Medicare 2026

Why Medicare late-enrollment penalties last for life in St George

ST. GEORGE, Utah — Missing a Medicare deadline can quietly follow you for the rest of your life. That's the hard truth about late-enrollment penalties for Part B (doctor visits and outpatient care) and Part D (prescription drugs): once they're added to your premium, they generally stay there as long as you have that coverage.

The good news is these penalties are almost always avoidable if you know when to sign up — and when it's safe to wait.

How the Part B late-enrollment penalty works

If you don't sign up for Part B when you're first eligible and you don't have other qualifying coverage, Medicare adds 10% to your Part B premium for every full 12-month period you could have had Part B but didn't.

That penalty is permanent. It's tacked onto your monthly premium for as long as you have Part B, and the dollar amount can grow over time as the base premium rises.

Most people become eligible around their 65th birthday. Your Initial Enrollment Period is a 7-month window: the three months before your 65th birthday month, your birthday month, and the three months after.

When it's safe to delay Part B

You can delay Part B without a penalty if you have "creditable" coverage — usually a group health plan through your (or your spouse's) current employer. When that coverage ends, you get an 8-month Special Enrollment Period to sign up for Part B penalty-free.

A few important cautions for St. George readers:

• COBRA and retiree coverage do not count as current employer coverage for this purpose. If you rely on those and skip Part B, a penalty can start building.
• Marketplace (ACA) plans do not count as creditable coverage for Part B either.
• If you're not sure whether your job-based plan counts, ask your HR office or benefits administrator for it in writing.

How the Part D late-enrollment penalty works

Part D has its own separate penalty. If you go 63 or more days in a row without Part D or other creditable drug coverage after you're first eligible, Medicare can add a permanent surcharge to your Part D premium.

The penalty is calculated as 1% of the "national base beneficiary premium" for every full month you were without creditable drug coverage. It's rounded, added to your monthly Part D premium, and — like the Part B penalty — usually lasts as long as you have Part D.

Creditable drug coverage often comes from an employer, union, VA, or TRICARE plan. Your plan should send you a notice each year telling you whether your drug coverage is creditable. Keep that notice. You may need it later to prove you shouldn't be penalized.

Why this matters more in 2027

Part D is changing in ways that make it worth paying attention to, even if you don't take many prescriptions today.

• The Part D out-of-pocket cap is $2,100 in 2026. Once you hit it, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old "donut hole" is gone as of 2025 — Part D now has three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA (an income-related surcharge on Part B and Part D premiums) starts above $109,000 for a single filer in 2026.

Because Part D coverage now has a firm annual ceiling, going without it — and racking up a penalty — is a harder decision to justify than it used to be, even for people who take few medications today.

Local context for St. George

St. George is in Washington County, where Medicare plan availability is set at the county level. That means residents here generally have a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage to choose from during enrollment periods. The specific plans, premiums, and networks change every year, which is exactly why the Annual Enrollment Period exists.

Key dates to remember:

• Annual Enrollment Period: October 15 – December 7, 2026 (change Part D or Medicare Advantage for 2027).
• Medicare Advantage Open Enrollment: January 1 – March 31 (limited changes for people already in a Medicare Advantage plan).

How to avoid these penalties — a simple checklist

1. Mark your Initial Enrollment Period. It starts three months before your 65th birthday month. 2. If you're still working at 65, confirm in writing that your employer plan is creditable for both Part B and Part D. 3. When employer coverage ends, use your 8-month Special Enrollment Period for Part B. Don't wait. 4. Don't go 63+ days without creditable drug coverage after you're first eligible for Part D. 5. Save your annual "creditable coverage" notices from employer or union drug plans. 6. If you think a penalty was added in error, you have the right to request a reconsideration.