Medicare 2026

How SHIP helps Wilkes Barre residents sort out Medicare

WILKES-BARRE, Pa. — If you live in the Wyoming Valley and Medicare has you scratching your head, you are not alone. With mailers stacking up, TV ads running nonstop, and enrollment deadlines on the calendar, it can be hard to know who is actually on your side.

Where to turn first when Medicare gets confusing

The good news: Wilkes-Barre has real, local help — some of it completely free and unbiased, and some of it from licensed agents who can walk you through your options. Here is how to tell them apart and how to reach each one.

PA MEDI: Pennsylvania's free SHIP counselors

Every state has a State Health Insurance Assistance Program (SHIP). In Pennsylvania, it is called PA MEDI (Pennsylvania Medicare Education and Decision Insight), and it is run through the state Department of Aging.

PA MEDI counselors are trained volunteers and staff who do not sell insurance and do not earn commissions. They can help you:

• Understand the difference between Original Medicare, Medicare Advantage, Medigap, and Part D.
• Compare drug plans on Medicare.gov's Plan Finder using your actual prescriptions.
• Sort out a bill, a denial, or a late enrollment penalty.
• Check whether you qualify for programs like Extra Help or a Medicare Savings Program.

In Luzerne County, PA MEDI services are offered through the Luzerne County Area Agency on Aging in Wilkes-Barre. You can also reach PA MEDI statewide at 1-800-783-7067.

Licensed local agents and brokers

If you would rather have someone handle the paperwork and stay with you year after year, a licensed independent agent can be a good fit. Agents are paid by insurance carriers, so their help is free to you, but keep in mind they can only sell plans from the carriers they are contracted with.

A few tips when working with any agent in the Wilkes-Barre area:

• Ask which carriers they represent. An agent who works with several carriers can compare more options.
• Ask them to run your drugs and your doctors through Plan Finder, not just quote a premium.
• Never share your Medicare number with someone who cold-called or knocked on your door uninvited.
• You are not required to enroll on the spot. Take the paperwork home.

What's actually available in Luzerne County

Wilkes-Barre is in Luzerne County, where CMS listed 77 Medicare Advantage plans for 2026, offered by 9 carriers with prescription drug coverage built in. The 2027 lineup is spelled out in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder, so your PA MEDI counselor or agent can pull the current list for your ZIP code. Stand-alone Part D drug plans are counted separately at the regional level.

For context, more than 65,000 people age 65 and older live in the county, so demand for straight answers is high — especially in the weeks around Annual Enrollment.

Key Medicare numbers worth knowing for 2027

Whether you talk to PA MEDI or a licensed agent, these Medicare facts apply everywhere:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once you hit it, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: Lets you spread your drug costs across the calendar year in monthly bills instead of paying big amounts at the pharmacy counter.
• IRMAA (higher Part B and Part D premiums for higher earners) begins above $109,000 in income for a single filer in 2026.
• Annual Enrollment Period: October 15 – December 7. Medicare Advantage Open Enrollment: January 1 – March 31.

How to prepare for any Medicare appointment

Before you sit down with a PA MEDI counselor or an agent, gather:

1. Your red, white, and blue Medicare card. 2. A current list of your prescriptions, with doses. 3. A list of the doctors and hospitals you want to keep. 4. Any plan letters you've received (Annual Notice of Change, denials, bills).

Walking in with this information saves an hour of guessing and helps whoever is helping you give real answers.