan's referral or approval rules.

Neither structure is "better." They're built for different priorities.

Drug coverage works differently on each path

On Original Medicare, prescription drugs aren't included, so you'd sign up for a separate Part D plan. On most Medicare Advantage plans, drug coverage is built in.

Either way, the same Part D rules apply for 2027:

• A maximum deductible of $615.
• A $2,100 yearly out-of-pocket cap on covered drugs.
• The old "donut hole" coverage gap is gone as of 2025, replaced by a simpler three-phase design.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter.

Higher-income enrollees may also owe an IRMAA surcharge on Part B and Part D premiums; for 2026, IRMAA starts above $109,000 in income for a single filer.

The Medigap timing rule people wish they'd known

Here's the mistake to avoid: Medigap has its own enrollment protections, and they're strongest when you first sign up for Part B. During your 6-month Medigap Open Enrollment Period, insurers in most states must sell you a policy at their best available rate regardless of your health.

Outside that window, in many states, a Medigap insurer can use medical underwriting — meaning they can charge you more or turn you down based on your health history. That's why choosing between Original Medicare + Medigap and Medicare Advantage isn't only about today. If you pick Advantage first and later want to switch to Original Medicare + Medigap, you may not be able to get the Medigap policy you want.

Wisconsin is one of a few states with its own standardized Medigap format, so the plan letters you see nationally look a little different here. A local counselor can walk you through what's actually available.

Plan availability in the Green Bay area

Green Bay is in Brown County, where Medicare plan availability is set at the county level. That means the number of Medicare Advantage plans, Part D plans, and Medigap options offered to a Green Bay resident is the same as it is for anyone else in Brown County. When you compare plans on Medicare.gov, entering your ZIP code pulls the county-level menu.

Availability changes every year, so what was offered last fall isn't necessarily what's offered this fall.

Key dates to keep on the calendar

• October 15 – December 7: Medicare Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan.
• January 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in an Advantage plan, you can switch to another Advantage plan or return to Original Medicare (and add a Part D plan).
• Your Medigap Open Enrollment Period: the 6 months starting when you're 65 or older and enrolled in Part B.

Where to get unbiased help

For personalized answers, three resources are worth bookmarking:

• Medicare.gov — official plan finder, rules, and publications.
• 1-800-MEDICARE — available 24/7.
• Wisconsin SHIP (the Medigap Helpline and Board on Aging & Long Term Care): free, one-on-one counseling from people who don't sell insurance.