Medicare 2026

Miss a Medicare sign-up window? The fee sticks for life

ROSEVILLE, Mich. — If you're getting close to 65, or helping a parent who is, one of the most important things to understand about Medicare has nothing to do with which plan you pick. It's the calendar. Sign up for Part B or Part D after your window closes without a good reason, and you can be charged a penalty every month — often for as long as you have Medicare.

The rules haven't changed for 2027, but a few program updates around them have. Here's a plain-language look at how the late-enrollment penalties work, who they hit, and how to steer clear.

How the Part B late penalty works

Part B covers doctor visits, outpatient care, and many preventive services. Most people first become eligible during their Initial Enrollment Period — the seven-month window around their 65th birthday.

If you don't sign up when you're first eligible and you don't have other qualifying coverage, Medicare adds 10% to your standard Part B premium for every full 12-month period you delayed. That surcharge doesn't go away after a year or two — in most cases, you pay it for as long as you have Part B.

Example: someone who waited three full years to sign up would pay 30% more each month, on top of the standard premium, going forward.

How the Part D late penalty works

Part D is prescription drug coverage. The penalty here is smaller each month but works the same way — it keeps adding up.

Medicare calculates the Part D penalty as 1% of the "national base beneficiary premium" for each full month you went without Part D or other creditable drug coverage after your Initial Enrollment Period ended. That amount is then added to your Part D premium every month. The base premium can change each year, so the exact dollar figure shifts, but the percentage stays with you.

This matters even more heading into 2027, because Part D has an annual out-of-pocket cap on covered drugs of $2,100 in 2026 and $2,400 in 2027, and a maximum deductible of $615 in 2026 and $700 in 2027. Going without drug coverage means missing out on those protections — and racking up penalty months at the same time.

"Creditable coverage" is the escape hatch

You don't have to enroll in Part B or Part D the second you turn 65 — but you do need to have coverage Medicare considers "creditable."

• For Part B, that usually means active group health coverage through your job or your spouse's job (at an employer with 20 or more employees). When that coverage ends, you get a Special Enrollment Period to sign up for Part B without a penalty.
• For Part D, creditable coverage means a drug plan (through an employer, union, or the VA, for example) that Medicare has determined pays at least as much as standard Part D. Your plan should send you a notice each year telling you whether it counts.

Keep those notices. If Medicare ever questions your enrollment timing, that paperwork is your proof.

Roseville-area context

Roseville is in Macomb County, where Medicare beneficiaries have a wide range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage to choose from during the Annual Enrollment Period, which runs Oct. 15 through Dec. 7 each year. Availability and specifics are set at the county level, not the city level.

If you're weighing options, the plan finder at medicare.gov lets you compare what's offered by ZIP code. Michigan's State Health Insurance Assistance Program — known locally as MMAP — offers free one-on-one counseling and can walk Macomb County residents through their choices without a sales pitch attached.

Common ways people get tripped up

A few situations lead to unexpected penalties more than others:

• Retiring after 65 and assuming COBRA counts. COBRA is not considered creditable coverage for Part B. If you're on COBRA and past 65, the clock is likely already ticking.
• Skipping Part D because you don't take prescriptions. Even if your medicine list is empty today, going without creditable drug coverage builds a penalty month by month for whenever you do enroll later.
• Missing the Part B window after job coverage ends. You typically have eight months from when employment or the group coverage ends — whichever comes first — to enroll in Part B penalty-free.

What income has to do with it

Higher-income beneficiaries pay an extra amount on top of their Part B and Part D premiums, called IRMAA (the Income-Related Monthly Adjustment Amount). For 2026, IRMAA surcharges begin above $109,000 in income for a single filer. IRMAA is separate from the late-enrollment penalty — but if you owe both, they're each added to your monthly premium.

For people managing drug costs, Medicare also offers the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket Part D costs across the year in monthly payments instead of paying a large bill at the pharmacy counter.