Medicare 2026

Lifetime premium add-ons: Medicare penalties in Virginia Beach

VIRGINIA BEACH, Va. — Some Medicare mistakes are easy to fix. Missing your Part B or Part D sign-up window is not one of them. If you enroll late without a good reason, the government can add a penalty to your monthly premium — and that extra charge can follow you for the rest of your life.

Here in Virginia Beach, where thousands of residents turn 65 each year, understanding these deadlines is one of the most important things you can do before you sign up for Medicare.

Why these penalties exist

Medicare is designed so that healthy and sick people join at roughly the same time. When people wait until they're sick to sign up, it drives costs up for everyone. To keep that from happening, Congress built in late-enrollment penalties for Part B (doctor and outpatient care) and Part D (prescription drugs).

The rules are set by the Centers for Medicare & Medicaid Services (CMS) and apply the same way in Virginia Beach as they do anywhere else in the country.

How the Part B penalty works

The Part B penalty is 10% of the standard Part B premium for each full 12-month period you were eligible but didn't sign up.

So if you waited three full years, your premium could be 30% higher — and that surcharge generally stays on your bill for as long as you have Part B. It's not a one-time fee. It's baked into your monthly premium going forward.

Your Initial Enrollment Period runs for 7 months: the 3 months before the month you turn 65, your birthday month, and the 3 months after. If you miss that window and don't qualify for a Special Enrollment Period, you may have to wait for the General Enrollment Period (January 1 – March 31) to sign up — and the penalty can apply.

How the Part D penalty works

The Part D penalty works a little differently. Medicare calculates it as 1% of the "national base beneficiary premium" for every month you went without Part D or other creditable drug coverage after you were first eligible.

That amount is added to your Part D premium every month, for as long as you're enrolled in Part D. Because the base premium can change each year, the dollar amount of your penalty can shift too — but the penalty itself doesn't go away.

"Creditable" coverage means drug coverage that's expected to pay, on average, at least as much as standard Medicare drug coverage. Job-based plans, retiree plans, and VA benefits often qualify. If you have coverage like this, keep the letter your plan sends each year confirming it's creditable — you may need it later to prove you don't owe a penalty.

How to avoid the penalties

The good news: these penalties are almost always avoidable if you plan ahead.

• Sign up during your Initial Enrollment Period unless you have other creditable coverage.
• If you're still working past 65 with employer coverage from a company with 20 or more employees, ask your HR department in writing whether your plan is creditable for both Part B and Part D purposes.
• When your job-based coverage ends, you generally get an 8-month Special Enrollment Period for Part B and a 63-day window for Part D. Don't let those clocks run out.
• Keep every "Notice of Creditable Coverage" you receive. That paperwork is your proof.

What's new for 2027

Even if you're already enrolled, it helps to know what's changing. In 2027, Part D includes a $2,400 annual out-of-pocket cap on covered drugs, and the maximum Part D deductible is $700. The old "donut hole" coverage gap was eliminated in 2025, leaving three simpler phases. There's also the Medicare Prescription Payment Plan, an optional program that lets you spread your drug costs across the year in monthly installments.

Higher-income beneficiaries may pay IRMAA surcharges on Part B and Part D — those kick in above $109,000 in income for a single filer in 2026.

Where Virginia Beach residents can get help

Virginia Beach is in Virginia Beach city, which Medicare treats as its own county for plan availability. If you want to compare what's offered locally or check whether your current coverage still fits, the tools at Medicare.gov let you search by ZIP code.

For personalized help — the kind that walks you through your own situation — Virginia has a free State Health Insurance Assistance Program (SHIP) called the Virginia Insurance Counseling and Assistance Program (VICAP). Counselors don't sell anything and don't work on commission.