Medicare Advantage

Nashua Medicare 2027: Your Guide to Hillsborough County Plan Counts

Nashua Medicare 2027: Hillsborough County plan counts and how the program's own costs fit together for the year ahead.

NASHUA, N.H. — If you're turning 65 in the Gate City or already using Medicare, the fall 2026 enrollment window brings a clearer cost picture for 2027 than in past years. Nashua sits in Hillsborough County, where 19 Medicare Advantage plans were available for 2026, offered by 4 carriers, according to the Centers for Medicare & Medicaid Services (CMS) plan landscape; the 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. With roughly 73,818 residents age 65 and older in the county, that's a meaningful number of options to sort through — and understanding how the program's own costs stack up is the best place to start.

What's available in Hillsborough County for 2027

Nashua's plan availability is set at the county level, so every Nashua ZIP code draws from the same Hillsborough County lineup. For 2026, that lineup included 19 Medicare Advantage plans across 4 carriers; the 2027 counts are in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. New Hampshire has 9 stand-alone Part D plans for 2026, sold statewide, and 8 for 2027 — anyone on Original Medicare in Nashua can join one of them, and a call to 1-800-MEDICARE or a visit to Medicare.gov can confirm what's shown in your specific ZIP for 2027.

Star Ratings are a separate CMS scorecard that rates contracts on quality and service. Under CMS's 2026 Star Ratings, 5 of the contracts offering plans in this county are rated 4 stars or higher. Ratings are one input among many; they aren't a recommendation, and they shift year to year.

How Medicare's cost pieces fit together for 2027

Think of Medicare as three cost layers stacked on top of one another. Understanding each layer — before looking at any specific plan — makes the choices feel less overwhelming.

Part A (hospital). Most people pay no premium for Part A because they or a spouse paid Medicare taxes while working. There is still a per-admission hospital deductible set by CMS each year.

Part B (doctor and outpatient). Part B has a standard monthly premium and an annual deductible, both set nationally by CMS. Higher-income beneficiaries pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard premium. IRMAA surcharges begin above $109,000 in income for a single filer in 2026.

Part D (prescription drugs). This is where recent years have brought the biggest structural changes, and 2027 continues that shift.

The 2027 Part D cost structure, in plain English

Part D now has just three phases: a deductible phase, an initial coverage phase, and a catastrophic phase. The old coverage gap — the "donut hole" — was eliminated as of 2025 and is not coming back.

Here are the program-level guardrails you can count on for 2027:

• Deductible: Part D plans may charge up to $615 as their annual deductible in 2026 and up to $700 in 2027. Some charge less.
• Out-of-pocket cap: Once your covered drug spending reaches the annual out-of-pocket cap — $2,100 in 2026 and $2,400 in 2027 — you pay nothing for covered Part D drugs the rest of the year. This is a hard cap set by CMS, and it applies whether your drug coverage comes through a stand-alone plan or is built into a Medicare Advantage plan.
• Medicare Prescription Payment Plan: This is an optional feature that lets you spread your Part D out-of-pocket drug costs across the calendar year in monthly amounts instead of paying at the pharmacy counter. It doesn't lower what you owe; it smooths when you owe it. You have to opt in.

Together, the deductible ceiling and the annual out-of-pocket cap put a known upper edge on drug costs — a big deal for anyone on expensive medications.

Where Medicare Advantage fits in the cost picture

A Medicare Advantage plan bundles Part A, Part B, and usually Part D into a single plan run by a private insurer under contract with Medicare. You still pay your Part B premium; the plan sets its own premium (which may be $0 or more), its own cost-sharing, and its own network. Because plans vary and cost-sharing can change every year, comparing them one at a time in Medicare's Plan Finder is the only reliable way to see what applies to your drugs and your doctors.

The point of naming the count — 19 plans, 4 carriers — is not to say more is better. It's to show that Hillsborough County residents have room to shop.

Deadlines to circle

• Oct. 15 – Dec. 7: Medicare 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 a different one once or drop back to Original Medicare (and add a Part D plan).

Missing these windows usually means waiting a full year, unless you qualify for a Special Enrollment Period.

Where to get unbiased help in Nashua

For personal answers, three free resources stand out:

• Medicare.gov — the official Plan Finder lets you enter your prescriptions and pharmacies to see estimated yearly costs.
• 1-800-MEDICARE (1-800-633-4227) — 24/7, in multiple languages.
• New Hampshire's SHIP — the State Health Insurance Assistance Program, called ServiceLink in New Hampshire, offers free one-on-one Medicare counseling. There's a ServiceLink office serving Nashua and the surrounding Hillsborough County area.