Medicare 2026

Why Mount Vernon residents face Medicare enrollment penalties

Mount Vernon, Wash. — If you're approaching Medicare eligibility here in Skagit County, one of the most important things to understand isn't which plan to pick — it's when to sign up. Missing your enrollment window for Part B or Part D can trigger a late-enrollment penalty that follows you for years, sometimes for life.

The good news: these penalties are avoidable once you know the rules.

How the Part B late-enrollment penalty works

Part B covers doctor visits, outpatient care, and many preventive services. If you don't sign up when you're first eligible — and you don't have other qualifying coverage, like an employer health plan based on active employment — Medicare can charge a lifelong penalty.

The math is simple but stings: your Part B premium goes up 10% for each full 12-month period you were eligible but didn't enroll. If you delayed three years, your premium could be 30% higher — and in most cases, that surcharge stays on your bill for as long as you have Part B.

How the Part D late-enrollment penalty works

Part D is prescription drug coverage. If you go 63 or more days in a row without Part D or other "creditable" drug coverage after your Initial Enrollment Period ends, you may owe a penalty when you finally sign up.

The penalty is calculated by multiplying 1% of the "national base beneficiary premium" by the number of full months you were uncovered, then rounding to the nearest 10 cents. That amount is added to your Part D premium every month, and it can go up when the base premium rises.

What "creditable coverage" means

Creditable coverage is drug coverage that's expected to pay, on average, at least as much as standard Medicare Part D. Common examples include coverage from a current employer, a union, TRICARE, or the VA.

Your plan should send you a notice each year telling you whether your coverage is creditable. Hold on to that notice — it's your proof if Medicare ever asks why you delayed Part D.

How Mount Vernon residents can avoid penalties

Mount Vernon is in Skagit County, where residents have several Medicare Advantage and stand-alone Part D options to consider when they're ready to enroll. But before comparing plans, focus on timing:

• Know your Initial Enrollment Period. It's the 7-month window around your 65th birthday — the three months before, your birthday month, and the three months after.
• If you're still working past 65, ask your HR department whether your employer coverage counts as creditable and whether Medicare should be primary or secondary.
• Watch for Special Enrollment Periods. If you lose employer coverage, you generally have 8 months to sign up for Part B and 63 days to pick up Part D without penalty.
• Don't rely on memory. Set calendar reminders for Oct. 15 – Dec. 7 (Annual Enrollment) and Jan. 1 – March 31 (Medicare Advantage Open Enrollment).

A few 2027 numbers worth knowing

Even outside the penalty question, 2027 brings some meaningful Part D changes:

• The out-of-pocket cap on covered Part D drugs is $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The coverage gap (the old "donut hole") remains eliminated — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments.
• IRMAA income-related surcharges begin above $109,000 for single filers.

These figures apply nationally, including here in Skagit County.

Where to get help in Skagit County

If you're unsure whether you'll owe a penalty — or whether your current coverage counts as creditable — free, unbiased help is available. Washington's SHIBA program (the state's SHIP counterpart) has trained counselors who can walk through your situation with you. You can also call 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov.