Medicare 2026

Miss These Medicare Deadlines and You'll Pay for Life

ST. ALBANS, Vt. — Turning 65 in the Champlain Valley comes with a stack of mail, a Medicare card, and a decision most people don't realize is on a clock. If you miss your window to sign up for Part B (doctor visits) or Part D (prescription drugs), Medicare can add a penalty to your premium — and in most cases, that penalty stays with you for as long as you have coverage.

The Small Signup Mistake That Follows You Forever

The good news: these penalties are almost entirely avoidable if you know the rules ahead of time. Here's what St. Albans residents need to know before their birthday month sneaks up.

How the Part B Late Penalty Works

Most people first become eligible for Medicare during a seven-month window called the Initial Enrollment Period — the three months before your 65th birthday month, your birthday month, and the three months after.

If you don't sign up for Part B during that window, and you don't have other qualifying coverage (like a job-based health plan from current employment), Medicare adds 10% to your Part B premium for every full 12 months you could have had it but didn't. That higher premium generally sticks for life.

Example: If you waited three full years to enroll, your Part B premium could be 30% higher — every month, from then on.

How the Part D Late Penalty Works

The Part D penalty is smaller in dollars but works the same way: it's permanent.

If you go 63 days or more without "creditable" prescription drug coverage after you're first eligible, Medicare tacks on a monthly penalty when you finally enroll. The amount is 1% of the "national base beneficiary premium" for each month you went without coverage, and it's added to your Part D premium for as long as you're in the program.

Even people who don't take any medications today should think carefully before skipping Part D. Signing up for a plan when you're first eligible — even a basic one — protects your future self.

What "Creditable Coverage" Means

You can delay Part B or Part D without penalty if you have other coverage Medicare considers as good as its own. That usually means:

• A health plan through your (or your spouse's) current employer
• Certain union or retiree drug plans that send you a "creditable coverage" notice each year
• VA prescription benefits (for Part D purposes)

Keep those notices. If you ever enroll in Medicare later, you'll need to prove you had qualifying coverage to avoid the penalty.

The St. Albans Snapshot

St. Albans sits in Franklin County, where Medicare beneficiaries have a range of Original Medicare, Medicare Advantage, and standalone Part D options to consider during enrollment periods. Plan availability is set at the county level by the Centers for Medicare & Medicaid Services (CMS), so two neighbors on the same street generally see the same menu of choices.

Vermonters can get free, unbiased, one-on-one help from the State Health Insurance Assistance Program (SHIP), known locally as Vermont's SHIP counselors through the Area Agency on Aging — a good first call before any sales conversation.

Key 2026 Dates and Figures to Remember

• Initial Enrollment Period: the 7 months around your 65th birthday.
• General Enrollment Period: January 1 – March 31 (for people who missed their initial window).
• Annual Enrollment Period: October 15 – December 7 (change your Part D or Advantage plan).
• Medicare Advantage Open Enrollment: January 1 – March 31.
• Part D out-of-pocket cap (2026): $2,100.
• Part D maximum deductible (2026): $615.
• The old "donut hole" coverage gap was eliminated in 2025 — Part D now has three simpler phases.
• IRMAA (higher-income premium surcharges) begins above $109,000 in income for single filers in 2026.