Medicare Supplement

Miss These Medicare Deadlines and You Could Pay for Life

LINCOLN, Neb. — Turning 65 comes with a stack of paperwork, and buried in it are a few Medicare deadlines that can quietly add to your bill every month for the rest of your life. The good news: once you understand how the timing works, they're not hard to avoid.

Here's what Lincoln readers need to know about late-enrollment penalties for Part B and Part D — and how to sidestep them.

Why Medicare has deadlines in the first place

Medicare is built on the idea that most people sign up when they first become eligible, usually around their 65th birthday. When people wait until they're sick to enroll, it drives up costs for everyone. To keep that from happening, Congress built in permanent penalties for signing up late without a good reason.

Two of those penalties — for Part B (doctor visits and outpatient care) and Part D (prescription drugs) — stick with you for as long as you have coverage.

The Part B late-enrollment penalty

If you don't sign up for Part B when you're first eligible, and you don't have other qualifying coverage (like a job-based health plan through active employment), your Part B premium can go up 10% for each full 12-month period you were eligible but didn't enroll.

That extra amount is added to your monthly premium — usually for life.

Your Initial Enrollment Period is a 7-month window: the 3 months before your 65th birthday month, your birthday month, and the 3 months after. If you miss it, you generally have to wait for the General Enrollment Period (January 1 – March 31) to sign up, with coverage starting the month after you enroll.

If you're still working at 65 with employer coverage, you may qualify for a Special Enrollment Period later — no penalty. But the rules are specific, so it's worth confirming with Medicare before you assume you're covered.

The Part D late-enrollment penalty

Part D has its own penalty, and this is the one that trips people up most often — because plenty of folks don't take a drug plan when they turn 65, figuring they'll add one when they need it.

Here's the catch: if you go 63 days or more in a row without Part D or other "creditable" drug coverage (coverage that's at least as good as Medicare's), you can owe a penalty when you finally enroll.

The penalty is calculated as 1% of the "national base beneficiary premium" for every month you went without creditable coverage, and it's added to your Part D premium for as long as you have Part D.

If you have drug coverage through an employer, a union, or the VA, ask for a creditable coverage notice in writing and keep it. That's your proof.

What's actually new for 2026

A few program-level facts are worth knowing as you plan:

• Part D out-of-pocket cap: Once you spend $2,100 out of pocket on covered drugs in 2026, you pay $0 for the rest of the year on those drugs.
• Maximum Part D deductible: $615 in 2026 (plans can set theirs lower).
• No more "donut hole": The old coverage gap was eliminated in 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: An optional program that lets you spread your drug costs across the year in monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA: Higher-income beneficiaries pay a surcharge on Part B and Part D premiums. For 2026, that starts above $109,000 in income for a single filer.

Key enrollment windows to circle

• Initial Enrollment Period: 7 months around your 65th birthday.
• General Enrollment Period: January 1 – March 31 (for people who missed their initial window).
• Annual Enrollment Period: October 15 – December 7 — for changing Part D or Medicare Advantage coverage.
• Medicare Advantage Open Enrollment: January 1 – March 31 — a one-time switch for people already on a Medicare Advantage plan.
• Special Enrollment Periods: Available if you lose employer coverage, move, or have other qualifying life events.

What Lincoln residents should know about local options

Lincoln is in Lancaster County, where Medicare plan availability is set at the county level. That means when you compare Advantage or Part D plans on Medicare.gov, the list you see is tied to your ZIP code and county, not the city itself. Availability can differ if you move to a neighboring county, so always plug in your actual address when you shop.