Medicare Supplement

Three months before to three after: Gresham Medicare IEP

If you live in Gresham and your 65th birthday is coming up, Medicare gives you a seven-month window to sign up. It's called the Initial Enrollment Period (IEP). It begins three months before the month you turn 65, includes your birthday month, and ends three months after.

Gresham, Ore. — Your 65th birthday starts a Medicare clock

Missing that window can mean late-enrollment penalties that stick with you for life. So the first step is simple: mark the calendar.

The four parts of Medicare, in plain English

Medicare has four moving pieces. Knowing what each does makes the rest of your decisions easier.

• Part A covers hospital stays, skilled nursing care, and some home health. Most people pay no premium because they (or a spouse) paid Medicare taxes for at least 10 years.
• Part B covers doctor visits, outpatient care, and preventive services. It has a monthly premium.
• Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare, offered by private insurers approved by CMS.
• Part D covers prescription drugs, also through private plans.

You'll choose one of two main paths: Original Medicare (A and B), often paired with a Part D drug plan and sometimes a Medigap supplement — or Medicare Advantage (Part C), which usually bundles drug coverage in.

Signing up: what to do in your IEP

If you're already getting Social Security, you'll 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.

A few tips for Gresham readers:

• Still working with employer coverage? You may be able to delay Part B without a penalty. Ask your HR department for written confirmation that your coverage is "creditable."
• Enrolling for the first time? Sign up during the first three months of your IEP so coverage starts the month you turn 65.
• Choosing a drug plan or Advantage plan? Availability is set at the county level. Gresham is in Multnomah County, where the specific set of plans offered is determined by CMS-approved carriers filing in that county.

What's new for 2026

A few program-wide changes are worth knowing before you compare plans:

• Part D out-of-pocket cap: $2,100 for 2026. Once you hit that in covered drug costs, you pay $0 for the rest of the year.
• Part D maximum deductible: $615. Plans can charge less, but not more.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan. This optional program lets you spread drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges — extra amounts higher earners pay for Parts B and D — kick in above $109,000 in income for a single filer in 2026.

Key dates after you're enrolled

Once you're in the Medicare system, two windows matter every year:

• Annual Enrollment Period: Oct. 15 – Dec. 7. You can join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect Jan. 1.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you can switch once to another Advantage plan or return to Original Medicare.

Where to get unbiased help in Gresham

You don't have to figure this out alone, and you don't have to talk to a salesperson to get answers.

• Medicare.gov — the official site, with a plan finder tool.
• 1-800-MEDICARE (1-800-633-4227) — 24/7 help.
• Oregon SHIBA — the state's Senior Health Insurance Benefits Assistance program, part of the national SHIP network. Free, one-on-one counseling with trained volunteers. No sales pressure.