Medicare Supplement

Medicare in Lexington: 65 Plan Options in Fayette County for 2026

LEXINGTON, Ky. — If you're turning 65 in the Bluegrass or already using Medicare, you have plenty to sort through this fall. In Fayette County, where Lexington sits, 65 Medicare Advantage plans are available for 2026, according to the Centers for Medicare & Medicaid Services (CMS) Landscape files.

That's a lot of choice — and a lot to read. Here's a plain-English look at what's on the table locally, along with the 2026 rules everyone on Medicare should know.

Lexington by the numbers

Lexington is in Fayette County, where CMS lists the following for the 2026 plan year:

• 65 Medicare Advantage plans available
• 9 carriers offering Medicare Advantage with prescription drug coverage (MA-PD)
• 10 stand-alone Part D plans available in Kentucky for 2026, sold statewide
• 8 contracts rated 4 stars or higher under CMS's 2026 Star Ratings

Fayette County is home to about 47,626 people age 65 and older, so the market here is sizable. Plan counts are set at the county level, not the city level, which is why availability in Lexington mirrors what's offered across Fayette.

A quick note on Star Ratings: CMS rates Medicare contracts from 1 to 5 stars based on things like customer service and care quality. Ratings can change year to year, and they're one tool among many — not a shopping shortcut.

What "65 plans" actually means

A big plan count doesn't necessarily mean 65 wildly different products. Many carriers offer several versions of a plan — for example, an HMO and a PPO, or a plan tailored to people who also qualify for Medicaid. When you use the Plan Finder at medicare.gov, you can filter by plan type, your doctors, and your prescriptions to narrow the list quickly.

If you don't take a Medicare Advantage plan, you can pair Original Medicare (Parts A and B) with a stand-alone Part D drug plan. Those are sold across a wider region, so even though the county file shows 0 listed at the county level, drug plans are still available to Kentucky residents through the federal marketplace on medicare.gov.

2026 rules that apply to everyone

A few program-wide changes and figures are worth memorizing before you shop:

• Part D out-of-pocket cap: $2,100. Once your drug spending hits this amount in 2026, you pay $0 for covered Part D drugs the rest of the year.
• Part D deductible: up to $615. Plans can charge less, but not more.
• The "donut hole" is gone. Since 2025, Part D has three phases instead of four.
• Medicare Prescription Payment Plan. This optional program lets you spread your drug costs into monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA. Higher-income beneficiaries pay extra for Part B and Part D. For 2026, the surcharge begins above $109,000 in income for a single filer.

Dates to circle

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

Missing these windows can lock you into a plan you don't love for a full year, so mark your calendar.

How to shop without getting overwhelmed

With 65 Medicare Advantage options in Fayette County, the trick is to start with your own life, not the plan list:

1. List your doctors and hospitals. Check whether they're in-network. 2. List your prescriptions and doses. Drug coverage varies a lot from plan to plan. 3. Think about travel. Do you spend part of the year outside Kentucky? 4. Compare total costs, not just premiums — that includes deductibles, copays, and the drug side of the plan.

Kentucky's State Health Insurance Assistance Program (SHIP), run through the Department for Aging and Independent Living, offers free one-on-one counseling. Counselors don't sell anything.