Medicare Advantage

Medicare in Bellevue: 2027 Cost Pieces

Medicare in Bellevue: What the 2027 cost pieces look like — plain-language Medicare information for Bellevue, Nebraska.

BELLEVUE, Neb. — If you live in Bellevue and are sorting through Medicare for 2027, the choices can feel like a wall of names and numbers. Bellevue is in Sarpy County, which had 45 Medicare Advantage plans on the shelf for 2026 from 9 carriers, according to the CMS Medicare Plan Finder and Landscape files. The 2027 lineup is in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. That is a lot to compare — and the smartest way to compare is to understand the cost pieces first, then let those pieces guide your questions.

This guide walks through how Medicare's costs are built for 2027 at the program level: premiums, deductibles, and the out-of-pocket protections. It does not name plans or quote plan prices, because those are personal to your situation. But once you know how the pieces fit, the county menu becomes far easier to sort.

Start with the four cost buckets

Medicare costs come out of four buckets, no matter which path you pick:

1. Part A (hospital) — most people pay no premium because they or a spouse paid Medicare taxes long enough. There is still a per-stay hospital deductible set by CMS each year. 2. Part B (doctor and outpatient) — has a standard monthly premium and an annual deductible set by CMS; CMS publishes the 2027 figures later in the fall. Higher-income beneficiaries pay an IRMAA surcharge on top. 3. Part D (prescription drugs) — a plan premium (varies), a deductible up to $700 in 2027, and cost-sharing on your medicines. 4. Extra coverage — this is where you choose a lane: Original Medicare plus a Medigap policy and a stand-alone Part D plan, OR a Medicare Advantage plan that bundles hospital, medical, and usually drug coverage together.

Every dollar you spend in Medicare comes through one of those four buckets. When a friend says a plan "cost more than they expected," it almost always traces back to one of them.

The 2027 Part D cap changes the math

The biggest cost-side change for 2026 is on the drug side. Part D now has a hard out-of-pocket cap ($2,100 in 2026, $2,400 in 2027). Once your true out-of-pocket spending on covered drugs hits that number, you pay $0 for the rest of the plan year on covered prescriptions.

A few things follow from that:

• The old coverage gap — the "donut hole" — is gone as of 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The deductible on any Part D plan can be no higher than $615 in 2026. Some plans set it lower.
• If your drug costs are high early in the year, you can spread them across the calendar year using the Medicare Prescription Payment Plan, an optional monthly smoothing tool. It does not lower the total — it just evens out the timing.

One local note: Nebraska has 11 stand-alone Part D plans for 2026, sold statewide, and residents of Sarpy County can join any of them. If you prefer Original Medicare, you can pair it with one of these stand-alone PDPs; otherwise, drug coverage in the area is often reached through Medicare Advantage plans that include Part D (called MA-PD). If you want Original Medicare with a stand-alone drug plan, check medicare.gov's Plan Finder using your ZIP code to see the 2027 lineup, which includes Nebraska's 9 stand-alone Part D plans for 2027, sold statewide. The 2027 lineup is in each plan's ANOC and on the Plan Finder. The 2027 lineup is in each plan's ANOC and on the Plan Finder.

Part B, IRMAA, and the income question

Part B has a standard monthly premium that nearly everyone pays. If your income is higher, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of both Part B and Part D.

For 2026, IRMAA surcharges begin above $109,000 in income for a single filer (higher for married couples filing jointly). Social Security uses your tax return from two years back to decide. If your income has dropped since then — retirement, loss of a spouse, reduced work — you can ask for a reconsideration using form SSA-44.

Medigap vs. Medicare Advantage: two different cost shapes

This is the fork in the road, and it is really about how you prefer to pay.

• Original Medicare + Medigap + Part D. You pay more predictably each month (Part B premium, Medigap premium, Part D premium). In return, most of your medical cost-sharing is covered by the Medigap policy, so surprises are smaller.
• Medicare Advantage (often with drug coverage built in). Monthly premiums are often lower, sometimes as low as the Part B premium alone. Instead, you pay copays and coinsurance as you use care, up to the plan's annual out-of-pocket maximum.

Neither shape is "better." One trades higher monthly cost for fewer surprises; the other trades lower monthly cost for pay-as-you-go. Your health, your budget, and your tolerance for variable bills all matter.

Sarpy County's 45 Medicare Advantage options and 9 carriers give Bellevue shoppers room to compare within the Advantage lane. For Medigap, plans are standardized by letter across the country, so the letter (Plan G, Plan N, and so on) tells you what is covered — carriers compete on price and service.

Dates that drive your costs

• October 15 – December 7: Annual Enrollment Period. Change your Medicare Advantage or Part D plan for the following year.
• January 1 – March 31: Medicare Advantage Open Enrollment. If you're already in an Advantage plan, you get one switch (to another Advantage plan or back to Original Medicare).
• Your Initial Enrollment Period: the 7-month window around your 65th birthday.
• Special Enrollment Periods: triggered by moves, loss of employer coverage, and certain life events.

Missing a window can mean late-enrollment penalties that follow you for life on Part B and Part D — so mark the calendar.

Where to get personal help

With 25,339 residents 65 and older in Sarpy County, you are far from alone in doing this homework. Free, unbiased help is available:

• medicare.gov/plan-compare — enter your ZIP and your drug list to see costs for your situation.
• 1-800-MEDICARE (1-800-633-4227), 24/7.
• Nebraska SHIP (Senior Health Insurance Information Program) — free one-on-one counseling from trained volunteers who do not sell plans.