Medicare Part D

Turning 65 in Reading? Your Medicare Enrollment Roadmap

READING, Pa. — If your 65th birthday is on the horizon, you're about to make some of the most important health coverage decisions of your life. The good news: Medicare gives you a clear window to sign up, and Reading residents have the same official resources available as anyone else in the country.

Here's what to know before your birthday month arrives.

Your Initial Enrollment Period is a 7-month window

When you turn 65, you get a personal 7-month window called the Initial Enrollment Period (IEP). It includes:

• The 3 months before your 65th birthday month
• Your birthday month
• The 3 months after

If you sign up during the three months before your birthday month, your coverage generally starts the first day of your birthday month. Sign up later in the window and your start date moves back accordingly, per Medicare.gov.

Missing this window can mean late enrollment penalties that stick with you for life, so mark your calendar early.

Do you need to actively sign up?

It depends on your situation:

• Already getting Social Security or Railroad Retirement benefits? You'll usually be enrolled in Parts A and B automatically, and your red, white, and blue Medicare card will arrive in the mail.
• Not yet drawing Social Security? You need to sign up yourself through the Social Security Administration.
• Still working with employer coverage? You may be able to delay Part B without penalty, but the rules depend on the size of your employer. Check with your HR department before your birthday month.

Understand the parts of Medicare

Before choosing, it helps to know what you're choosing between:

• Part A covers hospital stays. Most people pay no premium because they paid Medicare taxes while working.
• Part B covers doctor visits, outpatient care, and preventive services. It has a monthly premium set each year by CMS.
• Part D covers prescription drugs. In 2026, the maximum Part D deductible is $615, and there's a new $2,100 annual out-of-pocket cap on covered drugs. The old "donut hole" was eliminated in 2025, so Part D now has three phases instead of four.
• Part C (Medicare Advantage) is an alternative way to get Parts A, B, and usually D, offered through private insurers approved by Medicare.
• Medigap (Medicare Supplement) policies help pay some of Original Medicare's out-of-pocket costs. Your best pricing on Medigap is usually during your one-time 6-month Medigap Open Enrollment window that starts when you're 65 and enrolled in Part B.

What's available in the Reading area

Reading is in Berks County, where Medicare beneficiaries can choose between Original Medicare (Parts A and B, often paired with a Part D drug plan and sometimes a Medigap policy) or a Medicare Advantage plan offered by a private insurer contracted with Medicare.

To see exactly which plans serve Berks County — and to compare them side by side using your own doctors and prescriptions — use the official Plan Finder at Medicare.gov/plan-compare. It's the only tool that pulls live, ZIP-code-level data straight from CMS.

A few 2027 numbers worth knowing

• Part D out-of-pocket cap: $2,400 for the year (2027)
• Part D maximum deductible: $700 (2027)
• IRMAA (higher-income surcharges): kick in above $109,000 in income for single filers in 2026, based on your tax return from two years ago
• Medicare Prescription Payment Plan: an optional program that lets you spread your drug costs across the year in monthly payments instead of paying all at once at the pharmacy

Key dates after you're enrolled

Once you're on Medicare, two annual windows matter most:

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