Medicare 2026

Why Late Medicare Sign-Up Adds to Racine Premiums for Life

Racine, Wisconsin — For people turning 65 or leaving job-based health coverage, one of the most common Medicare mistakes is signing up too late. Miss your window for Part B (doctor visits) or Part D (prescription drugs), and you could pay a penalty added to your premium every month for as long as you have Medicare.

The good news: these penalties are avoidable if you know the rules and act on time.

How the Part B late 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 coverage that counts, like a current employer's group health plan — Medicare adds 10% to your Part B premium for every full 12-month period you delayed.

That penalty sticks around for as long as you have Part B, not just a year or two. Someone who waits three years past their eligibility could pay 30% more every month, essentially forever.

You can generally only sign up for Part B during your Initial Enrollment Period, a Special Enrollment Period (for example, after losing job-based coverage), or the General Enrollment Period from January 1 to March 31 each year.

How the Part D late penalty works

Part D covers prescription drugs. The penalty here is calculated differently: Medicare takes 1% of the "national base beneficiary premium" and multiplies it by the number of full months you went without creditable drug coverage after your Initial Enrollment Period ended.

"Creditable coverage" means drug coverage that's at least as good as standard Medicare Part D — often from an employer, union, or the VA. If you have that, keep the letter your plan sends you each year proving it. You'll need it if you enroll in Part D later.

Like the Part B penalty, the Part D penalty is usually permanent and added to your monthly plan premium.

Your Initial Enrollment Period: the easiest way to avoid trouble

Most people become eligible for Medicare at 65. Your Initial Enrollment Period is a 7-month window: the three months before your birthday month, the month itself, and the three months after.

Signing up during this window — or having other creditable coverage lined up — is the simplest way to skip penalties entirely. If you're already getting Social Security, you'll usually be enrolled in Parts A and B automatically. If not, you have to sign up yourself through the Social Security Administration.

What if you're still working at 65?

Many Racine-area residents keep working past 65 and stay on an employer's health plan. If that employer has 20 or more employees, you can generally delay Part B without a penalty and get a Special Enrollment Period once you retire or lose coverage.

But small-employer plans, retiree coverage, COBRA, and marketplace plans don't always count as creditable for Medicare purposes. Before you delay, confirm in writing with your benefits administrator that your coverage lets you postpone Medicare without penalty.

Local help in Racine

Racine is in Racine County. For personalized, unbiased help — including whether your current coverage counts as creditable — Wisconsin offers a free State Health Insurance Assistance Program (SHIP) known as the Medigap Helpline at 1-800-242-1060. Counselors don't sell plans; they explain your options.

You can also reach the Aging and Disability Resource Center (ADRC) of Racine County for local guidance on Medicare, Medicaid, and related programs.

Key dates to remember

• Initial Enrollment Period: 7 months around your 65th birthday.
• General Enrollment Period for Part B: January 1 – March 31 each year.
• Medicare Annual Enrollment Period: October 15 – December 7 (for Part D and Medicare Advantage changes).
• Medicare Advantage Open Enrollment: January 1 – March 31.