Medicare 2026

Part D Out-of-Pocket Cap in Baltimore, MD 2027

BALTIMORE, Md. — For people turning 65 in and around Baltimore, the difference between a smooth Medicare start and a lifetime penalty often comes down to a few dates on the calendar. Miss the wrong window, and higher premiums can follow you for as long as you have coverage.

Baltimore is in Baltimore city, where Medicare enrollment rules follow the same federal calendar used everywhere else. The rules are set by the Centers for Medicare & Medicaid Services (CMS), not by any plan or ZIP code — which means the dates below apply whether you live in Federal Hill, Hamilton, or out toward the county line.

The one window almost everyone gets

Your Initial Enrollment Period (IEP) is seven months long. It begins three months before the month you turn 65, includes your birthday month, and runs for three months after. That is the window most people should use to sign up for Part A, Part B, and (if they need it) Part D.

If you enroll in the three months before your birthday month, coverage starts the first day of your birthday month. If you wait until your birthday month or the three months after, coverage starts the first day of the following month.

Skipping this window without another form of qualifying coverage is what triggers the penalties described below.

Part B: 10% for every year you waited

The Part B late-enrollment penalty adds 10% to your standard Part B premium for each full 12-month period you could have had Part B but didn't. In most cases you pay that surcharge every month for as long as you're enrolled in Part B — not just for a year or two.

Example: if you delayed Part B by 26 months and had no other qualifying coverage, you'd owe an extra 20% on top of the standard premium (two full 12-month periods). That amount is recalculated when the standard premium changes each year, so the penalty grows over time.

If you missed your IEP and don't qualify for a Special Enrollment Period, the General Enrollment Period runs January 1 through March 31, with coverage starting the first of the month after you sign up.

Part D: a smaller percentage, but it adds up

The Part D late-enrollment penalty works differently. It kicks in when you go 63 days or more in a row without "creditable" prescription drug coverage after your IEP ends. "Creditable" means coverage — often from an employer, union, or the VA — that CMS considers at least as good as a standard Part D plan.

The penalty is 1% of the national base beneficiary premium for every month you were uncovered, rounded to the nearest 10 cents. It's added to your monthly Part D premium and, like the Part B penalty, generally lasts as long as you have Part D coverage.

Keep any letter you get each fall from an employer or drug plan telling you whether your coverage is creditable. That letter is the proof Medicare will ask for later.

The Special Enrollment Period that saves people from Part B penalties

If you or your spouse is still working at 65 and you have health coverage through that active employment, you can usually delay Part B without a penalty. When the job or the job-based coverage ends, you get an eight-month Special Enrollment Period (SEP) to sign up for Part B.

Two details trip people up:

• COBRA and retiree coverage do not count as active employer coverage for this SEP. The eight-month clock starts when the job-based coverage ends, not when COBRA runs out.
• The Part D SEP after losing creditable drug coverage is only 63 days — much shorter than the Part B window. Don't confuse the two.

How the other Medicare dates fit in

Two more windows show up often, but they are not about avoiding penalties:

• Annual Enrollment Period (Oct. 15 – Dec. 7): anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan for the next year.
• Medicare Advantage Open Enrollment (Jan. 1 – March 31): if you're already in a Medicare Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare.

Neither of these fixes a missed Part B enrollment. That's what makes the IEP and the SEP so important.

What's changing in 2027

A few program-level updates are worth knowing as you weigh your options during Fall enrollment:

• Part D out-of-pocket costs are capped at $2,100 in 2026 ($2,400 in 2027) for the year.
• The Part D deductible cannot exceed $615 in 2026 ($700 in 2027).
• The old coverage gap ("donut hole") is gone as of 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments instead of paying large amounts at the pharmacy counter.
• Income-related Part B and Part D surcharges (IRMAA) begin above $109,000 in income for a single filer in 2026.

None of these change the penalty rules — but they may change how you feel about signing up for Part D on time.