Medicare 2026

Part B and Part D late-enrollment penalties in Gresham

GRESHAM, Ore. — Some Medicare mistakes fade fast. Others follow you every month for as long as you have coverage. Missing your sign-up window for Part B (doctor visits) or Part D (prescription drugs) falls in that second category — the late-enrollment penalties are added to your premium and, in most cases, never go away.

Here in Gresham, where thousands of residents age into Medicare each year, the rules aren't complicated once someone explains them plainly. The trick is knowing which deadline applies to you before it passes.

Why these penalties exist

Medicare is built on the idea that everyone pays in. If people only signed up when they got sick, premiums would climb for everyone. The late penalties are meant to encourage timely enrollment — but for someone who simply didn't know the rules, they can feel like a trap.

The good news: if you understand your Initial Enrollment Period and the handful of exceptions, you can sidestep both penalties entirely.

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

If you don't sign up for Part B when you're first eligible — and you don't qualify for a Special Enrollment Period — your monthly Part B premium goes up by 10% for each full 12-month period you could have had it but didn't.

That surcharge is permanent. It's added to your premium every month for as long as you have Part B.

Your Initial Enrollment Period is a 7-month window: the three months before your 65th birthday month, the month itself, and the three months after. Signing up during that window keeps you penalty-free.

When you're allowed to delay Part B

You can put off Part B without penalty if you have qualifying health coverage from a current job — yours or your spouse's — at an employer with 20 or more employees. When that job coverage ends, you get an 8-month Special Enrollment Period to sign up.

Two important warnings:

• COBRA doesn't count. Once your active employment ends, your Part B clock starts, even if COBRA is still paying claims.
• Retiree coverage doesn't count either. If your only insurance is a retiree plan from a former employer, you generally need to enroll in Part B on time.

If you're not sure whether your coverage qualifies, ask your benefits administrator in writing before you delay.

The Part D penalty: small numbers that add up

The Part D late-enrollment penalty works differently. It's calculated as 1% of the "national base beneficiary premium" for every full month you went without creditable drug coverage after you were first eligible.

That amount is then added to your Part D premium every month — again, usually for life. A few missed months is minor. A few missed years is not.

You avoid the Part D penalty by doing one of three things when you first become eligible: enroll in a Medicare drug plan, enroll in a Medicare Advantage plan that includes drug coverage, or keep other "creditable" drug coverage (such as from an employer). Your current insurer is required to tell you each year in writing whether your drug coverage is creditable — save those notices.

What's new for 2027

The Part D program looks very different than it did just a few years ago. Out-of-pocket spending on covered drugs is capped at $2,100 in 2026 and $2,400 in 2027, and the maximum Part D deductible is $615 in 2026 and $700 in 2027. The old "donut hole" coverage gap was eliminated in 2025, leaving three simpler payment phases. Enrollees can also opt into the Medicare Prescription Payment Plan to spread drug costs evenly across the year instead of facing big bills at the pharmacy counter.

Higher-income beneficiaries should note that IRMAA surcharges — extra amounts added to Part B and Part D premiums — begin above $109,000 in income for a single filer in 2026.

Key dates to circle

• Your Initial Enrollment Period: the 7 months around your 65th birthday.
• General Enrollment Period: January 1 – March 31, for people who missed their initial window and don't qualify for a Special Enrollment Period.
• Annual Enrollment Period: October 15 – December 7, when anyone with Medicare can change drug or Advantage plans for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31, a one-time chance each year for Advantage enrollees to switch plans or return to Original Medicare.

Where Gresham residents can get help

Gresham is in Multnomah County, where Medicare beneficiaries have access to a wide range of stand-alone Part D and Medicare Advantage plans during Annual Enrollment. Availability and plan details are set at the county level, so what's offered in Portland is generally what's offered in Gresham.

For unbiased, one-on-one help — including questions about penalties, creditable coverage letters, and enrollment windows — Oregon's SHIBA program (the state's federally funded SHIP) offers free counseling. You can also call 1-800-MEDICARE (24/7) or use the plan finder at medicare.gov.