Medicare 2026

Why the Initial Enrollment Period shapes Medicare in Livingston

# Turning 65 in Livingston? Your first Medicare decisions, step by…

LIVINGSTON, Mont. — Turning 65 near the Yellowstone River comes with paperwork you don't want to put off. Your Initial Enrollment Period (IEP) — the seven-month window built around your 65th birthday — is when most people first sign up for Medicare, and missing it can mean paying late penalties for years.

Here's a plain-language walkthrough of what to do, when to do it, and where to get free local help.

What the Initial Enrollment Period actually is

Your IEP is a seven-month window tied to your 65th birthday. It includes:

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

If you sign up during the first three months, your Medicare generally starts the first day of your birthday month. If you wait until your birthday month or later, coverage starts the first of the month after you enroll. That timing matters if you're leaving a job's health plan or lining up prescriptions.

Source: CMS — Medicare enrollment periods (medicare.gov).

Step 1: Decide if you need to actively enroll

Some people are enrolled automatically. If you're already getting Social Security or Railroad Retirement benefits before 65, you'll usually be signed up for Part A (hospital) and Part B (medical) without lifting a finger, and your red, white and blue card will arrive by mail.

If you're not drawing those benefits yet — common for folks still working or waiting to file — you need to sign up yourself through the Social Security Administration at ssa.gov or by calling 1-800-772-1213.

Step 2: Think through Part B if you're still working

Many Livingston residents work past 65, whether at a ranch, a small business, or the hospital. If you have solid coverage through a current employer (yours or a spouse's) with 20 or more employees, you may be able to delay Part B without a penalty and use a Special Enrollment Period later.

If your employer has fewer than 20 employees, or you have retiree coverage or COBRA, the rules are different — and getting this wrong can trigger a lifelong Part B late-enrollment penalty. This is a good moment to call a SHIP counselor before you decide.

Step 3: Choose your coverage path

Once you have Part A and Part B (Original Medicare), you generally pick one of two paths:

• Original Medicare, often paired with a standalone Part D drug plan and, if you want, a Medigap (Medicare Supplement) policy to help with out-of-pocket costs.
• Medicare Advantage (Part C), private plans that bundle Part A, Part B, and usually Part D into one plan, sometimes with extra benefits.

Livingston is in Park County, where multiple Medicare Advantage and Part D plans are offered. You can see the 2027 options — with premiums, networks, and drug coverage — using the Plan Finder at medicare.gov, and check your current plan's Annual Notice of Change.

One important note about Medigap: in most states, including Montana, you have a six-month Medigap Open Enrollment Period that starts the month you're 65 and enrolled in Part B. During that window, insurers can't turn you down or charge more for health reasons. After it closes, those protections shrink.

Step 4: Understand what's new for 2027 drug coverage

Part D has changed a lot in the past two years, and the 2027 rules matter whether you pick a standalone drug plan or a Medicare Advantage plan with drug coverage:

• The annual out-of-pocket cap for covered Part D drugs is $2,100 in 2026 and $2,400 in 2027. Once you hit it, you pay nothing more for the rest of the year on covered medications.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027 (plans can charge less).
• The old coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs across monthly payments instead of paying big amounts at the pharmacy counter. It's optional and free to opt into through your plan.

Higher-income retirees should also know about IRMAA — an extra monthly amount added to Part B and Part D premiums. In 2026, IRMAA generally kicks in above $109,000 in income for a single filer (based on your 2024 tax return).

Step 5: Mark the calendar

After your IEP, two other windows matter every year:

• Annual Enrollment Period: Oct. 15 – Dec. 7. You can switch Medicare Advantage or Part D plans; changes start Jan. 1.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance to switch to another or drop back to Original Medicare.

Where to get free, unbiased help in Livingston

You don't have to figure this out alone, and you don't have to pay anyone to compare basic options.

• Medicare.gov — the official site for plan comparisons and enrollment.
• 1-800-MEDICARE (1-800-633-4227) — 24/7 help.
• Montana SHIP (State Health Insurance Assistance Program) — free, one-on-one counseling from trained volunteers who don't sell plans. Call 1-800-551-3191 to find a counselor serving Park County.