Medicare 2026

Turning 65 in Novi? How to Dodge Medicare's Forever Fees

# Turning 65 in Novi? How to Dodge Medicare's Forever…

NOVI, Mich. — If you're approaching Medicare eligibility in Novi, one of the most important things to understand isn't which plan to pick — it's when to sign up. Miss the wrong deadline for Part B or Part D, and you could pay a penalty added to your premium for as long as you have Medicare. The good news: these penalties are avoidable once you know the rules.

How the Part B penalty works

Part B covers doctor visits, outpatient care, and many preventive services. If you don't sign up when you're first eligible — and you don't have other qualifying coverage — Medicare adds 10% to your monthly Part B premium for each full 12 months you delayed.

That surcharge sticks around the entire time you have Part B. So a two-year delay generally means a 20% higher premium for life. The penalty is calculated on the standard Part B premium, which can change from year to year.

How the Part D penalty works

Part D covers prescription drugs. The penalty here is smaller month-to-month but adds up the same way. For every month you go without Part D or other "creditable" drug coverage after your Initial Enrollment Period ends, Medicare adds 1% of the national base beneficiary premium to your Part D premium once you finally enroll.

"Creditable" is the key word. It means your current drug coverage is expected to pay, on average, at least as much as standard Medicare Part D. Employers and unions are required to send you a notice each year telling you whether your coverage is creditable — hold onto that letter.

The enrollment windows that protect you

Most people avoid penalties by signing up during one of these windows:

• Initial Enrollment Period (IEP): The seven-month window around your 65th birthday — three months before, your birthday month, and three months after.
• Special Enrollment Period (SEP): If you kept working past 65 and had creditable coverage through an employer, you generally have up to 8 months after that coverage ends to enroll in Part B without a penalty, and 63 days for Part D.
• General Enrollment Period: January 1 – March 31, for people who missed earlier windows. Coverage starts the month after you sign up, but penalties may still apply.
• Annual Enrollment Period: October 15 – December 7, for changes to Part D and Medicare Advantage.

Common Novi-area situations that trip people up

Some real-world scenarios cause the most penalties:

• Retiring from an employer but keeping only retiree health coverage or COBRA. COBRA and retiree plans are generally not considered creditable for Part B, and the clock keeps ticking.
• Assuming a spouse's plan protects you. It might — but only if the employer has 20 or more employees and the coverage is active (not retiree).
• Skipping Part D because you don't take medications yet. Even if your prescription list is empty today, going without creditable drug coverage builds a penalty for later.

If you're not sure whether your current coverage counts, ask your benefits administrator for the creditable coverage notice in writing.

Other program numbers worth knowing

While you're planning, a few program-level figures are useful context:

• Part D out-of-pocket costs are capped at $2,100 for the year.
• The Part D deductible can be no higher than $615.
• The coverage gap (the old "donut hole") has been eliminated since 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 at the pharmacy.
• IRMAA income-related surcharges for Part B and Part D begin above $109,000 for single filers in 2026.

Where to get unbiased help in Oakland County

Novi is in Oakland County, and Michigan's State Health Insurance Assistance Program — called MMAP here — offers free, one-on-one counseling from trained volunteers who don't sell insurance. That's the safest first stop if you're weighing a delay or trying to figure out whether your employer coverage is creditable.

You can also call 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov for the official rules and to enroll.