Medicare 2026

Turning 65 in Issaquah? Don't Miss Your 7-Month Window

# Turning 65 in Issaquah? Don't Miss Your 7-Month…

ISSAQUAH, Wash. — For people in Issaquah approaching their 65th birthday, the road into Medicare starts with one important calendar: the Initial Enrollment Period, or IEP. It's a seven-month window that can shape your coverage — and your costs — for years to come. Miss it, and you could face late penalties that follow you for life.

The good news? A little planning goes a long way. Here's what to know before the mail from Medicare starts arriving.

What the Initial Enrollment Period actually is

Your IEP is a seven-month window built around your 65th birthday. It includes the three months before the month you turn 65, the month itself, and the three months after. For most people in Issaquah, this is the first chance to enroll in Medicare Part A (hospital) and Part B (medical).

If you're already receiving Social Security benefits, you'll likely be enrolled in Parts A and B automatically. If you're not, you'll need to sign up yourself through the Social Security Administration at ssa.gov or by calling 1-800-772-1213.

Why timing inside the window matters

Not all seven months are equal. Enrolling in the first three months of your IEP means your Medicare coverage can begin the first day of your birthday month. Wait until your birthday month or later, and your start date gets pushed back — sometimes by a full month or more.

That gap can matter if you're planning to leave an employer plan, schedule a surgery, or start a new prescription. Signing up early is the simplest way to avoid a coverage gap.

The penalties for waiting

Medicare's late-enrollment penalties are one of the most common — and most painful — mistakes new beneficiaries make.

• Part B penalty: For most people, delaying Part B without other qualifying coverage adds 10% to your monthly premium for every full 12-month period you were eligible but didn't enroll. That surcharge typically lasts as long as you have Part B.
• Part D penalty: If you go 63 days or more without creditable drug coverage after becoming eligible, a Part D late fee gets added to your premium — and it, too, generally sticks around for life.

If you're still working at 65 and covered by a large employer's health plan, you may be able to delay Part B without penalty. Confirm this with your benefits administrator before you make a decision.

First steps to take right now

Even if your birthday is still months away, a few early moves can save you headaches:

1. Create a my Social Security account at ssa.gov to check your enrollment status and start dates. 2. Ask your employer or retiree plan in writing whether your current drug coverage is "creditable" for Part D purposes. 3. Learn the parts: Original Medicare (Parts A and B), Part D drug plans, Medigap supplemental policies, and Medicare Advantage (Part C) all work differently. 4. Check availability locally. Issaquah is in King County, where a wide range of Medicare Advantage and Part D plans are offered each year. Plan choices, networks, and pharmacy lists change annually, so review before you enroll.

Key 2027 numbers worth knowing

Even outside your IEP, some program-level figures are helpful context as you compare coverage:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027 — once you hit that limit, you pay nothing more for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 and $700 in 2027.
• The coverage gap ("donut hole") is gone as of 2025; Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread drug costs into monthly installments instead of paying at the pharmacy counter.
• IRMAA — the income-related surcharge for higher earners — begins above $109,000 for a single filer in 2026.

Where to get unbiased help

You don't have to figure this out alone, and you shouldn't rely on a sales pitch to make a lifelong decision.

• medicare.gov — the official federal site, with a plan finder tool.
• 1-800-MEDICARE (1-800-633-4227) — 24/7 help from Medicare directly.
• Washington SHIBA (Statewide Health Insurance Benefits Advisors) — free, one-on-one Medicare counseling from trained volunteers, available to Issaquah residents through the state's SHIP program.