Medicare 2026

Medicare sign-up windows in South Burlington: Part B and Part D

SOUTH BURLINGTON, Vt. — Missing a Medicare sign-up window doesn't just delay your coverage. For two parts of the program — Part B (doctor visits and outpatient care) and Part D (prescription drugs) — signing up late can add a penalty to your monthly premium for as long as you have Medicare. That means a missed deadline in your 60s can quietly raise your bill in your 80s.

The good news: the rules are clear, and most people can avoid these penalties with a little planning.

How the Part B late penalty works

Most people are first eligible for Medicare during a 7-month window around their 65th birthday — the three months before, the birthday month, and the three months after. This is called the Initial Enrollment Period.

If you don't sign up for Part B when you're first eligible, and you don't have other qualifying coverage (usually a current employer's group health plan), your monthly Part B premium can go up 10% for every full 12-month period you could have had it but didn't. That higher premium generally sticks with you the entire time you have Medicare.

For example, if you delayed Part B for three years without a valid reason, you could pay 30% more than the standard premium — every month, for life.

How the Part D late penalty works

Part D has its own separate penalty. If you go 63 days or more in a row without "creditable" prescription drug coverage after your Initial Enrollment Period ends, Medicare can add a late fee to your Part D premium once you finally enroll.

"Creditable" simply means the drug coverage you already have (say, from an employer, union, or the VA) is expected to pay, on average, at least as much as standard Medicare Part D. Your plan should send you a notice each year telling you whether your coverage counts. Save those notices.

The Part D penalty is calculated using a national base premium and the number of months you went without creditable coverage. Like the Part B penalty, it usually lasts the rest of the time you're enrolled in Part D.

Special Enrollment Periods can save you

You don't have to take Part B at 65 if you're still working and covered by an employer group health plan (from your job or your spouse's job). When that coverage ends, you get an 8-month Special Enrollment Period to sign up for Part B without a penalty.

A few important cautions:

• COBRA and retiree coverage do NOT count as active employer coverage for delaying Part B. Many people learn this the hard way.
• Marketplace (Affordable Care Act) plans also do not protect you from the Part B penalty.
• If you're not sure whether your coverage qualifies, ask your HR department in writing, then confirm with Medicare.

The key dates to remember

• Initial Enrollment Period: the 7 months around your 65th birthday.
• General Enrollment Period: Jan. 1 – March 31, for people who missed their initial window.
• Annual Enrollment Period (AEP): Oct. 15 – Dec. 7, when anyone with Medicare can join, switch, or drop a Part D or Medicare Advantage plan.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31, a one-time chance each year to switch Advantage plans or return to Original Medicare.

What South Burlington residents should know

South Burlington is in Chittenden County, where Medicare beneficiaries can choose from Original Medicare (Parts A and B) plus a stand-alone Part D drug plan, or a Medicare Advantage plan that bundles those benefits. County-level plan availability is set by CMS each year, and you can compare what's offered using the Plan Finder at medicare.gov.

A few program facts worth knowing as you plan:

• Part D out-of-pocket drug costs are capped at $2,100 for the year.
• The Part D deductible cannot be more than $615.
• The old coverage gap, or "donut hole," is gone as of 2025 — Part D now has three straightforward phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly payments instead of paying at the pharmacy counter.
• Higher-income beneficiaries pay an IRMAA surcharge on Part B and Part D premiums, starting above $109,000 in income for a single filer in 2026.

How to avoid a penalty in the first place

1. Mark your Initial Enrollment Period on the calendar the year you turn 64. 2. If you plan to keep working past 65, ask your employer — in writing — whether the health plan is considered creditable coverage and whether it will remain your primary payer. 3. Keep every "Notice of Creditable Coverage" letter you receive from a drug plan. 4. If you lose employer coverage, act fast. You have 8 months to enroll in Part B and 63 days to pick up a Part D plan without penalty. 5. When in doubt, call before the deadline, not after.