Medicare Supplement

Turning 65 in Augusta? Your Medicare Guide for 2026

If you live in Augusta and 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 enroll, and you don't have to figure it all out in one afternoon.

AUGUSTA, Ga. — Your 65th birthday is coming. Here's what to do first.

This guide walks through the basics — what Medicare is, when to sign up, and where to get free, unbiased help right here in the Augusta area.

Know your Initial Enrollment Period

Your Initial Enrollment Period (IEP) is a 7-month window built around your 65th birthday. It includes:

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

For most people, this is the first — and best — chance to enroll in Medicare without a late penalty. If you sign up in the three months before your birthday month, coverage generally starts on the first day of your birthday month. Sign up later in the window, and coverage begins the month after you enroll.

Missing your IEP can mean lifelong Part B late-enrollment penalties, so mark your calendar.

Understand the parts of Medicare

Medicare has four parts, and it helps to know what each one does before you make choices:

• Part A covers hospital stays, skilled nursing, and some home health care. Most people pay no premium for Part A because they (or a spouse) paid Medicare taxes while working.
• Part B covers doctor visits, outpatient care, preventive services, and durable medical equipment. It has a monthly premium.
• Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare, offered by private insurers approved by Medicare.
• Part D covers prescription drugs.

You can either stay with Original Medicare (Parts A and B, often paired with a standalone Part D drug plan and sometimes a Medigap supplement) or choose a Medicare Advantage plan that bundles hospital, medical, and usually drug coverage together.

What's new for 2026

A few program-wide updates worth knowing before you enroll:

• Part D out-of-pocket cap: $2,100. Once your drug costs hit that limit in 2026, you pay $0 for covered drugs the rest of the year.
• Part D deductible maximum: $615. No drug plan can charge more than this as a deductible.
• The old "donut hole" is gone. Since 2025, Part D has just three phases: deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan. This optional program lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying at the pharmacy counter.
• IRMAA surcharges on Part B and Part D premiums begin above $109,000 in income for single filers in 2026 (higher for joint filers).

Plan availability in the Augusta area

Augusta is in Richmond County, where Medicare beneficiaries typically have a range of Medicare Advantage and standalone Part D options offered by multiple private carriers. The exact number of plans and carriers changes each year, and availability is set at the county level — not the city level.

To see the current-year plan list for your ZIP code, use the Medicare Plan Finder at medicare.gov/plan-compare. You can filter by the drugs you take, the pharmacies you use, and — for Medicare Advantage — the doctors and hospitals in the network.

A quick word on Star Ratings

Medicare rates plans on a 1-to-5 star scale based on member experience, customer service, and quality measures. Stars are one data point among many. They don't tell you whether your doctor is in-network, whether your prescriptions are covered, or how a plan will fit your budget. Use them as context, not as a shortcut.

Your step-by-step checklist

1. Confirm your IEP dates. Write down the 7-month window on your calendar. 2. Decide about Part B. If you (or your spouse) are still working and have employer coverage, ask HR whether you need to enroll in Part B now or can delay without penalty. 3. Enroll in Part A — almost everyone should, since it's usually premium-free. 4. Choose your path: Original Medicare (possibly with Medigap and a Part D plan) or Medicare Advantage. 5. Compare plans on medicare.gov using your drug list and preferred providers. 6. Ask for help. Georgia's SHIP program — called GeorgiaCares — offers free, one-on-one counseling from trained volunteers who don't sell insurance.