Medicare Supplement

Miss These Medicare Deadlines and Pay a Penalty for Life

WARREN, Mich. — If you live in Warren and you're getting close to 65, there are two Medicare deadlines you really don't want to miss. Not because something dramatic happens right away, but because the penalties for signing up late can follow you for the rest of your life.

Here's the good news: once you understand how the timing works, avoiding these penalties is pretty simple.

Why late enrollment matters so much

Medicare isn't a "sign up whenever you feel like it" program. It has specific enrollment windows, and if you miss yours without a valid reason, Medicare can add a permanent surcharge to your monthly premium — for Part B (medical) and Part D (prescription drugs).

This isn't a one-time fine. It's built into your premium every month, for as long as you have that coverage. That's why getting the timing right the first time is worth a little planning now.

The Part B late-enrollment penalty

Part B covers doctor visits, outpatient care, and many preventive services. Most people become eligible during their Initial Enrollment Period — a 7-month window that starts three months before the month you turn 65 and ends three months after.

If you don't sign up when you're first eligible, and you don't have other qualifying coverage (like a job-based health plan through your or your spouse's active employment), you could owe a Part B penalty.

According to Medicare.gov, the penalty is generally 10% of the standard Part B premium for each full 12-month period you could have had Part B but didn't. And it usually sticks with you the whole time you have Part B.

If you delayed because you had job-based coverage, you likely qualify for a Special Enrollment Period to sign up without penalty when that coverage ends. Keep proof of your prior coverage in case you need it.

The Part D late-enrollment penalty

Part D covers prescription drugs. The rule here is that once you're first eligible for Medicare, you're expected to have some form of "creditable" drug coverage — meaning coverage that's at least as good as standard Medicare drug coverage. That could be Part D, a Medicare Advantage plan with drug coverage, or coverage from an employer or union that qualifies.

If you go 63 or more days in a row without creditable drug coverage after your Initial Enrollment Period, you may owe a Part D late-enrollment penalty when you finally sign up.

The penalty is calculated as 1% of the "national base beneficiary premium" for each full month you went without creditable coverage, and it's added to your Part D premium going forward. Like the Part B penalty, it's typically permanent.

Tip: If you have drug coverage through a current or former employer, ask them each year for a "creditable coverage" notice and hold on to it.

Key 2026 numbers Warren readers should know

A few program-level figures for 2026 to keep on your radar:

• Part D out-of-pocket cap: $2,100. Once your out-of-pocket spending on covered drugs hits this amount, you pay $0 for covered drugs the rest of the year.
• Part D maximum deductible: $615.
• The "donut hole" coverage gap is gone. As of 2025, Part D has three phases instead of four.
• Medicare Prescription Payment Plan. This optional program lets you spread your out-of-pocket drug costs across monthly payments instead of paying at the pharmacy counter all at once.
• IRMAA surcharges (higher premiums for higher earners) begin above $109,000 in income for a single filer in 2026.

Enrollment dates to circle

• Initial Enrollment Period: the 7 months around your 65th birthday month.
• General Enrollment Period: January 1 – March 31, if you missed your initial window and don't qualify for a Special Enrollment Period.
• Annual Enrollment Period (AEP): October 15 – December 7 each year, to join, switch, or drop a Medicare Advantage or Part D plan.
• Medicare Advantage Open Enrollment: January 1 – March 31, for people already in a Medicare Advantage plan who want to switch once.

Warren is in Macomb County, and plan availability — including how many Medicare Advantage and stand-alone Part D options are offered — is set at the county level. You can see the current Macomb County options by using the Plan Finder at Medicare.gov and entering your ZIP code.

How to decide what to do

If you're approaching 65 in Warren, ask yourself three questions:

1. Do I have other coverage right now? If yes, is it from a current employer, and is the drug portion "creditable"? Get that in writing. 2. When does my Initial Enrollment Period start and end? Mark it on the calendar. 3. If I delay Part B or Part D, do I clearly qualify for a Special Enrollment Period later? If you're not sure, that's a strong reason to enroll on time.

When in doubt, talk to someone who doesn't sell plans. Michigan's MMAP (Michigan Medicare/Medicaid Assistance Program) is the state's SHIP — a free, unbiased counseling service.