Medicare Supplement

How Rochester Residents Can Sidestep Medicare Penalties

ROCHESTER, Minn. — For most people turning 65, Medicare feels like a maze of dates. Miss the wrong one, and the price tag can follow you for the rest of your life.

That's the part that surprises people in Rochester and across Olmsted County: the penalties for enrolling late in Part B (doctor visits) or Part D (prescription drugs) aren't one-time fees. They're added to your monthly premium — often for as long as you have Medicare.

Here's how the deadlines work in 2026, and how to sidestep the most common mistakes.

Your first window: the Initial Enrollment Period

When you first become eligible for Medicare, you get a seven-month window to sign up. It starts three months before the month you turn 65, includes your birthday month, and ends three months after.

That window is your cleanest shot at avoiding penalties. If you enroll during it — and you don't have other qualifying coverage — you generally won't face a late fee later.

If you're already getting Social Security benefits when you turn 65, you're usually enrolled in Parts A and B automatically. If not, signing up is on you.

The Part B penalty: 10% for every year you wait

If you don't sign up for Part B when you're first eligible, and you don't have other creditable coverage (like a current employer's group health plan), Medicare adds 10% to your Part B premium for every full 12 months you could have had it but didn't.

That surcharge doesn't go away. It stays on your monthly bill for as long as you have Part B.

Common trap: dropping employer coverage or retiring and assuming you have plenty of time. You actually get an eight-month Special Enrollment Period after your job-based coverage ends to enroll in Part B without a penalty. Miss that window, and the clock starts.

The Part D penalty: small but permanent

Part D covers prescription drugs. If you go 63 days or more in a row without either a Part D plan or other "creditable" drug coverage after you're eligible, you can be hit with a Part D late-enrollment penalty when you finally sign up.

The penalty is 1% of the "national base beneficiary premium" for each month you went without coverage, added to your Part D premium every month. Like the Part B penalty, it generally lasts as long as you have Part D.

The fix is simple: if you're eligible for Medicare and don't have drug coverage from another source (like a current employer or the VA), enroll in a Part D plan — even if you don't take medications yet.

What's new for 2026

There are real reasons to pay attention to Part D this year, even if you've skipped it before:

• A $2,100 cap on out-of-pocket prescription drug costs for the year.
• A $615 maximum Part D deductible.
• No more "donut hole" — the coverage gap was eliminated in 2025, leaving three simpler phases.
• Medicare Prescription Payment Plan — an optional program that lets you spread your drug costs across the year in monthly installments instead of paying big bills at the pharmacy.
• IRMAA surcharges (higher premiums for higher earners) kick in above $109,000 in income for a single filer in 2026.

These are program-wide changes, not tied to any one plan.

The dates to circle

Two enrollment windows come around every year:

• Annual Enrollment Period: Oct. 15 – Dec. 7. This is when you can join, switch, or drop a Medicare Advantage or Part D plan for the following year.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance to switch to another Advantage plan or go back to Original Medicare.

Neither of those windows fixes a missed Part B deadline, though. For that, there's the General Enrollment Period (Jan. 1 – March 31), but signing up then usually means late penalties.

What Rochester residents can expect locally

Rochester is in Olmsted County, where Medicare beneficiaries choose from a range of stand-alone Part D plans and Medicare Advantage plans offered by multiple carriers. The exact number changes each year as insurers add or drop plans.

Because plan availability is set at the county level, the menu in Olmsted County may look different from what a friend or relative sees a few counties away. You can check what's offered in your ZIP code using the Plan Finder at medicare.gov.