Medicare 2026

Medicare Part B and Part D enrollment timing for Lima readers

LIMA, Ohio — Medicare has a few deadlines that don't just sting once. Miss them, and you can pay extra every month for as long as you have coverage. The good news: once you know how the timing works, these penalties are almost entirely avoidable.

Here's a plain-English look at how the Part B and Part D late-enrollment penalties work, who is at risk, and how to protect yourself.

Why these penalties exist

Medicare is built on the idea that people sign up when they're first eligible, not just when they get sick or need expensive drugs. To keep the system fair, the government adds a permanent surcharge to your monthly premium if you wait too long without other approved coverage.

That surcharge is called a late-enrollment penalty. It's added to your bill for as long as you stay in Medicare — sometimes for the rest of your life.

The Part B penalty: 10% for every 12 months you delay

Most people become eligible for Medicare at 65. Your Initial Enrollment Period runs for seven months — the three months before your 65th birthday month, your birthday month, and the three months after.

If you don't sign up for Part B during that window and don't have other qualifying coverage (like an employer group health plan through active work), the Part B penalty kicks in. It adds 10% to your monthly Part B premium for every full 12-month period you went without it.

That penalty stays on your premium the entire time you have Part B. Twenty years in Medicare with a 20% penalty means paying more every single month for two decades.

You can generally only sign up later during the General Enrollment Period (January 1 – March 31), with coverage starting the month after you enroll — so a gap in coverage is common on top of the penalty.

The Part D penalty: small numbers that add up

Part D covers prescription drugs. If you go 63 days or more after your Initial Enrollment Period without Part D or other "creditable" drug coverage (coverage at least as good as Medicare's), you can owe a Part D late-enrollment penalty when you finally sign up.

The formula is technical, but here's the shorthand: Medicare multiplies 1% of the "national base beneficiary premium" by the number of full months you went without coverage, then adds that to your monthly Part D premium. Like the Part B penalty, it usually sticks around for as long as you have Part D.

Even people who don't take any prescriptions today can get hit with this later. That's why many folks enroll in a Part D plan at 65 even if their pill bottle is empty — it's cheap insurance against a lifelong surcharge.

The "creditable coverage" escape hatch

You don't have to sign up for Part B or Part D at 65 if you have other coverage that Medicare considers acceptable. The most common examples:

• Active employer coverage (yours or your spouse's) from a company with 20 or more employees can delay Part B without penalty.
• Creditable drug coverage — through an employer, union, VA, or TRICARE — can delay Part D without penalty.

Two important tips: keep the notices your plan sends each year confirming the coverage is "creditable," and enroll in Medicare within 8 months of losing that job-based coverage (for Part B) or within 63 days (for Part D). Retiree coverage and COBRA do not count as active employer coverage for the Part B rule.

What's happening in Lima and Allen County

Lima is in Allen County, where a range of Medicare Advantage and stand-alone Part D plans are offered each year. The number of options can change from year to year, so it's worth reviewing the plan finder at medicare.gov during the Annual Enrollment Period (October 15 – December 7) — the main window to join, switch, or drop drug and Advantage plans.

A few program facts worth keeping in mind:

• Part D out-of-pocket cap: $2,100 for 2026.
• Part D maximum deductible: $615.
• The old coverage gap ("donut hole") is gone as of 2025.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments.
• IRMAA income surcharges start above $109,000 for single filers in 2026.

None of these change the penalty rules — but they do change the math on whether a Part D plan is worth having, and for most people the answer is yes.

How to avoid the penalties in the first place

A simple checklist:

1. Mark your Initial Enrollment Period — the 7 months around your 65th birthday. 2. If you're still working at 65, confirm in writing that your employer coverage is "creditable" for both medical and drugs. 3. When employer coverage ends, don't wait — use your Special Enrollment Period right away. 4. If you're not sure whether you need Part D, enroll anyway in a low-premium plan. The cost is usually less than the penalty you'd owe later. 5. Keep every "creditable coverage" letter your insurer sends. That paperwork is what removes a penalty if Medicare wrongly bills you for one.