Medicare 2026

Before 65 in Bloomington? Read the Part B and D rules

BLOOMINGTON, Ill. — If you're turning 65 soon or helping a parent sort out Medicare, one detail is worth writing down now: missing your enrollment window for Part B or Part D can add a penalty to your premium every month — often for as long as you have Medicare. The good news is these penalties are entirely avoidable once you know how the timing works.

How the Part B late-enrollment penalty works

Part B covers doctor visits, outpatient care, and many preventive services. Most people become eligible in a seven-month window around their 65th birthday — the three months before the birthday month, the birthday month itself, and the three months after. That's your Initial Enrollment Period.

If you don't sign up during that window and don't qualify for a Special Enrollment Period, your monthly Part B premium can go up by 10% for each full 12-month period you were eligible but not enrolled. Unlike a one-time fee, this surcharge stays attached to your premium for as long as you have Part B. That's why waiting "just a couple of years" can quietly turn into a permanent 20% add-on.

How the Part D late-enrollment penalty works

Part D helps pay for prescription drugs. The penalty for signing up late is calculated a little differently: it's 1% of the "national base beneficiary premium" multiplied by the number of full months you went without Part D or other creditable drug coverage after your Initial Enrollment Period ended.

Because the national base premium can change each year, the dollar amount of your penalty can shift over time too. And like the Part B penalty, it's typically added to your premium for as long as you're enrolled in Part D.

What counts as "creditable coverage"

You don't get penalized for skipping Part B or Part D if you have other coverage that Medicare considers at least as good. That's called creditable coverage, and common examples include:

• Group health insurance from your job or your spouse's job
• Retiree coverage that includes drug benefits
• Union or federal employee plans
• TRICARE or VA drug coverage (for Part D purposes)

Each fall, plan sponsors are required to send a notice telling you whether your drug coverage is creditable. Keep those letters. When you eventually sign up for Medicare, they're the paper trail that shows you don't owe a penalty.

Deadlines every Bloomington reader should mark

Bloomington is in McLean County, where beneficiaries follow the same national Medicare calendar as everyone else. A few dates to know:

• Initial Enrollment Period: the seven months around your 65th birthday.
• General Enrollment Period: January 1 – March 31, for people who missed their initial window and don't qualify for a Special Enrollment Period.
• Annual Enrollment Period: October 15 – December 7, when you can join, switch, or drop a Part D or Medicare Advantage plan.
• Medicare Advantage Open Enrollment Period: January 1 – March 31, for people already in a Medicare Advantage plan who want to change.

If you're leaving employer coverage, you generally have an eight-month Special Enrollment Period for Part B and a 63-day window to pick up Part D without a penalty. Don't wait until the last week — small paperwork snags can eat those windows quickly.

How to avoid the penalty in the first place

A few practical habits go a long way:

1. Mark your Initial Enrollment Period on the calendar as soon as you know your Medicare eligibility date. 2. Ask your HR department, in writing, whether your current health and drug coverage is creditable. 3. If you're delaying enrollment because you're still working, confirm the employer plan qualifies — some smaller-employer plans don't. 4. Enroll in Part D on time even if you don't take medications. A basic plan generally costs less than years of accumulated penalties later. 5. When your job coverage ends, start the Medicare enrollment process right away rather than waiting for the next open period.

For McLean County residents, free one-on-one counseling is available through Illinois SHIP (Senior Health Insurance Program), which is not affiliated with any insurance company and doesn't sell plans.