05/21/2026
This is an updated version of a post I ran about a month ago. Two additions based on your comments.
The Part B late enrollment penalty is 10% of the standard premium for each full 12-month period you went without enrolling. On the 2026 standard premium of $202.90, a two-year delay adds $40.58 per month permanently.
IRMAA surcharges are based on your 2024 income for 2026 premiums. A one-time capital gain, Roth conversion, or home sale can push you into a higher bracket. What many people don't know: if the income spike was a one-time event, you can appeal using Form SSA-44 and may get the surcharge reduced or eliminated.
The Medigap open enrollment window is exactly 6 months from the date your Part B coverage begins. After that window closes, insurers in most states can charge you more or deny coverage based on health history.
Medicare Savings Programs (QMB, SLMB, and QI) can cover part or all of your Part B premium. The income limits run roughly $1,255 to $1,700 per month for singles in 2026, but most states also have asset limits, so eligibility depends on more than income alone.
COBRA does not count as current employer coverage for Medicare purposes. Staying on COBRA past 65 without enrolling in Medicare starts the clock on the permanent Part B penalty.
Part D formularies change every year. A drug fully covered on your current plan can shift to a higher tier or be dropped from the formulary entirely, so reviewing your plan during open enrollment each fall matters.
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