Medicare 2026

Medicare Coverage Structures for Gillette Residents

GILLETTE, Wyo. — Picking how you get your Medicare is one of the biggest choices you'll make as you approach 65 or think about switching during a future enrollment window. In Campbell County, as in the rest of the country, the choice really comes down to two paths: Original Medicare paired with a Medigap policy, or a Medicare Advantage plan. They both start with the same federal program, but they work very differently once you actually use them.

Here's a plain-English walk-through so you can think it through before the Annual Enrollment Period (Oct. 15 – Dec. 7) or your Initial Enrollment window.

Two paths, same starting point

Everyone with Medicare has Part A (hospital) and Part B (doctor and outpatient). What you decide is how those benefits are delivered to you.

• Path 1: Original Medicare + Medigap (and usually a stand-alone Part D drug plan). You stay in the federal program. A private Medigap policy helps pay the out-of-pocket costs Original Medicare leaves behind. You add a separate Part D plan for prescriptions.
• Path 2: Medicare Advantage (Part C). A private plan, approved by Medicare, takes over your Part A and Part B coverage. Most Advantage plans also include Part D drug coverage and sometimes extras like dental or vision.

You can't be on both paths at once. That's the fork in the road.

How you see doctors is different

With Original Medicare, you can go to any doctor or hospital in the U.S. that accepts Medicare — no network, no referrals. That matters in a place like Gillette, where you or a family member might travel to Casper, Billings, or even farther for specialty care.

With Medicare Advantage, plans use networks (HMO, PPO, and others). You may need to stay in-network, get referrals, or get prior approval before certain services. Advantage plans are set up at the county level, so what's offered in Campbell County isn't the same as what's offered in, say, Sheridan or Natrona County.

How costs are structured is different

This is where people get tripped up.

• With Original Medicare + Medigap, you pay a monthly premium for Medigap (and Part B, and usually Part D). In return, most of your day-to-day medical costs are predictable — Medigap picks up much of the coinsurance and deductibles Original Medicare doesn't cover. There's no yearly cap on Original Medicare's own out-of-pocket costs, which is exactly why Medigap exists.
• With Medicare Advantage, premiums are often lower, but you generally pay copays as you use services. Every Advantage plan has a yearly out-of-pocket maximum for Part A and Part B services, which protects you from a catastrophic year.

Neither path is automatically cheaper. It depends on how much care you use, what drugs you take, and whether you travel.

Prescription drugs in 2027

Drug coverage rules changed in a big way, and they apply no matter which path you pick:

• The Part D out-of-pocket cap is $2,100 in 2026. Once you hit that, you pay $0 for covered drugs the rest of the year.
• The Part D deductible can be no higher than $615 in 2026 and $700 in 2027.
• The old coverage gap ("donut hole") is gone — Part D now has three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments instead of paying a big bill at the pharmacy counter. It's optional and free to join.

If you choose Original Medicare, you'll pick a stand-alone Part D plan. If you choose Medicare Advantage, drug coverage is usually built in.

Medigap has its own enrollment rules

This is the mistake we hear about most often. When you first sign up for Part B at 65, you get a 6-month Medigap Open Enrollment Period. During that window, insurers must sell you any Medigap policy they offer, at their best available rate, regardless of your health.

After that window closes, in most states, insurers can use medical underwriting — meaning they can charge you more or turn you down based on health history. Wyoming follows the federal baseline here, so if you start on Medicare Advantage and later want to switch to Original Medicare + Medigap, getting a Medigap policy isn't guaranteed. It's worth understanding before you make your first choice.

A quick word on IRMAA

If your income is above $109,000 as a single filer (or $218,000 married filing jointly) on your 2024 taxes, you'll pay an income-related surcharge — called IRMAA — on top of your Part B and Part D premiums in 2026. This applies on both paths.