Medicare 2026

Before 65 in Grand Rapids? Here's Your IEP Checklist

# Grand Rapids at 65? Your 7-Month Medicare Window…

If a 65th birthday is on the calendar in Grand Rapids this year, Medicare is about to become part of your life — and the clock is already ticking. The Initial Enrollment Period, or IEP, is the seven-month stretch built around your birthday month when you first sign up for Medicare. Miss it, and you could face late penalties that stick with you for years.

Here's what West Michigan readers turning 65 need to know before that window closes.

What the Initial Enrollment Period actually is

The IEP is your one-time, seven-month window to enroll in Original Medicare (Parts A and B) when you first become eligible at 65. It starts three months before your birthday month, includes your birthday month, and runs three months after.

For example, if you turn 65 in June, your IEP runs from March 1 through September 30. Sign up during the first three months, and your coverage begins the first day of your birthday month. Sign up during or after your birthday month, and coverage starts the first of the following month.

If you already receive Social Security benefits, you'll usually be enrolled in Part A and Part B automatically. Everyone else needs to sign up through the Social Security Administration at ssa.gov or by calling 1-800-772-1213.

Why the deadline matters

Skipping enrollment without creditable coverage from an employer isn't a small mistake. The Part B late enrollment penalty adds 10% to your monthly premium for every 12 months you were eligible but didn't sign up — and you pay it for as long as you have Part B. Part D has its own late penalty tied to how long you went without drug coverage.

If you're still working past 65 and covered by a group health plan through a current job (yours or a spouse's), you may qualify for a Special Enrollment Period later. Talk to your employer's benefits office before you turn 65 so you don't guess wrong.

First steps for Grand Rapids readers

Once you're within a few months of 65, here's a simple order of operations:

1. Confirm your eligibility date and check whether you'll be auto-enrolled through Social Security. 2. Decide on Part B. If you have strong employer coverage, you may delay. Otherwise, enroll during the IEP. 3. Think about drug coverage. Even if you take no medications today, signing up for Part D (or a Medicare Advantage plan that includes drug coverage) during your IEP avoids the Part D late penalty. 4. Choose your path. You can pair Original Medicare with a standalone Part D plan and possibly a Medigap policy, or you can choose a Medicare Advantage plan that bundles coverage.

Grand Rapids is in Kent County, where a range of Medicare Advantage and Part D plans are available. Use the Plan Finder at medicare.gov to compare what's offered in ZIP codes 49503, 49505, 49546 and the rest of the metro area.

2026 and 2027 numbers worth knowing

A few program-wide figures will shape your first year on Medicare:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your out-of-pocket drug spending hits that number, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that lets you spread drug costs across the year in monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges — extra premium amounts for higher earners — begin above $109,000 in income for a single filer in 2026.

Key dates after you're enrolled

Your IEP is a one-time window, but Medicare has recurring enrollment periods once you're in the system:

• Annual Enrollment Period (AEP): October 15 – December 7. This is when you can switch Medicare Advantage or Part D plans for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in a Medicare Advantage plan, you can switch once to another MA plan or drop back to Original Medicare.

Mark those on the calendar — they're your chances each year to reconsider your coverage as your health and budget change.

Where to get local help

You don't have to figure this out alone, and you shouldn't rely on a sales pitch to do it. Michigan's State Health Insurance Assistance Program is called MMAP (Michigan Medicare/Medicaid Assistance Program). MMAP counselors are trained volunteers who give free, unbiased help — no plans to sell. Call 1-800-803-7174 to reach a counselor serving Kent County.

You can also visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227), which is staffed 24/7.