Medicare Advantage

Medicare in Missoula: Weighing 2027 Options by Cost

Medicare in Missoula: Weighing Your 2027 Options by Cost — plain-language Medicare information for Missoula, Montana.

MISSOULA, Mont. — If you are turning 65 in the Garden City, or already on Medicare and reviewing your coverage for 2027, you have real choices to make. Missoula is in Missoula County, where 16 Medicare Advantage plans were offered for 2026, alongside the traditional path of Original Medicare paired with a Medigap policy and a stand-alone drug plan. The 2027 lineup is in each plan's ANOC and on Medicare.gov's Plan Finder. Which path fits you often comes down to how the cost pieces stack up.

This guide walks through the program-level cost structure — the premiums, deductibles, and out-of-pocket limits that shape every Medicare decision — so you can compare paths with clear eyes.

Two paths, two different cost structures

Every person on Medicare picks between two basic frameworks:

1. Original Medicare (Parts A and B), often paired with a Medigap (Supplement) policy and a stand-alone Part D drug plan. 2. Medicare Advantage (Part C), a private plan that bundles Part A, Part B, and usually Part D together.

Both paths use the same building blocks — premiums, deductibles, coinsurance, and out-of-pocket limits — but they arrange those blocks very differently. Understanding the arrangement is the whole game.

The cost pieces on the Original Medicare side

Under Original Medicare, you pay the standard Part B premium (set by CMS each year and higher for people whose income exceeds the IRMAA threshold — $109,000 for a single filer in 2026). Part A has its own hospital deductible per benefit period, and Part B has an annual deductible followed by 20% coinsurance on most covered services.

The catch: Original Medicare on its own has no annual out-of-pocket cap. That 20% coinsurance keeps running, no matter how large the bills. This is why many people on this path add a Medigap policy, which pays some or all of those cost-sharing pieces in exchange for a monthly premium.

For prescriptions, you would typically add a stand-alone Part D plan. Montana has 11 stand-alone Part D plans for 2026, sold statewide — a list to review on Medicare's Plan Finder before enrolling, and one reason many local shoppers also look at Advantage plans that include drug coverage.

The cost pieces on the Medicare Advantage side

Advantage plans in Missoula County — 16 for 2026, from 2 carriers offering drug coverage — bundle everything into a single plan with its own cost structure. The 2027 lineup is in each plan's ANOC and on Medicare.gov's Plan Finder. You still pay the Part B premium, and the plan sets its own deductibles, copays, and network rules.

The important guardrail: every Medicare Advantage plan must have an annual out-of-pocket maximum for in-network Part A and Part B services. Once you hit that ceiling, the plan covers the rest for the year. That built-in cap is a key structural difference from Original Medicare alone.

Part D: the same drug-cost rules apply either way

Whether your drug coverage comes from a stand-alone Part D plan or is baked into an Advantage plan, the program rules for 2027 are the same:

• The Part D out-of-pocket cap is $2,400 in 2027 (it is $2,100 in 2026). Once your drug spending reaches that ceiling, you pay nothing for covered drugs the rest of the year.
• The Part D deductible cannot exceed $700 in 2027 (the 2026 ceiling is $615).
• The old "donut hole" coverage gap is gone as of 2025. Part D now runs in three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments, if a big bill at the pharmacy counter would be hard on your budget.

These are program-level facts, not specific to any one plan.

How Missoula shoppers can compare on cost

When you sit down to compare, look at the total picture over a year, not just one number:

• Add up expected premiums (Part B, Part D or Advantage, and Medigap if applicable).
• Add expected deductibles.
• Estimate your cost-sharing based on how often you see doctors or take prescriptions.
• Note the worst-case ceiling — the plan's out-of-pocket max, plus the $2,400 Part D cap in 2027.

Star Ratings can also inform quality — CMS publishes them to help members judge plan performance — but they are not a stand-in for a cost comparison.

Missoula County has more than 20,000 residents age 65 and older, and no two households run the numbers the same way. A Missoula SHIP counselor (Montana's State Health Insurance Assistance Program) can walk through this with you at no cost.

Key dates to keep on the calendar

• Oct. 15 – Dec. 7, 2026: Annual Enrollment Period. Switch, drop, or add Medicare Advantage or Part D coverage; changes take effect Jan. 1, 2027.
• Jan. 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you are already in an Advantage plan, you get one chance to change to another Advantage plan or return to Original Medicare.