Medicare 2026

Why missing Medicare deadlines costs Mishawaka enrollees

MISHAWAKA, Ind. — Most Medicare mistakes are fixable. Late-enrollment penalties for Part B and Part D are not. If you miss your sign-up window without other qualifying coverage, the extra charges can be added to your premium for as long as you have Medicare — sometimes for the rest of your life.

Miss a Medicare sign-up window, and the bill can follow you forever

The good news: these penalties are avoidable once you know the deadlines. Here is what people turning 65 in Mishawaka, and those retiring later, should keep in mind.

The Part B late penalty: 10% for every 12 months you delay

Part B covers doctor visits, outpatient care, and many preventive services. If you do not sign up when you are first eligible — and you do not have other creditable coverage, such as an employer group health plan based on active work — Medicare can add 10% to your Part B premium for every full 12-month period you could have been enrolled but were not.

That surcharge is not a one-time fee. It stays on your monthly premium for as long as you have Part B.

Two windows matter most:

• Initial Enrollment Period (IEP): the seven-month window around your 65th birthday — the three months before, your birthday month, and the three months after.
• General Enrollment Period: January 1 – March 31 each year, for people who missed their IEP and do not qualify for a Special Enrollment Period. Coverage starts the month after you enroll.

If you are still working past 65 and covered by a large employer's health plan, you may qualify for a Special Enrollment Period to sign up for Part B later without a penalty. But this exception has strict rules, and retiree coverage or COBRA does not count as active employer coverage. Confirm your situation before you delay.

The Part D late penalty: small numbers that add up for life

Part D is the prescription drug benefit. If you go 63 days or more in a row without Part D or other creditable drug coverage after you were first eligible, you can owe a Part D late-enrollment penalty when you finally sign up.

The penalty is calculated as 1% of the national base beneficiary premium, multiplied by the number of full months you went without coverage. That amount is rounded and added to your Part D premium every month — again, generally for as long as you have Part D.

"Creditable" simply means the drug coverage is expected to pay, on average, at least as much as standard Medicare Part D. Employer plans, union plans, VA benefits, and TRICARE often qualify. Each year, those plans are required to send you a notice telling you whether your coverage is creditable. Keep those letters. They are your proof if Medicare ever asks.

Mishawaka in context: what's local, what's national

Mishawaka is in St. Joseph County, where Medicare beneficiaries have a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage to choose from during enrollment periods. Plan choices are set at the county level and change each year, so it is worth reviewing your options during the Annual Enrollment Period (October 15 – December 7).

Enrollment deadlines and penalties, however, are federal — they work the same way in Mishawaka as they do anywhere else in the country. Local SHIP counselors (Indiana's State Health Insurance Assistance Program) offer free, unbiased help understanding how the rules apply to your situation.

A few 2027 numbers worth knowing

Even if you avoid penalties, these program-level figures shape what Part D will look like in 2027:

• $2,400 — the annual out-of-pocket cap on covered prescription drugs under Part D in 2027 (up from $2,100 in 2026).
• $700 — the maximum Part D deductible a plan can charge in 2027 (up from $615 in 2026).
• The old "donut hole" coverage gap is gone; Part D now has three phases (deductible, initial coverage, catastrophic).
• The Medicare Prescription Payment Plan lets you spread your drug out-of-pocket costs across the calendar year in monthly installments instead of paying at the pharmacy counter.
• IRMAA — the higher-income surcharge — begins above $109,000 in income for a single filer in 2026.

How to avoid a penalty in the first place

A short checklist:

1. Mark your Initial Enrollment Period. Enroll in Part A, Part B, and a drug plan (or a Medicare Advantage plan with drug coverage) during that seven-month window unless you have creditable coverage elsewhere. 2. Confirm — in writing — that any coverage you keep is creditable. Ask your employer's or union's benefits office. Save the notice. 3. If you're still working past 65, talk to your HR department and Medicare or a SHIP counselor before you delay Part B. The rules for employer size and active-employee status matter. 4. Don't let a gap open up. After you lose other coverage, you generally have 63 days to enroll in Part D and 8 months to enroll in Part B under a Special Enrollment Period. 5. Review during AEP each year (Oct. 15 – Dec. 7). Formularies and networks change.