Medicare 2026

Miss These Medicare Deadlines and You'll Pay for Life

SOUTH KINGSTOWN, R.I. — Most Medicare mistakes can be fixed. Missing your enrollment window for Part B or Part D usually can't. The penalties attach to your monthly premium, and for many people, they last as long as you have Medicare — which is to say, for the rest of your life.

If you're turning 65 soon in South Kingstown, still working, or helping a parent sort this out, here's what you need to know about the deadlines that matter most — and the simple steps that keep you out of trouble.

Why late-enrollment penalties exist

Medicare is built on the idea that healthy people and sick people enroll together. If folks could wait until they got sick to sign up, premiums would climb for everyone. So Congress built in penalties to encourage people to enroll when they're first eligible — and to keep credible drug coverage in place once they have it.

The two penalties that trip people up the most are the Part B late-enrollment penalty (for medical coverage) and the Part D late-enrollment penalty (for prescription drugs).

The Part B penalty: 10% for each year you delay

If you don't sign up for Part B when you're first eligible — and you don't qualify for a Special Enrollment Period — your monthly Part B premium can go up 10% for every full 12-month period you could have had Part B but didn't.

That extra amount is added to your premium for as long as you have Part B. Delay three years, and you could be paying an extra 30% every month, forever.

Your Initial Enrollment Period is the seven-month window around your 65th birthday: the three months before your birthday month, the month itself, and the three months after.

The big exception: If you're still working at 65 and have health coverage through your (or your spouse's) current employer, you can usually delay Part B without penalty. When that job-based coverage ends, you get an eight-month Special Enrollment Period to sign up. COBRA and retiree coverage do not count as current employer coverage for this purpose — a detail that catches a lot of Rhode Islanders off guard.

The Part D penalty: small numbers that add up

The Part D penalty works differently. It's calculated as 1% of the "national base beneficiary premium" for every full month you went without creditable drug coverage after your Initial Enrollment Period ended.

That may sound minor, but it adds up. Go 24 months without creditable coverage, and your penalty is roughly 24% of the base premium — added to your Part D premium every month, for life.

"Creditable" is the key word. It means drug coverage that Medicare considers at least as good as a standard Part D plan. Plans required to send you a notice each year (usually in September) telling you whether your coverage is creditable. Keep those letters. If you ever get a penalty, that paperwork is how you fight it.

What's changing in 2026 that makes Part D worth having

Part D has changed dramatically. For 2026, out-of-pocket spending on covered drugs is capped at $2,100, and the maximum deductible any plan can charge is $615. The old "donut hole" coverage gap was eliminated in 2025, leaving three simpler phases.

There's also the Medicare Prescription Payment Plan, which lets you spread your drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter.

The point: even if you don't take many prescriptions today, enrolling in some form of creditable drug coverage when you're first eligible protects you from a lifetime penalty — and gives you real financial protection if your health changes later.

Mark these dates

• Your Initial Enrollment Period: the 7 months around your 65th birthday.
• General Enrollment Period: Jan. 1 – March 31, for people who missed their initial window (coverage starts the month after you enroll).
• Annual Enrollment Period: Oct. 15 – Dec. 7 each year, when you can join, drop, or switch Part D and Medicare Advantage plans.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31, a one-time chance each year to switch or drop Advantage coverage.

South Kingstown is in Washington County, and plan availability — including how many Part D and Medicare Advantage options are offered — is set at the county level. When you're comparing options on medicare.gov, use your ZIP code so you see what's actually available where you live.

How to avoid the penalties: a short checklist

1. Know your dates. Write down the first month you're eligible for Medicare and the last day of your Initial Enrollment Period. 2. If you're still working past 65, confirm in writing from your employer's benefits office whether your coverage counts as "current employer" coverage for Medicare purposes. 3. Save every creditable-coverage letter you get from any drug plan or employer plan. 4. Don't rely on COBRA to protect you from Part B penalties. It doesn't. 5. Call for help before you decide. In Rhode Island, the SHIP program is called THE POINT / SHIP-RI and offers free, unbiased counseling. You can also call 1-800-MEDICARE or visit medicare.gov.