Medicare Advantage

San Antonio Medicare IEP: how the 7-month window works

Bexar County has 98 Medicare Advantage plans for 2027. Compared with 2026, 28 plans are not coming back, 26 are new, and 36 continuing plans changed in some way you should check before December 7, 11 of them under a new name. This guide covers what those numbers mean for San Antonio, not which plan to pick.

SAN ANTONIO — Turning 65 comes with a stack of mail, a lot of jargon, and one very important calendar: your Initial Enrollment Period, or IEP. Get the timing right and Medicare falls into place. Miss it, and you could face late penalties that follow you for life.

Turning 65 in San Antonio? Here's How to Handle Your First Medicare Decisions

Here's a plain-language walk-through of what to do, when to do it, and where to get free help — with a few notes tailored to Bexar County.

Your 7-Month Window: What the IEP Actually Is

Your Initial Enrollment Period is seven months long. It starts three months before the month you turn 65, includes your birthday month, and ends three months after.

For example, if your 65th birthday is in June, your IEP runs from March 1 through September 30.

A quick tip that trips people up: if you sign up in the three months before your birthday month, coverage begins the month you turn 65. If you sign up during or after your birthday month, coverage can be delayed. Signing up early is usually the safer play.

Source: CMS — Medicare enrollment periods (medicare.gov).

Step 1: Decide About Part A and Part B

Part A covers hospital stays; Part B covers doctor visits and outpatient care. Most people get Part A premium-free because of their (or a spouse's) work history.

• Already getting Social Security? You'll usually be enrolled in Part A and Part B automatically.
• Not yet on Social Security? You need to sign up yourself at ssa.gov, by phone, or at a Social Security office.
• Still working with employer coverage? You may be able to delay Part B without a penalty. Ask your HR department in writing whether your plan is considered "creditable coverage."

Missing your window without creditable coverage can mean a Part B late enrollment penalty that lasts as long as you have Medicare.

Step 2: Choose Your Coverage Path

Once you have Original Medicare (Parts A and B), you generally choose one of two paths:

1. Original Medicare — often paired with a standalone Part D drug plan, and sometimes a Medigap (supplement) policy to help with out-of-pocket costs. 2. A Medicare Advantage plan (Part C) — private plans that bundle Parts A, B, and usually D, sometimes with extra benefits.

San Antonio is in Bexar County, where residents typically have a wide range of Medicare Advantage and Part D plans to compare. Availability, networks, and drug lists are all set at the county level, so it's worth using the plan finder at medicare.gov and entering your ZIP code to see the current Bexar County options for the plan year you're shopping.

Step 3: Understand the 2027 Drug Coverage Rules

Part D looks different than it did a few years ago, and the 2027 numbers matter:

• The out-of-pocket cap for Part D is $2,100 in 2026. Once you hit it, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027 (plans can charge less).
• The old "donut hole" coverage gap is gone — as of 2025, Part D has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs into predictable monthly payments instead of paying big amounts at the pharmacy counter. It's optional and free to join.

Even if you don't take many prescriptions today, enrolling in some form of drug coverage during your IEP helps you avoid the Part D late enrollment penalty later.

Step 4: Know About IRMAA (If Your Income Is Higher)

If your income is above certain limits, you'll pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of your Part B and Part D premiums. For 2026, IRMAA begins above $109,000 in income for a single filer (higher thresholds apply for joint filers).

Social Security uses your tax return from two years earlier to decide. If your income has dropped due to retirement, marriage, or another life event, you can appeal using Form SSA-44.

Common Mistakes to Avoid

• Assuming you'll be auto-enrolled. Only people already receiving Social Security are enrolled automatically.
• Skipping drug coverage because you're healthy. The late penalty adds up over time.
• Guessing about employer coverage. Get written confirmation that it's creditable before delaying Part B.
• Waiting until the last week of your IEP. Paperwork takes time.

Key Dates to Keep on Your Fridge

• Your IEP: the 7 months around your 65th birthday.
• Annual Enrollment Period: October 15 – December 7, when you can change your Medicare Advantage or Part D plan for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31, for people already in an Advantage plan who want to switch or return to Original Medicare.