Medicare Advantage

Portsmouth-Area 2026 Medicare Plan Choices: What's Nearby

If you live in or around Portsmouth, you probably know that Medicare choices can look different from one county to the next. That's because Medicare Advantage and Part D plans are sold by county, not by city or ZIP code alone. So when a neighbor across the river or one county over talks about their coverage, they may be choosing from a different menu than you are.

Portsmouth, Ohio — A Look at What's Available Nearby for 2026

Here's a plain-English look at what plan availability shapes up like in the Portsmouth area for 2026 — and what to keep in mind as the Annual Enrollment Period (October 15 through December 7) approaches.

How Plan Availability Works in the Portsmouth Area

Portsmouth sits in Scioto County, and that's the county Medicare uses to decide which plans you can pick from. According to the 2026 CMS Medicare Advantage and Part D Landscape data, Scioto County has 58 Medicare Advantage plans available, offered by 8 different carriers that provide Medicare Advantage with prescription drug coverage (MA-PD).

Interestingly, there are 0 stand-alone Part D prescription drug plans listed for the area for 2026 in this data set. That doesn't mean drug coverage isn't available — most Medicare Advantage plans in the area include prescription drug coverage built in. But if you have Original Medicare and want a separate drug plan, it's worth checking medicare.gov's Plan Finder to confirm what's offered where you live.

None of the Medicare Advantage contracts serving the area currently carry an overall Star Rating of 4 stars or higher for 2026. Star Ratings are CMS's way of measuring plan quality on things like customer service and care coordination — they're one data point among many, not a ranking of which plan is right for you.

Why Nearby Counties Can Look Different

Medicare Advantage carriers decide, county by county, where they want to offer plans. That's why someone in Lawrence, Pike, Adams, or Jackson County — all neighbors of Scioto — may see a different total number of plans, different carriers, and different Star Ratings than someone in Portsmouth.

If a family member lives one county away and raves about their coverage, that specific plan may or may not be sold in Scioto County. Always check availability by your own county before making a decision.

Scioto County is home to roughly 13,671 residents age 65 and older, so there's a sizable Medicare population here — and carriers pay attention to that when they design their service areas.

2026 Rules That Apply No Matter Which Plan You Pick

Some Medicare changes for 2026 apply everywhere, not just in Portsmouth:

• Part D out-of-pocket cap: $2,100. Once your covered drug costs reach that amount, you pay $0 for covered prescriptions the rest of the year.
• Part D deductible maximum: $615. Individual plans can set a lower deductible, but not higher.
• No more "donut hole." The old coverage gap phase was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan. This is an optional program that lets you spread your drug costs out in monthly payments instead of paying a large amount at the pharmacy counter.
• IRMAA surcharges for higher-income beneficiaries begin above $109,000 in income for a single filer in 2026.

Key Dates to Circle

• October 15 – December 7: Annual Enrollment Period. This is when most people compare plans and switch for the coming year.
• January 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you get one chance during this window to switch to another MA plan or return to Original Medicare.