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HomeMedicare 2026VirginiaArlingtonPart B and Part D penalty rules for Arlington Medicare enrollees

Medicare 2026

Part B and Part D penalty rules for Arlington Medicare enrollees

ARLINGTON, Va. — For Medicare, the calendar is everything. Miss the wrong window by even a month, and you can end up paying a penalty tacked onto your premium for as long as you have coverage. The good news: the deadlines are fixed, published, and easy to plan around once you know how they line up.

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Key takeaways

  • Your Initial Enrollment Period runs seven months around your 65th birthday — three months before, your birth month, and three months after.
  • The Part B late penalty is generally 10% added to your premium for each full 12-month period you were eligible but didn't sign up, and it usually lasts as long as you have Part B.
  • The Part D late penalty is 1% of the national base premium for each month you went without creditable drug coverage after eligibility, and it also lasts for as long as you have Part D.
  • If you have job-based coverage past 65, ask HR whether it counts as "creditable" and use a Special Enrollment Period when you retire to avoid both penalties.

This guide walks Arlington readers through the enrollment windows that trigger Part B and Part D late penalties, what happens if one slips by, and how the dates fit together.

The seven-month window that starts everything

Most people become eligible for Medicare at 65. Your Initial Enrollment Period (IEP) is a seven-month window: the three months before your 65th birthday, the month you turn 65, and the three months after. Sign up during that window and no penalty applies.

Signing up in the three months before your birthday month means coverage starts the first day of your birthday month. Signing up after your birthday month delays your start date, so most people who don't have other coverage aim for the earlier half of the window.

If you miss the IEP and don't qualify for a special exception, you generally have to wait for the General Enrollment Period, January 1 through March 31, with coverage starting the month after you enroll. That gap between eligibility and enrollment is where the Part B penalty is calculated.

How the Part B penalty is built — and why it usually never goes away

The Part B late enrollment penalty is 10% of the standard Part B premium for each full 12-month period you could have had Part B but didn't. It's added to your monthly premium and, in almost all cases, you pay it for as long as you're enrolled in Part B.

Two full years late means 20% added on top of the premium. Four years late means 40%. Because the penalty is a percentage of the current-year premium, it also grows a bit each year as the base premium changes.

The Part D penalty is smaller per month — but it stacks

Part D works differently. The penalty is 1% of the "national base beneficiary premium" for each full month you went without creditable prescription drug coverage after your Initial Enrollment Period ended. "Creditable" means coverage the government considers at least as good as a standard Part D plan — often employer or union drug coverage.

Because the penalty is counted in months, not years, even shorter gaps add up. Twenty months without creditable coverage becomes a 20% add-on to the base premium, and it sticks to your Part D premium for as long as you have Part D.

The takeaway for timing: if you don't take a drug plan at 65 because you're not on medications, you still need creditable drug coverage from somewhere — or you'll owe the penalty later when you finally enroll.

When the dates interact: three common Arlington scenarios

Turning 65 with no other coverage. Enroll during your seven-month IEP for both Part B and Part D. Waiting for the General Enrollment Period (Jan. 1 – March 31) means a late-enrollment penalty and a delayed start.

Still working at 65 with employer coverage. If your employer plan is creditable, you can usually delay Part B and Part D without penalty. When the job or coverage ends, an eight-month Special Enrollment Period opens for Part B, and a 63-day window for Part D. Miss those, and the penalty clocks start counting from when your IEP ended — not from when your job coverage stopped.

Enrolled in Part A only. Many people take premium-free Part A at 65 and postpone Part B. That's fine if you have other creditable coverage. Without it, the Part B penalty accrues quietly in the background.

Arlington is in Arlington County, where residents can compare Medicare Advantage and Part D plan options during the Annual Enrollment Period, Oct. 15 – Dec. 7, and the Medicare Advantage Open Enrollment Period, Jan. 1 – March 31. Those windows are for changing plans, not for first-time Part B enrollment.

How to keep the penalty clocks at zero

Where to get personalized help

Penalty math depends on your exact dates, and one document — like a creditable-coverage letter from an employer — can change the outcome. For personalized answers, contact:

By the numbers

Medicare Part B premium, 2006–2026

The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.

$0$50$100$150$200200820122016202020242026

Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.

By the numbers

How people get Medicare in Arlington County

30% are on Medicare Advantage
(MA penetration in Arlington County)
30%
70%
Medicare Advantage Medicare Supplement (Medigap) Original Medicare only
U.S. average

MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.

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Medicare Advantage companies in Arlington County

By local enrollment size · informational, not a ranking
CompanyLocal enrollmentPlans offeredLocal agentsAction
UnitedHealthcareNational—Yes
Kaiser PermanenteRegional—Yes
HumanaNational—Yes
Elevance Health (Anthem)National—Yes
Aetna (CVS Health)National—Yes
Johns Hopkins Healthcare LLCRegional—Yes
Enrollment data: CMS Medicare Advantage enrollment by company (county level). Figures shown are illustrative sample data pending the current CMS file. Listed by enrollment size, largest first — this is not a ranking, recommendation, or endorsement of any company or plan.

Provided by licensed insurance partners; MyMedicarePlans.org may be compensated. Not a ranking or endorsement of any plan.

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When can you enroll? An interactive year

JFMAMJJASOND
October 15 – December 7 — anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect January 1.

Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.

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The parts of Medicare

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no premium for Part A.

Good to know

Frequently asked questions

How long does the Part B late enrollment penalty last?
In most cases, the Part B penalty stays with you for as long as you have Part B. It's calculated as 10% of the standard premium for each full 12-month period you were eligible but not enrolled, and it's added to your monthly premium going forward.
What counts as "creditable" drug coverage for Part D?
Creditable coverage is prescription drug coverage that Medicare considers at least as good as a standard Part D plan. Employer, union, VA, and some retiree plans often qualify. Your plan is required to send you a notice each year telling you whether it's creditable — keep those notices.
I have job coverage and I'm turning 65. Do I have to sign up for Part B?
Usually no, if your employer coverage is creditable and the employer has 20 or more employees. You can typically delay Part B and use a Special Enrollment Period when the job or coverage ends. Confirm the details with your HR department and Social Security before your birthday month.
Can a Part D penalty ever be removed?
Sometimes. If you believe the penalty was applied in error — for example, you actually had creditable coverage during the gap — you can request a reconsideration through the plan that assessed it. Your plan will send instructions and a form when the penalty is added.
Sources & further reading
  • CMS — Medicare enrollment periods (medicare.gov)

For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.

Also for Arlington

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This page was last updated: September 2026.

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