Medicare Advantage

Moving Soon? Your Medicare Plan List Could Change

Scarborough sits inside a Medicare market that stretches well beyond its own ZIP codes. Because Medicare Advantage and Part D plan availability is drawn on county lines, the choices a Scarborough resident sees are the same ones offered across all of Cumberland County — and they don't always match what a friend in York, Sagadahoc, or Androscoggin County sees. Heading into 2027, it's worth stepping back to look at how plan availability lines up across the greater Portland area.

Why plan availability is a county-by-county picture

Medicare Advantage and stand-alone Part D plans are approved by CMS to serve specific service areas, which are drawn at the county level. Scarborough is in Cumberland County, so every Medicare-eligible resident in town sees the same menu of plans as someone in Portland, Brunswick, or Bridgton. Cross the town line into Old Orchard Beach, though, and you're in York County — a different service area with its own list.

That matters most for people who split time between two homes, who care for a parent in a nearby county, or who are thinking about moving. A plan that works in one county may not be offered — or may work differently — in the next one over.

What the 2026 numbers looked like around Scarborough

For 2026, Cumberland County has 40 Medicare Advantage plans available, according to the CMS Medicare Plan Finder and Landscape files. Those plans come from 6 carriers offering Medicare Advantage with prescription drug coverage (MA-PD). The 2027 counts are in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. The 2027 counts are in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder.

A few other details about the local picture:

• There are 0 stand-alone Part D drug plans listed for the county in the 2026 file. Anyone shopping for drug coverage for 2027 should confirm current options on medicare.gov, since Part D availability is updated for the new plan year.
• CMS Star Ratings in the area for 2026 do not currently show contracts rated 4 stars or higher. Star Ratings measure things like customer service, member complaints, and how well plans manage chronic conditions — they're a quality signal, not a recommendation.

These are area-level counts. They tell you how much choice exists; they don't tell you which plan fits any one person.

How nearby counties fit into the metro

The greater Portland metro spills into several counties, and each has its own plan lineup:

• Cumberland County (Scarborough, Portland, South Portland, Falmouth, Windham, Brunswick and more).
• York County to the south (Old Orchard Beach, Biddeford, Saco, Kennebunk).
• Sagadahoc County to the northeast (Bath, Topsham).
• Androscoggin County inland (Lewiston, Auburn).

Plan counts, participating carriers, and provider networks differ across these counties. If you're comparing options with a family member in a neighboring town, don't assume you're both looking at the same list. The safest step is to enter each person's ZIP code separately on medicare.gov.

Program rules that apply everywhere

No matter which county you live in, some Medicare rules are set nationally for 2026:

• The Part D out-of-pocket cap is $2,100. Once your covered drug spending hits that amount, you pay $0 for covered Part D drugs the rest of the year.
• The maximum Part D deductible is $615, though many plans set theirs lower.
• The old coverage gap, or "donut hole," was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly bills instead of paying at the pharmacy counter. It's optional.
• IRMAA — the income-related surcharge on Part B and Part D premiums — begins above $109,000 in income for a single filer in 2026.

Enrollment dates to circle

• Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect Jan. 1.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you can switch to another MA plan or go back to Original Medicare (and add a Part D plan).

Outside those windows, you generally need a Special Enrollment Period — for example, if you move to a new county.