Medicare Part D

Denver Medicare: The 7-Month Window

DENVER — If you're approaching your 65th birthday in the Mile High City, Medicare is about to become part of your life. The good news: you don't have to figure it out all at once. You have a defined window to enroll, clear rules to follow, and free help available right here in Colorado.

Denver: Your 65th Birthday Kicks Off a 7-Month Window

This guide walks you through your Initial Enrollment Period (IEP), what each part of Medicare covers, and where to get personalized answers before you sign anything.

Your Initial Enrollment Period: 7 Months Around Your Birthday

Your IEP is a 7-month window: the three months before the month you turn 65, your birthday month, and the three months after. That's it — miss it without other qualifying coverage, and you could face lifetime late-enrollment penalties on Part B and Part D.

A few tips to keep in mind:

• Sign up early in your window. If you enroll in the three months before your birthday month, your Part A and Part B coverage generally starts the first day of your birthday month.
• Already getting Social Security? You'll usually be enrolled in Parts A and B automatically. If not, you need to sign up yourself through the Social Security Administration at ssa.gov or by calling 1-800-772-1213.
• Still working at 65? If you have qualifying employer coverage, you may be able to delay Part B without penalty. Confirm this with your HR office and with Medicare before you make a decision.

The Parts of Medicare, in Plain English

• Part A (Hospital Insurance): Inpatient hospital stays, skilled nursing, hospice. Most people pay no premium because they or a spouse paid Medicare taxes while working.
• Part B (Medical Insurance): Doctor visits, outpatient care, preventive services, durable medical equipment. Has a monthly premium set each year by CMS.
• Part C (Medicare Advantage): An alternative way to get your Part A and Part B benefits through a private plan approved by Medicare. Often bundles drug coverage.
• Part D (Prescription Drug Coverage): Optional drug coverage through a private plan. You can add it to Original Medicare or get it built into a Medicare Advantage plan.
• Medigap (Medicare Supplement): Private policies that help pay some of Original Medicare's out-of-pocket costs. Cannot be combined with Medicare Advantage.

What's New for 2027 You Should Know

A few program-wide numbers to file away as you compare your options:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your prescription spending hits that ceiling, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027 (plans can set theirs lower).
• The "donut hole" is gone. Since 2025, Part D has three phases — deductible, initial coverage, and catastrophic — with no coverage gap.
• Medicare Prescription Payment Plan: An optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying all at once at the pharmacy counter.
• IRMAA surcharges: Higher-income enrollees pay more for Parts B and D. For 2026, surcharges begin above $109,000 in income for a single filer (based on your 2024 tax return).

Denver-Area Plan Availability

Denver is in Denver County, where multiple Medicare Advantage and stand-alone Part D plans are offered by a range of private carriers approved by CMS. Plan availability, provider networks, and drug formularies are set at the county level, so what's offered in Denver County may differ from neighboring counties like Arapahoe, Jefferson, or Adams.

To see the exact list of plans available at your address, use the Plan Finder at medicare.gov/plan-compare. It's the official, unbiased tool and will show you every plan sold in your ZIP code.

Two Enrollment Periods to Remember After You're In

Once you're enrolled in Medicare, two annual windows matter:

• Annual Enrollment Period (AEP): October 15 – December 7. Switch, drop, or join Medicare Advantage or Part D plans. Changes take effect January 1.
• Medicare Advantage Open Enrollment Period: January 1 – March 31. If you're already in a Medicare Advantage plan, you can switch to another MA plan or drop back to Original Medicare.

What About Star Ratings?

Every year, CMS publishes Star Ratings (1 to 5 stars) for Medicare Advantage and Part D plans. The ratings measure things like customer service, member complaints, and how well plans manage chronic conditions. They're a useful data point when comparing plans on medicare.gov — but they're one piece of a bigger picture that also includes your doctors, your medications, and your budget.