Medicare 2026

Medicare enrollment windows Westerly residents should track

Westerly, R.I. — Missing a Medicare deadline can cost you for the rest of your life. That's the hard truth behind Part B and Part D late-enrollment penalties, two of the most common — and most preventable — mistakes new beneficiaries make.

The good news: if you understand the rules, you can sidestep both. Here's what people turning 65 in Westerly, and those helping older family members, should know.

Why the penalties exist

Medicare is built on the idea that most eligible people will sign up when they first become eligible. When someone waits, and then joins later — often after a health scare — it pushes costs up for everyone. The late-enrollment penalties are Medicare's way of encouraging on-time enrollment.

They are not one-time fees. In most cases they are added to your monthly premium permanently, which is why avoiding them matters so much.

The Part B penalty, in plain English

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 (like a current employer's group health plan based on active work), you can owe a penalty.

The formula: your Part B premium goes up 10% for each full 12-month period you were eligible but not enrolled. That higher premium generally stays with you for as long as you're on Part B.

Example: if you waited three full years, your premium could be 30% higher — every month, for life.

The Part D penalty, in plain English

Part D covers prescription drugs. The penalty here works differently. Medicare multiplies 1% of the "national base beneficiary premium" (a figure Medicare sets each year) by the number of full months you went without Part D or other creditable drug coverage after your Initial Enrollment Period ended.

That amount is rounded and added to your Part D premium each month, for as long as you have Part D. Even people who "don't take any drugs right now" can get hit years later when they finally need coverage.

How to avoid both penalties

A few straightforward steps prevent most problems:

• Enroll on time. Your Initial Enrollment Period is a 7-month window: the three months before the month you turn 65, your birthday month, and the three months after.
• If you're still working past 65, confirm in writing that your employer coverage counts as "creditable" for both Part B (a large-employer group plan tied to active work) and Part D (creditable drug coverage). Keep those notices — you may need them later.
• Use your Special Enrollment Period. When your employer coverage ends, you generally have 8 months to sign up for Part B and 63 days to pick up Part D without a penalty.
• Don't rely on COBRA or retiree coverage to protect you from the Part B penalty. Those usually do not count as active employer coverage for Medicare's purposes.
• If you're low-income, look into Extra Help (also called the Low-Income Subsidy). People who qualify for Extra Help do not pay the Part D late-enrollment penalty.

What 2027 changes mean for your decision

There's more reason than ever to take Part D seriously. The Part D out-of-pocket cap on covered drugs is $2,100 in 2026 and $2,400 in 2027, and the maximum Part D deductible is $615 in 2026 and $700 in 2027. The old "donut hole" coverage gap is gone — the program now has three phases. Medicare also offers the Medicare Prescription Payment Plan, which lets you spread drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter.

Higher-income beneficiaries should also know about IRMAA — an income-related surcharge that begins above $109,000 for a single filer in 2026. IRMAA is separate from the late-enrollment penalty, but both can raise your monthly cost, so it's worth planning ahead.

Local context for Westerly

Westerly is in Washington County, where Medicare beneficiaries choose from Original Medicare (with or without a stand-alone Part D drug plan and, often, a Medigap policy) or a Medicare Advantage plan that bundles coverage. Plan availability is set at the county level, not the town level, and it can change each year.

Two dates to circle: the Annual Enrollment Period runs October 15 through December 7, when anyone with Medicare can join, switch, or drop a Part D or Medicare Advantage plan. If you're already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period runs January 1 through March 31, giving you one chance to switch Advantage plans or return to Original Medicare.

Neither of those windows, however, replaces your Initial Enrollment Period around your 65th birthday. Miss that, and the penalty clock can start.