Newsroom
Blog & resources
Plain-English Medicare guidance and real local health data — written for the people we serve, not for search engines.
Medicare before 65 on disability in 2026: the 24-month wait, what you pay, and Colorado's Medigap rule for the Roaring Fork Valley
If you are under 65 and on Social Security disability, Part A and Part B start automatically after 24 months of benefits (no wait for ALS; kidney failure follows its own clock). You pay what a 65-year-old pays — $0 for Part A, $202.90 a month for Part B in 2026. Federal law does not make Medigap companies sell to people under 65, but Colorado Regulation 4-3-1 does: six months from your first month of Part B, any plan a company sells, no health questions. What the under-65 premium rules say, the second Medigap window at 65, Medicare Advantage availability (0 general-enrollment plans in Garfield County, 3 rising to 6 in Pitkin), how 2026's $1,210 trial work months and 93 months of continued Medicare protect you if you go back to work — and the 788 people in Pitkin, Garfield and Eagle counties this applies to.
Read →
Medicare Advantage plan ending in 2027? What the letter means and what your rights are in Mesa County
CMS's first 2027 plan file lists 13 Medicare Advantage plans open to general enrollment in Mesa County, down from 21 — and 10 of this year's plan IDs are not in it. How to tell a non-renewal notice from a consolidation, what happens if you do nothing (Original Medicare, generally without drug coverage), the December 8 – February 28 Special Enrollment Period and why December 31 is still the practical deadline, and the 63-day guaranteed right to buy Medigap Plan A, B, C, D, F or G without health questions.
Read →
Medicare for snowbirds and travelers in 2026: what covers you when you leave Delta County for the winter
Original Medicare and Medigap work with any provider that takes Medicare in any state, at the same cost as at home. A Medicare Advantage plan covers emergencies and urgent care nationwide, but routine care is tied to its network — and the plan must disenroll you after more than 6 months out of its service area, or 12 with a visitor/traveler benefit. How to fill prescriptions away from home, what Medicare pays outside the country (almost nothing) and what Medigap's $50,000 foreign travel emergency benefit adds, an eight-step checklist before you leave — and why it matters in Delta County, where 47.3% of 10,535 Medicare beneficiaries are in a Medicare Advantage or other health plan.
Read →
The Part D late enrollment penalty in 2026: how the 1% a month works, what "creditable coverage" means, and why this fall's notice matters in Montrose County
Go 63 days without a Medicare drug plan or other creditable drug coverage and Medicare adds 1% of the national base beneficiary premium — $38.99 in 2026, $41.33 in 2027 — for every month you went without, generally for as long as you have drug coverage. What counts as creditable and what does not, the penalty at 6 months to 10 years in both years, why CMS retiring the 60% employer test for a 73% one makes this fall's notice worth reading, the 2-month window if your coverage fails it, how to appeal a wrong penalty within 60 days — and the 2,721 Montrose County beneficiaries whose drug coverage does not come from Medicare.
Read →
Does Medicare cover physical therapy? The 2026 rules, the $2,480 threshold, and what a course of rehab costs in Garfield County
Part B pays 80% of medically necessary outpatient physical, occupational and speech therapy with no visit limit — and under Original Medicare alone, the other 20% has no annual ceiling. The $2,480 figure your therapist watches in 2026 is a documentation threshold, not the cap it replaced; $3,000 is where some claims may be reviewed; neither ends coverage. The plan-of-care clock (a doctor signs within 30 days, renews every 90, a progress report every 10 visits), what Medigap Plan G and Plan N each pay, why Garfield County's 10,764 beneficiaries have no Medicare Advantage plan open to the general public in 2026, and where the county's 83 physical therapists actually are. Every figure sourced.
Read →
Medicare's negotiated drug prices: what changed in 2026, what changes in 2027, and what it means at a Grand Junction pharmacy
For the first time, Medicare negotiated drug prices directly with the companies that make them. Ten took effect January 1, 2026 — Eliquis fell from a $521 list price to $231 for a 30-day supply, Januvia from $527 to $113 — and fifteen more start January 1, 2027, including Ozempic, Trelegy and Breo Ellipta, Linzess and Janumet. Every Medicare drug plan has to cover them at the negotiated price, and you do nothing to get it. But a negotiated price is not a copay: if you pay coinsurance or sit in the $615 deductible you save, if you pay a flat copay the plan decides, and above the $2,100 cap nothing changes. The complete 2026 and 2027 price tables, the 2028 list with the first Part B drugs, and the 32,438 Mesa County people with drug coverage it reaches. Every figure sourced.
Read →
Will your doctor be in network? Medicare Advantage HMO vs PPO in Montrose County for 2026
The premium is the number everyone compares. The network is the number nobody can see. In CMS's 2026 landscape file, 10 of the 11 Medicare Advantage plans open to everyone in Montrose County are PPOs — and because CMS classifies the county as Rural, a network can put your primary care doctor 40 minutes away and a cardiologist 75 minutes away and still be approved. What HMO, HMO-POS and PPO actually mean for your doctor, the 45-day warning a plan owes you when a provider leaves, the once-only Special Enrollment Period that requires CMS to call the change significant, the 15% limiting charge on the no-network side, and the 5,710 Montrose County residents whose doctor list renews every January. Every figure sourced.
Read →
Medicare and ambulance rides in 2026: what a ground or air ambulance costs in Pitkin County
Part B covers the ride when travelling any other way would endanger your health — and on a covered trip, federal law bars the ambulance company from billing you a dollar beyond the deductible and the 20%. What decides the number is the pickup ZIP code. In CMS's own ambulance file, Aspen, Snowmass Village, Basalt, Carbondale, Glenwood Springs, Rifle, Montrose, Delta and Ouray are all flagged super rural, worth 22.6% on the base rate; Grand Junction and Fruita are urban. Colorado's real 2026 fee schedule amounts, three worked examples, when a helicopter qualifies, and the 88.2% of Pitkin County beneficiaries on Original Medicare with no out-of-pocket ceiling behind them. Every figure sourced.
Read →
Medicare and durable medical equipment in 2026: what oxygen, a walker or a hospital bed costs in Ouray County
Part B pays 80% of the approved amount for equipment you use at home — and under Original Medicare alone, the other 20% has no annual ceiling. The 2026 rules: the $283 deductible, the 13-month rental that ends with the equipment in your name, the 36-month oxygen clock that is a payment cap and not a coverage cap, and the four questions to ask a supplier before anything is unloaded. Plus the local wrinkle — no medical-equipment supplier lists an Ouray or Ridgway address in the federal NPI registry, so yours will be in Montrose or Grand Junction. Every figure sourced.
Read →
The letter that decides your 2027 Medicare costs: reading the Annual Notice of Change in Delta County
It arrives by September 30, it is thin, and it looks like junk mail — and if you set it aside your plan renews automatically at whatever it decides to charge in January. Two federal ceilings already moved for 2027: the maximum drug plan deductible rises from $615 to $700 and the out-of-pocket cap from $2,100 to $2,400. And the demonstration that has been holding stand-alone drug plan premiums down since 2025 ends December 31. The seven lines to check, all ten Colorado drug plans priced side by side, and the 3,587 Delta County people sitting directly in the path of it. Every figure sourced.
Read →
Medicare and mental health care in 2026: what's covered in Garfield County
Therapy has no visit limit and one depression screening a year costs nothing — but the 20% coinsurance has no ceiling under Original Medicare, and 73% of Garfield County's 10,764 beneficiaries are on Original Medicare. The full 2026 coverage map, the counselors who could not bill Medicare until January 2024, the one telehealth benefit Congress made permanent, and why the 190-day psychiatric limit probably does not apply to you. Every figure sourced.
Read →
Spread your 2026 drug costs across the year: the Medicare Prescription Payment Plan in Mesa County
Pay the pharmacy $0 and get a monthly bill from your plan instead. Every Part D plan has to offer it, it costs nothing, and the first bill is capped — $175 if you join in January. It also does not save you a dime, and Medicare's own example shows a December bill three times the size of a normal month. The formula, the fit test, and the 26,122 Mesa County Part D enrollees with no Extra Help softening a bad January. Every figure sourced.
Read →
Medicare denied your care. Here's how the 2026 appeal works in Montrose County
Nine out of ten Medicare Advantage denials are never appealed — and 80.7% of the ones that are get partially or fully overturned. For nursing-home rehab the HHS Inspector General put the reversal rate at 95%. The five levels, the two filing deadlines, and the fast appeal you have to request by noon the day before your care ends. Every figure sourced.
Read →
Does Medicare cover home health care? The 2026 rules, and what they mean in Pitkin County
Covered home health services cost $0 in 2026 — no deductible, no coinsurance, no visit limit. The hard part is the two conditions: you must be homebound, and you must need part-time or intermittent skilled care. Personal care alone does not qualify. And you do not have to be improving — the Jimmo settlement settled that. Of Colorado's 222 Medicare-certified home health agencies, 11 list a Western Slope address and none list one in Pitkin County. Every figure sourced.
Read →
Moving and Medicare in 2026: the Special Enrollment Period that follows you to Ouray County
Original Medicare and a Medigap policy travel with you anywhere in the country. A Medicare Advantage plan stops at a county line. A move gives you two full months to switch Part C or Part D — one month longer if you tell your plan before you go — and it opens a guaranteed issue right to buy Medigap that most people forfeit by accident. In 2025, 27.6% of Ouray County's Medicare beneficiaries were in a Medicare Advantage or other health plan, versus 47.3% in Delta County. Every figure sourced.
Read →
Medicare and diabetes in 2026: what supplies and insulin cost in Delta County
Your meter, strips, lancets, and CGM are Part B equipment at 20%. Your insulin is capped at $35 a month. Your syringes are neither — unless you have a drug plan. The full 2026 map, plus the four diabetes drugs whose Medicare-negotiated prices took effect January 1 and the no-cost services most people skip. 12.4% of Delta County adults have diagnosed diabetes, the highest of the six counties we serve. Every figure sourced.
Read →
Working past 65 in Garfield County: your 2026 Medicare decision
Still on the job at 65 in Rifle or Glenwood Springs? Whether you can safely delay Part B turns on one number — your employer's headcount. And about 92% of Garfield County's business establishments have fewer than 20 employees, the threshold where Medicare becomes your primary payer whether you enrolled or not. The 20-employee rule, the HSA trap, the 8-month window, and the COBRA mistake. Every figure sourced.
Read →
Medicare preventive services in 2026: the $0 checklist for Montrose County
Part B covers the yearly “Wellness” visit and roughly twenty screenings, vaccines, and counseling services at no cost to you in 2026 — but every $0 has conditions. The full list, the four reasons a “free” screening generates a bill, and the covered test 37 out of 100 Montrose County adults still skip. Every figure sourced.
Read →
Medicare hospital and rehab costs in 2026: the observation-status trap in Mesa County
A hospital stay costs $1,736 per benefit period in 2026, and skilled nursing rehab runs $217 a day after day 20 — but only if you were an inpatient for 3 days first. Why nights spent “under observation” don't count, what the MOON notice means, and where Western Slope rehab beds actually are. Every figure sourced.
Read →
What Medicare doesn't cover in 2026: dental, vision, and hearing
Original Medicare pays nothing toward routine dental work, eye exams for glasses, or hearing aids — but it does cover the diagnostic side. Where every line falls in 2026, and why Garfield County has the fewest Medicare Advantage options on the Western Slope to fill the gap. Every figure sourced.
Read →
VA benefits and Medicare in 2026: a Western Slope veteran's guide
VA health care and Medicare are two separate programs, and using the VA does not shield you from Medicare's Part B late enrollment penalty — though VA prescriptions do count for Part D. How the two fit together for Western Slope veterans in 2026, with every figure sourced.
Read →
Medicare Advantage Open Enrollment 2026: your Grand Valley window
Already in a Medicare Advantage plan and January's coverage isn't a fit? The MA Open Enrollment Period (Jan 1–Mar 31) gives you one change. What you can and can't do in Mesa County for 2026, who qualifies, and the 16 local plans to measure against — every figure sourced.
Read →
Dual-Eligible D-SNP plans in 2026: a Delta County guide
If you have both Medicare and Medicaid in Delta County, a Dual-Eligible Special Needs Plan (D-SNP) is built for exactly that. How D-SNPs work in 2026, who qualifies, what they cost, and the monthly enrollment window most duals miss — every figure sourced.
Read →
Medicare Savings Programs 2026: help paying Part B in Mesa County
Three programs — QMB, SLMB, and QI — can pay your 2026 Part B premium, and QMB covers deductibles and copays too. The income and resource limits, the Extra Help bonus, and how to apply free in Colorado — every figure sourced.
Read →
Switching Medigap in Pitkin County: your 2026 window
Your one-time 6-month Medigap Open Enrollment window is when a Colorado insurer can't say no. How it works, why underwriting matters after it closes, and the guaranteed-issue rights that reopen the door — every figure sourced.
Read →
Medicare Extra Help 2026: lower Part D drug costs in Ouray County
The Part D Low-Income Subsidy — “Extra Help” — can wipe out your drug-plan premium, deductible, and most copays. Who qualifies in 2026, what it's worth, and how to apply free — every figure sourced.
Read →
Medicare Part B late enrollment penalty: a Delta County guide
Sign up for Part B late and you can pay a surcharge for life. How the penalty is figured in 2026, who actually owes it, and how working past 65 in Delta County lets you avoid it — every figure sourced.
Read →
Medicare AEP 2026: your Montrose County action plan
The Annual Enrollment Period runs Oct 15–Dec 7. What you can change, the 2026 costs to measure every plan against, and the December 7 deadline you can't miss — every figure sourced.
Read →
Medicare IRMAA in 2026: what higher-income retirees in the Roaring Fork Valley will pay
The official 2026 IRMAA brackets, the two-year income lookback that surprises new retirees, why home sales in the valley trigger one-year surcharges, and the SSA-44 appeal — every figure sourced.
Read →
The 2026 Part D $2,100 cap: what it means for prescription costs in Rifle and Glenwood Springs
Medicare now caps what you pay out of pocket for covered Part D drugs at $2,100 in 2026. How the cap works in Garfield County, what doesn't count toward it, and the monthly payment option — every figure sourced.
Read →
Medigap vs Medicare Advantage in Montrose & Delta counties: a 2026 comparison
Two very different ways to build your Medicare coverage — networks, 2026 costs, out-of-pocket protection, and the one-time enrollment window, compared in plain English with every figure sourced.
Read →
Turning 65 in Grand Junction: your 2026 Medicare roadmap
Your 7-month enrollment window, what Part B and Part D actually cost in 2026, and how to avoid lifetime late penalties — every figure linked to its federal source.
Read →