Medicare 2026

Initial Enrollment Period for Medicare in Westerly RI

# Aging into Medicare: the enrollment window you don't want to…

WESTERLY, R.I. — If a 65th birthday is on the horizon at your house, the calendar is already working for you — or against you. Medicare gives most people a one-time, seven-month runway called the Initial Enrollment Period, and using it well can spare you late penalties, coverage gaps, and a lot of paperwork headaches down the road.

Here in Westerly, the rules are the same as anywhere else in the country, but the plan choices you'll compare later are set at the county level. Westerly is in Washington County, where the mix of Medicare Advantage and Part D plans is decided each fall by the Centers for Medicare & Medicaid Services (CMS).

Let's walk through what the Initial Enrollment Period is, when it starts, and the first steps to take so you don't miss it.

What the Initial Enrollment Period actually is

The Initial Enrollment Period, or IEP, is the seven-month window built around your 65th birthday. It includes:

• The three months before the month you turn 65
• The month you turn 65
• The three months after the month you turn 65

During this window, you can enroll in Part A (hospital insurance), Part B (medical insurance), a stand-alone Part D drug plan, or a Medicare Advantage (Part C) plan that bundles them together. You can also add a Medigap (Medicare Supplement) policy during your one-time Medigap Open Enrollment window, which starts when you're 65 and enrolled in Part B.

This is separate from the fall Annual Enrollment Period (Oct. 15 – Dec. 7) and the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31). Those are for people already on Medicare.

When your coverage actually starts

Timing inside the window matters. Under current rules:

• Enroll in any of the three months before your birthday month → coverage starts the first day of your birthday month.
• Enroll during your birthday month or in the three months after → coverage starts the first day of the month after you sign up.

So if you wait until the tail end of your IEP, you can end up with a month or more without Medicare in place. For most people, signing up early in the window is the safer play.

Do you have to enroll at 65?

Not always — and this is where people trip up.

If you're already receiving Social Security or Railroad Retirement benefits, you'll usually be enrolled in Part A and Part B automatically the month you turn 65. If you're not drawing those benefits yet, you have to sign up yourself through the Social Security Administration.

If you're still working at 65 and have solid employer coverage (from a company with 20+ employees), you may be able to delay Part B without penalty and use a Special Enrollment Period later. But COBRA, retiree coverage, and marketplace plans generally do not count as qualifying coverage that delays your Part B deadline. Before you decide to wait, confirm with your benefits administrator — and, if you can, with SHIP.

The penalties you're trying to avoid

Missing your IEP without qualifying coverage can cost you for life:

• Part B late penalty: typically 10% added to your monthly Part B premium for each full 12-month period you could have had Part B but didn't. It usually lasts as long as you have Part B.
• Part D late penalty: roughly 1% of the national base beneficiary premium for every month you went without creditable drug coverage. It's added to your Part D premium going forward.

These are the kinds of mistakes that are much easier to prevent than to fix.

First steps to take in Westerly

Here's a simple checklist to work through in the months before you turn 65:

1. Create a "my Social Security" account at ssa.gov. This is where most people enroll in Part A and Part B online. 2. Decide on Part B timing. Talk to your HR department if you're still working, and get written confirmation that your current coverage is "creditable" if you plan to delay. 3. Make a list of your prescriptions and preferred doctors. You'll need it when you compare drug and Advantage plan options in Washington County. 4. Learn the 2026 program-level rules. Part D now has an annual out-of-pocket cap of $2,100, the Part D maximum deductible is $615, and the old coverage gap ("donut hole") was eliminated in 2025, leaving three simpler phases. There's also an optional Medicare Prescription Payment Plan that lets you spread drug costs across the year. 5. Check whether IRMAA might affect you. Higher-income beneficiaries pay Part B and Part D surcharges; for 2026, IRMAA begins above $109,000 in income for a single filer. 6. Get free, unbiased help. Rhode Island's State Health Insurance Assistance Program can walk you through your options at no cost.