Medicare 2026

How Portland Retirees Avoid Medicare Part B, Part D Fees

PORTLAND, Maine — For people turning 65 here on Munjoy Hill or retiring up in Falmouth, Medicare comes with a stack of dates. Miss the wrong one, and you can pay a penalty every month for as long as you have Medicare. Not for a year. For life.

That is the part that catches Mainers off guard. The rules for Part B (doctor visits and outpatient care) and Part D (prescription drugs) do not just say "sign up when you can." They say "sign up on time, or pay more forever." Here is how the windows line up, and what to do if one is closing in on you.

The first deadline: your Initial Enrollment Period

The clock everyone starts with is the Initial Enrollment Period, or IEP. It is seven months long: the three months before the month you turn 65, your birthday month, and the three months after. If your birthday is in June, your window opens March 1 and closes September 30.

Sign up for Part A and Part B during those seven months and you are on time. Wait, and you may be looking at the Part B late-enrollment penalty for the rest of your Medicare life.

One thing to know if your birthday is coming up: since 2023, Part B coverage now starts the month after you enroll, no matter which month of the IEP you sign up in. That is a change worth remembering if you were told otherwise years ago.

What the Part B penalty actually looks like

The Part B late penalty is 10% added to your monthly premium for every full 12-month period you could have had Part B but did not. Two years late? 20% extra, every month. Five years late? 50% extra.

And it does not fall off. In most cases you pay it as long as you have Part B. That is why Medicare treats the "sign up on time" rule so seriously — it is not a slap on the wrist, it is a permanent line item.

What the Part D penalty looks like

Part D has its own penalty, and it works differently. If you go 63 days or more in a row without "creditable" prescription drug coverage after your IEP ends, Medicare adds 1% of the national base beneficiary premium for each month you went without, rounded to the nearest ten cents.

"Creditable" is the key word. It means drug coverage that is expected to pay, on average, at least as much as standard Part D. If you had employer or union drug coverage, the plan should send you a notice each year telling you whether it counts. Keep those notices. If you enroll in Part D later, that piece of paper is your proof.

The Part D penalty also generally lasts for life, and it is added to your monthly drug plan premium.

If you are still working past 65

This is where a lot of Portland-area workers get tripped up, especially folks staying on a spouse's plan or working part-time at a hospital or the university.

If you (or your spouse) have health coverage through a current employer with 20 or more employees, you usually can delay Part B without a penalty. When that job coverage ends, you get a Special Enrollment Period — generally eight months to sign up for Part B, and 63 days to pick up Part D — without owing the late fees.

Two cautions:

• Retiree coverage and COBRA are not the same as active employer coverage. They do not protect you from the Part B penalty. Once you retire, the SEP clock starts.
• Marketplace coverage (like CoverME.gov here in Maine) does not count as creditable for Medicare purposes either.

If you are not sure whether your plan qualifies, call the employer's benefits office and ask in writing.

The other windows people mix up

The Annual Enrollment Period, October 15 through December 7, is for changing your Medicare Advantage or Part D plan for the following year. It is not for signing up for Part B for the first time.

The Medicare Advantage Open Enrollment Period, January 1 through March 31, lets someone already on Advantage switch once. Again, not a fix for missing your Part B window.

The General Enrollment Period, January 1 through March 31, is the backstop for people who missed their IEP and do not qualify for an SEP. Coverage starts the month after you enroll — but the late penalty usually still applies.

Where Portland fits in

Portland sits in Cumberland County, where plan availability and drug plan options are set at the county level. Whichever route you take — Original Medicare with a standalone Part D plan, or a Medicare Advantage plan that includes drug coverage — the enrollment deadlines above apply the same way. The penalties do not care which product you pick; they care whether you signed up on time.

For 2026, a few program-wide numbers are worth keeping in mind as you plan: the Part D out-of-pocket cap is $2,100, the maximum Part D deductible is $615, and the old coverage gap ("donut hole") is gone — Part D now has three phases. There is also the Medicare Prescription Payment Plan, an optional way to spread your drug costs across the year instead of paying big bills at the pharmacy counter. Higher-income surcharges (IRMAA) start above $109,000 for a single filer in 2026.