Medicare 2026

Miss These Medicare Deadlines and You'll Pay for Life

PORTAGE, Ind. — Medicare has a few deadlines that don't just cost you once. Miss them, and the penalty sticks to your monthly premium for as long as you have coverage. That's the tough truth about Part B and Part D late-enrollment penalties — and the good news is they're almost always avoidable if you know the rules.

Here's what folks in Portage need to understand before they turn 65 or lose other coverage.

Why the Part B penalty hurts the most

Part B covers doctor visits, outpatient care, and many preventive services. Most people sign up during their Initial Enrollment Period — the seven-month window around their 65th birthday (three months before, the birth month, and three months after).

If you don't enroll when you're first eligible and you don't have other qualifying coverage, Medicare adds 10% to your Part B premium for every full 12 months you went without it. That higher premium isn't temporary. It generally stays with you for the rest of your time on Medicare.

Example: If you waited three full years to sign up, your Part B premium could be 30% higher — every month, for life.

The Part D penalty is smaller, but just as permanent

Part D is prescription drug coverage. If you go 63 days or more without "creditable" drug coverage after becoming eligible for Medicare, you can face a late-enrollment penalty when you finally sign up.

The penalty is 1% of the "national base beneficiary premium" for each month you were uncovered, rounded to the nearest 10 cents, and added to your Part D premium going forward. It's not huge in any single month, but like the Part B penalty, it doesn't go away.

"Creditable" simply means the drug coverage you had was expected to pay, on average, at least as much as standard Medicare Part D. Employer plans, union plans, and VA benefits often qualify — but you should get that confirmation in writing from the plan every year.

When you can delay without a penalty

Not everyone needs to enroll at 65. You can usually delay Part B and Part D without a penalty if you have:

• Active employer coverage through your job or your spouse's job (at an employer with 20 or more employees).
• TRICARE, VA, or certain other federal coverage that counts as creditable.

When that coverage ends, you get a Special Enrollment Period — generally 8 months for Part B and 2 months for Part D — to sign up without penalty. COBRA and retiree coverage do not count as active employer coverage for Part B purposes, which trips up a lot of people.

If you're unsure whether your current coverage protects you from a penalty, ask your HR department or plan administrator for a "creditable coverage" letter and keep it.

The calendar dates to circle

A few Medicare dates worth writing down:

• Initial Enrollment Period: the 7-month window around your 65th birthday.
• General Enrollment Period: January 1 – March 31, for people who missed their initial window.
• Annual Enrollment Period: October 15 – December 7, when anyone with Medicare can change Part D or Medicare Advantage coverage.
• Medicare Advantage Open Enrollment: January 1 – March 31, for people already in a Medicare Advantage plan.

Portage is in Porter County, where Hoosiers have a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage to choose from during those windows. Availability is set at the county level, so two neighbors in different ZIP codes usually see the same choices.

What's changing in 2026

A few program-level updates worth knowing as you plan:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your covered drug spending hits that ceiling, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible is $615.
• The old coverage gap (the "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 the calendar year in monthly installments instead of paying big amounts at the pharmacy.
• IRMAA — the higher-income surcharge on Part B and Part D premiums — starts above $109,000 in income for a single filer in 2026.

A simple way to avoid a lifelong penalty

Three habits protect most people:

1. Mark your Initial Enrollment Period on a calendar the year you turn 64. 2. Get creditable coverage confirmed in writing if you plan to delay Part B or Part D. 3. Act fast when other coverage ends — don't wait past your Special Enrollment window.