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Medicare General Enrollment Period – Who Can Use It

Medicare offers several enrollment windows, and knowing which one applies to your situation is essential for avoiding coverage gaps and late-enrollment penalties. One key enrollment period; especially for those who missed their initial opportunity, is the Medicare General Enrollment Period (GEP).

For those who didn’t sign up for Medicare when first eligible, the GEP may provide a second chance to enroll. Let’s break down what the GEP is, who qualifies to use it, and what to expect.

Understanding the Medicare General Enrollment Period

The Medicare General Enrollment Period runs every year from January 1 to March 31. It exists to help individuals who:

• Did not enroll in Medicare Part A and/or Part B during their Initial Enrollment Period (IEP), and
• Do not qualify for a Special Enrollment Period (SEP)

During the GEP, eligible individuals can sign up for Medicare Part A (if they have to pay a premium for it), Medicare Part B, or both.

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Who Can Use the GEP

You may be able to use the Medicare General Enrollment Period if:

1. You turned 65 and missed your Initial Enrollment Period
2. You left employer coverage and did not enroll during a Special Enrollment Period
3. You declined Medicare when first eligible and later changed your mind
4. You were not automatically enrolled and never completed enrollment

You cannot use the GEP if

You already enrolled or declined Medicare during your IEP or SEP
You currently qualify or applied for a Special Enrollment Period (for example, due to loss of employer coverage)

When Coverage Begins After Enrolling

Unlike past years when coverage began in July, Medicare’s updated rules mean that coverage starts the first day of the month after you enroll during the GEP.

For example:

• Enroll in January – Coverage starts February 1
• Enroll in March – Coverage starts April 1

What About Late-Enrollment Penalties

If you’re enrolling during the GEP because you didn’t qualify for a Special Enrollment Period, be aware that late-enrollment penalties may apply:

• Part B penalty: 10% increase for each full 12-month period you didn’t enroll when eligible
• Part A penalty: Applies if you’re required to pay a premium and delayed enrollment

These penalties typicallylast for a lifetime, so enrolling as soon as you’re eligible; or using a SEP if qualified, is critical.

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Can You Enroll in Medicare Advantage or Part D After the GEP

Yes. After enrolling in Medicare during the GEP, you have a Medicare Advantage and Part D enrollment window from April 1 to June 30 each year.

During this time, you can:

• Join a Medicare Advantage (Part C) plan
• Enroll in a standalone Part D prescription drug plan

Missing your Initial Enrollment Period doesn’t mean you’re out of options. The Medicare General Enrollment Period offers an important second chance to gain coverage, but acting promptly is key.

If you’re unsure whether you qualify for the GEP or a Special Enrollment Period, consider speaking with a licensed Medicare agent who can help you understand your enrollment options and avoid unnecessary penalties or coverage delays.

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UnitedHealthcare UCard Benefits 2026

UnitedHealthcare continues to innovate member experience for Medicare Advantage enrollees, and the 2026 UCard remains a standout feature. More than an ID card, the UCard is designed to simplify access to multiple plan benefits, making it easier for members to stay healthy, shop for everyday essentials, and manage their care in one place.

What Is the UCard

The UnitedHealthcare UCard combines functions that traditionally required multiple cards or portals. For eligible 2026 plans, it may serve as:

• Your medical ID card for doctor visits and to fill prescriptions at your local pharmacy
• An over-the-counter (OTC) benefit card
• A healthy food and grocery card (on select plans)
• Access your gym membership
• A rewards and incentive card
• A payment tool for certain utilities and transportation on qualifying plans

By integrating benefits, UnitedHealthcare aims to reduce confusion and help members use the services available to them more easily.

Accessing Your UCard Benefits

Members can check their UCard balance and benefits in a few convenient ways:

• UnitedHealthcare UCard Hub – Log in to view balances, track reward earnings, and see eligible spending categories.
• UHC Mobile App – Scan products, check approved retailers, and track benefit usage in real time.
• UCard Customer Support Line – Speak with a representative for help activating or understanding benefits. Members will find the customer support number on the back of their UCard.

Members can also review benefit details in their plan documents or contact a licensed Medicare agent for assistance.

Watch a YouTube video on the Discontinued Medicare Advantage Plan Special Enrollment Period

Where Can Members Use the UCard

UCard spending benefits can be used at thousands of participating retail and online locations. Depending on the plan and benefit type, members may access approved products and services at:

• Major supermarket chains
• National pharmacy chains
• Big-box retailers
• Convenience and dollar stores
• Local participating grocers
• Online retailers that partner with UHC

At checkout, members simply swipe the card like a debit card for qualified purchases. Items not covered will need a separate form of payment. For select plans offering utility or transportation assistance, members may use funds through approved vendors or billing arrangements.

Why the UCard Matters

The UCard simplifies Medicare Advantage benefits by eliminating multiple cards and making it easier for members to actually use what they’re entitled to. This system supports better health outcomes, encourages preventive care, and adds everyday convenience.

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Canceling Medicare Part B – What You Need to Know

Medicare Part B helps cover doctor visits, outpatient services, preventive care, and durable medical equipment. It’s a cornerstone of healthcare for many older adults. Although, there are some situations when cancelling Medicare Part B is the best option for you

Whether due to employer coverage, cost concerns, or personal circumstances, canceling Part B is a decision that needs careful consideration. Here’s what you should know before making the move.

Why Someone Might Cancel Part B

Most people keep Part B once they enroll, but in certain situations, canceling may make sense, such as:

• Returning to Employer Coverage
  If you or your spouse returns to work and gains coverage through a credible employer health plan, you may choose to cancel Part B to avoid paying the monthly premium.
• Cost Concerns
  Individuals on a fixed budget may reconsider Part B due to premium costs. However, this should be carefully weighed against healthcare needs.
• VA Benefits Only
  Some veterans rely solely on VA benefits and opt to drop Part B, though this comes with some risk if VA access is delayed or preferences change later.

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How to Cancel Medicare Part B

Canceling Part B isn’t as simple as clicking a button online. The Social Security Administration requires a signed request, and often a Form CMS-1763 must be completed. Typically, you will need to:

1. Contact Social Security by phone or visit your local office to request cancellation.
2. Complete Form CMS-1763 in person or by phone with a Social Security representative.
3. Confirm your disenrollment once processed.

This extra step is intentional; Medicare wants to be sure beneficiaries understand the consequences before dropping coverage.

Watch a YouTube video on Medicare Enrollment Periods

Important Considerations Before Canceling

Canceling Part B can have long-term implications. Here are key points to consider:

• You May Pay a Late Enrollment Penalty Later
  If you cancel and don’t have other credible coverage (like large-group employer insurance), you may face a permanent surcharge if you re-enroll later.
• Limited Re-Enrollment Windows
  You can’t re-enroll anytime. Most people must wait for the General Enrollment Period (January 1 – March 31), with coverage beginning July 1; potentially leaving gaps.
• Future Coverage Access
  If your health needs change unexpectedly, getting back into Medicare Part B isn’t immediate.
• Medigap Implications
  Canceling Part B can impact your ability to retain or buy a Medicare Supplement plan, since Part B is required to maintain Medigap coverage.

When Not to Cancel Part B

Avoid canceling Medicare Part B if:

You do not have other credible employer-based coverage
Your VA benefits are your only backup and you want broader provider access
You plan to enroll in a Medicare Advantage or Medigap plan; both require Part B

If you’re unsure, speak with a licensed Medicare agent before making changes.

Canceling Medicare Part B is possible, but it’s not a decision to take lightly. With potential penalties, waiting periods, and the importance of ongoing medical access, it’s essential to make sure you have another qualifying form of coverage in place first.

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If your circumstances have changed and you’re considering this step, be sure to talk with a Medicare expert who can help you understand the rules and avoid costly gaps in coverage.

Deductibles and Other Medical Costs: What They Mean for Your Healthcare Budget

Healthcare terms can feel confusing, especially when it comes to how much you’ll actually pay for medical services. One of the most important pieces to understand when choosing insurance, or reviewing your current coverage, are deductibles and other medical costs.

These costs directly impact what you spend before your insurance steps in and how much you’re responsible for throughout the year. Understanding them helps you plan better, compare plans accurately, and avoid unexpected medical bills.

What Is a Deductible

A deductible is the amount you must pay for covered healthcare services before your insurance begins to share the costs.

For example, if your deductible is $2,500, you pay the first $2,500 of covered medical expenses yourself. After you meet your deductible, your insurance typically starts paying a portion of costs (often through coinsurance).

Think of the deductible as your first layer of financial responsibility in your insurance plan.

What Are Out-of-Pocket Costs

Out-of-pocket costs are expenses you’re responsible for when receiving care. They may include:

• Deductibles
• Copayments (fixed dollar amounts per service)
• Coinsurance (a percentage of the cost of services)
• Non-covered services

When comparing plans, look not only at the deductible but also the overall cost-sharing structure. A low-deductible plan may have higher premiums but lower out-of-pocket expenses when you receive care and vice versa.

Understanding the Out-of-Pocket Maximum

Most health insurance plans also include an out-of-pocket maximum (OOPM). This is the most you’ll pay in a policy year for covered services. Once you reach that limit, your insurance covers 100% of eligible expenses for the remainder of the year.

This limit is an important financial safeguard, especially for individuals with chronic conditions or unexpected medical events.

Watch a Video on Medicare IRMAA & Part B SEP Rules

Why Your Deductible and OOP Spending Matter

Knowing your deductible and out-of-pocket maximum helps you:

• Budget healthcare expenses
• Select a plan that fits your needs
• Avoid surprises when receiving care
• Plan ahead for prescriptions, specialists, or procedures
• Understand how preventive services are covered (This is key; many preventive services are covered before deductible!)

Tips for Choosing the Right Plan

When evaluating health plans, consider:

• How often you visit doctors
• Whether you take ongoing prescriptions
• Expected medical needs (e.g., planned surgery, therapies)
• Monthly premium cost versus potential annual expenses
• Your comfort level with risk and unexpected bills

People who expect regular medical care may benefit from lower deductibles and higher premiums. Those who rarely seek care may prefer a lower-premium, higher-deductible option.

Deductibles and out-of-pocket costs aren’t just insurance jargon; they are vital components of your financial health plan. Understanding them helps you to make smarter decisions and choose coverage that protects both your health and your wallet.

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If you ever feel uncertain about comparing plans or estimating potential costs, don’t hesitate to ask questions. Being informed is the first step to confident healthcare decisions. That is why working with a licensed insurance agent is so important.

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Medicare SSBCI vs. VBID: What’s the Difference

Two major innovations in the Medicare Advantage (MA) program; special supplemental benefits for the chronically Ill (SSBCI) and the Value-Based Insurance Design (VBID) Model, both aim to improve outcomes for beneficiaries with chronic conditions. However, they differ in purpose, eligibility, benefits, and future outlook. Here’s what you should know about Medicare SSBCI vs VBID and how they compare.

What Is SSBCI

The Special Supplemental Benefits for the Chronically Ill (SSBCI) program was created under the Bipartisan Budget Act of 2018. It allows Medicare Advantage plans to offer non-traditional, non-medical benefits designed to help people with serious chronic illnesses maintain or improve their health and daily function.

To qualify, a beneficiary must:

1. Have one or more complex chronic conditions,
2. Be at high risk of hospitalization or other negative outcomes, and
3. Require intensive care coordination.

Unlike standard Medicare benefits, SSBCI may cover services such as healthy groceries, home air-quality equipment, pest control, transportation, or home modifications. These benefits address social factors that affect health, such as nutrition, housing, and access to care.

Watch a YouTube video on the prescription payment program

SSBCI benefits are optional, meaning not every MA plan offers them. Plans also decide what types of benefits to include and who qualifies. CMS is increasing oversight to ensure these benefits are supported by evidence showing they can improve or maintain a member’s health or function.

SSBCI represents a shift in Medicare Advantage toward whole-person care; addressing more than just medical needs.

What Is VBID?

The Value-Based Insurance Design (VBID) Model, launched by the CMS Innovation Center, allowed participating Medicare Advantage plans to align cost-sharing and benefits with the clinical value of care. The goal was to lower barriers to high-value care (like preventive services or chronic disease management) while discouraging unnecessary spending.

VBID gave participating plans flexibility to reduce copays, expand supplemental benefits, and even test hospice care integration within MA. These features often targeted individuals with chronic illnesses, low income, or those living in underserved areas.

However, VBID was a demonstration model, not a permanent part of Medicare. In 2025, CMS announced it will end the VBID Model after determining that program costs to Medicare were higher than anticipated. While the model is ending, many of its design ideas; like targeted cost-sharing and flexible benefits, are expected to influence future MA benefit structures.

SSBCI vs. VBID: A Quick Comparison

Why It Matters

Both programs reflect a growing focus on integrated, person-centered care in Medicare Advantage.

• For beneficiaries: SSBCI can provide meaningful extra help for daily living and health support, but eligibility rules apply. Not everyone in an MA plan will qualify.
• For VBID participants: The model’s end may change how some plan benefits are structured in 2026, but many innovations are expected to remain.
• For all MA enrollees: When comparing plans, look beyond premiums and copays. Review whether a plan offers SSBCI or other supplemental benefits that fit your personal needs.

Always review your plan’s Summary of Benefits and Evidence of Coverage to see if SSBCI options are available, and confirm your eligibility with the plan.

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SSBCI and VBID have both pushed Medicare Advantage toward smarter, more holistic care. While VBID will conclude in 2025, SSBCI continues to grow; helping address many factors that shape health outcomes. Together, they represent Medicare’s evolving goal: not just to pay for medical care, but to help beneficiaries live healthier, more independent lives.

Medicare as Primary Insurance

When you turn 65 or qualify for Medicare due to disability, one of the most important things to know is whether Medicare becomes your primary or secondary insurance. Understanding Medicare as primary insurance helps avoid billing issues and unexpected out-of-pocket costs.

What Does “Primary” Mean

The primary payer is the insurance that pays your medical bills first. The secondary payer may cover costs that the primary insurance doesn’t pay; such as deductibles, coinsurance, or copays.
When Medicare is your primary insurance, your healthcare providers bill Medicare first. Once Medicare pays its share, any remaining balance may be sent to your secondary insurance, such as an employer plan or Medigap policy.

When Medicare Is Primary

Medicare typically pays first in these situations:

1. You’re retired and not covered by active employer insurance.
   Once you stop working and lose active coverage from an employer, Medicare becomes your primary insurance.
2. You have a small employer plan (fewer than 20 employees).
   If you’re still working or covered under a spouse’s small employer plan, Medicare pays first.
3. You have retiree coverage.
   Retiree insurance or COBRA coverage always pays after Medicare.
4. You have no other insurance.
   If Medicare is your only health coverage, it’s automatically primary.
5. You’re covered by Medicaid.
   Medicaid is always the payer of last resort, so Medicare pays first.

Learn about Medicare and employer coverage

When Medicare Is Secondary

In some cases, Medicare may pay after another insurance plan:

• You or your spouse are actively working for an employer with 20 or more employees, and you’re covered under that employer’s health plan.
• You’re receiving workers’ compensation or have a claim covered under no-fault or liability insurance.
• You’re under age 65 and have employer coverage due to disability, and the employer has 100 or more employees.

In these situations, your employer or other insurance must pay first, and Medicare acts as a secondary payer.

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Why It Matters

Knowing when Medicare is primary ensures your medical claims are processed correctly. If you enroll in Medicare but fail to tell your other insurer, or vice versa, you could face denied claims or late enrollment penalties.
Always confirm your coverage status with both Medicare and your employer’s benefits administrator to avoid costly mistakes.

Medicare’s role; whether it’s primary or secondary, depends on your work status, the size of your employer, and any additional coverage you may have.
If you’re nearing retirement or changing jobs, take time to review how your coverage coordinates. Doing so helps ensure smooth billing and gives you peace of mind knowing your healthcare costs are properly covered.

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Reasons for MA Plan Cuts – What’s going on

Recently, many insurers are pulling back or dropping Medicare Advantage plans in certain counties. Many Medicare advantage carriers are reducing offerings. This is especially true for PPO plans, which tend to be less restrictive for patients, but also costlier/riskier for insurers. Here’s a breakdown of the reasons for MA plan cuts and why some Medicare Advantage (MA) plans are leaving the market, what it means for enrollees, and how to prepare.

Why Some Medicare Advantage Plans Are Leaving the Market

In 2025 and beyond, several major insurers are scaling back or exiting certain Medicare Advantage (MA) markets. Companies like UnitedHealthcare, Humana, and Aetna are discontinuing specific plans or leaving select counties, affecting hundreds of thousands of beneficiaries. So, what’s driving these exits and what does it mean for Medicare enrollees?

Rising Costs and Slower Reimbursements

The main driver behind these exits is financial pressure. Health care costs; doctor visits, hospital stays, and prescription drugs continue to rise. Meanwhile, the Centers for Medicare & Medicaid Services (CMS) has limited how much funding increases for MA plans each year.

When reimbursement rates don’t keep pace with actual medical spending, insurers are forced to make tough decisions. Some reduce coverage areas; others leave markets entirely. The challenge is even greater in rural counties, where fewer enrollees mean higher per-member costs and less opportunity to spread financial risk.

Increased Regulation and Administrative Burdens

Medicare Advantage plans are subject to strict federal oversight. CMS star ratings, which measure quality and satisfaction, directly affect plan payments and bonuses. Plans with low ratings can face penalties or reduced funding.

New rules around prior authorization, marketing practices, and network adequacy have also added administrative costs. While these policies aim to protect consumers, they make operating certain plans more expensive and complex; especially for smaller carriers.

Shrinking Margins and Risky Plan Types

Preferred Provider Organization (PPO) plans, which allow greater provider flexibility, are especially expensive for insurers to run. In response, many companies are narrowing their focus to Health Maintenance Organization (HMO) plans with tighter networks and lower costs.

However, even with these adjustments, many insurers report that the combination of higher utilization, slower reimbursements, and increased regulation has made some plans unsustainable. As a result, certain counties are seeing fewer plan options for 2026.

Cutting Back on Benefits

To stay competitive and manage costs, insurers are also reducing extra benefits that have become popular selling points for Medicare Advantage plans.

Perks such as dental, vision, hearing, over-the-counter allowances, and fitness memberships are being scaled back or dropped altogether. Some plans have increased copays for specialists, raised out-of-pocket maximums, or restricted drug formularies.

While these changes help insurers control spending, they can leave beneficiaries with fewer incentives to stay on a plan—prompting more people to explore other options like Original Medicare with a Medigap supplement.

What This Means for Beneficiaries

If your Medicare Advantage plan is ending or changing benefits, you’ll receive an Annual Notice of Change (ANOC) this fall. It’s important to read this document carefully. You may find that your premiums, networks, or covered benefits are changing even if your plan remains available.

Here’s what to watch for:

• Fewer local plan options—especially in smaller or rural markets.
• Higher out-of-pocket costs due to benefit reductions or network changes.
• Provider access changes as plans narrow their networks.
• Reduced extra benefits, such as dental, vision, and wellness perks.

Watch a video on discontinued Medicare advantage plan special enrollment periods

If your plan is leaving your area entirely, you’ll qualify for a Special Enrollment Period (SEP) to choose a new plan or return to Original Medicare.

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What You Can Do

1. Review your ANOC early to understand all upcoming changes.
2. Compare new plans on Medicare.gov or with a licensed agent to see what’s available in your ZIP code.
3. Look beyond the premium. Consider total out-of-pocket costs, copays, and your provider network.
4. Verify your prescriptions. Ensure your medications are still covered under the plan’s formulary.
5. Explore Medigap and Part D options if you want more stability or broader provider access.

The Bottom Line

Medicare Advantage remains a strong and growing program, but rising costs and tighter reimbursement rules are forcing insurers to reassess their participation. Many are choosing to leave certain counties or reduce extra benefits to stay financially viable.

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For beneficiaries, staying informed is key. Review your plan each year, compare options carefully, and don’t assume your current benefits will stay the same. A little preparation can help avoid surprises and ensure you continue to get the coverage and care you need.

Medicare Part B Costs 2026

Medicare Part B helps cover medically necessary outpatient services, doctor visits, preventive services, medical equipment, and more. Because like many aspects of health care, its costs change annually, We will discuss the Medicare Part B costs 2026. beneficiaries and future enrollees need to know what’s ahead.

Below, we explore the projected premiums, deductibles, income-based surcharges (IRMAA), and strategies for planning.

What’s Covered by Part B & Basic Costs

Before diving into 2026, here’s a quick recap of how Part B costs typically work:

• You pay a monthly premium for Part B (unless you qualify for assistance).
• You also pay a yearly deductible before Medicare pays (for most services).
• After meeting the deductible, Medicare generally covers 80% of approved costs for covered outpatient services; you’re responsible for the remaining 20% coinsurance (unless another plan helps).
• If your income is above certain thresholds, you may pay an extra surcharge (IRMAA).
• Costs can vary based on where you live, your coverage options (like Medigap or Medicare Advantage), and your income.

These rules remain consistent, even as dollar amounts shift over time.

Projected Part B Premium in 2026

According to the Medicare Trustees’ projections and other financial analysts, the standard Part B monthly premium is expected to rise from $185 in 2025 to $206.50 in 2026 an increase of $21.50, or roughly 11.6%.

That jump would be the largest single-year dollar increase in recent years.

It’s crucial to note: this “standard” premium applies to beneficiaries without additional income-based surcharges (i.e. those whose incomes fall under the IRMAA thresholds). Those with higher incomes will pay more.

Expected Part B Deductible in 2026

While the exact deductible for 2026 will not be finalized until closer to year-end 2025, current projections suggest it may rise from $257 in 2025 to $288 in 2026.

That would be a roughly 12% increase in the amount beneficiaries pay out of pocket before Medicare starts covering your outpatient services.

Some Medigap (supplemental) plans cover the deductible; others require you to pay it yourself, so an increase could matter more to those on certain Medigap plans.

Income-Related Monthly Adjustment Amount (IRMAA) for 2026

One of the most significant cost levers in Medicare is the IRMAA surcharge: higher-income beneficiaries pay extra on top of the base premium. Here’s what’s projected for 2026:

• The 2026 IRMAA brackets and surcharge amounts are based on modified adjusted gross income (MAGI) from your 2024 tax return.
• The income thresholds (for moving among surcharge tiers) are expected to be indexed upward (adjusted for inflation) for 2026.
• The average surcharge increases for Part B are projected to be modest; around 1.04%.

Because of IRMAA, two people in the same city with different incomes might pay very different Part B amounts.

Why Are Costs Rising

Several forces contribute to rising Medicare Part B costs:

1. Medical inflation and utilization – Outpatient services, physician-administered drugs, diagnostics, and usage of health services often rise faster than general inflation.
2. Aging population / higher demand – As more retirees enter Medicare and health care needs grow, the burden on the system increases.
3. Cost shifting – Higher-income beneficiaries absorb more of the cost via IRMAA, but base premiums still have to cover a portion of system-wide costs.
4. Policy adjustments & fund dynamics – Adjustments to how much premiums are allowed to cover, budget pressures, and funding decisions all play a role.
5. Legislative changes – New laws affecting drug pricing, Medicare rules, and benefit design indirectly affect Part B costs over time.

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What It Means for Beneficiaries

• Budget impact: That extra $21.50 per month may absorb a significant chunk of any Social Security cost-of-living adjustment (COLA). Indeed, projections show much of retirees’ COLA gains may be eaten by higher health costs.
• Planning ahead: If your income is near an IRMAA threshold, small changes (e.g. capital gains, extra work income, withdrawals) could push you into a higher bracket.
• Review your coverage: Supplemental (Medigap) or Medicare Advantage plans may mitigate some out-of-pocket costs. If your Medigap plan covers the Part B deductible, the increase matters more.
• Appeal or exemption: If your income decreases substantially due to life events (e.g. retirement, widowhood), you may be able to appeal IRMAA adjustments.
• Stay informed: Final Medicare pricing is announced in late 2025. Propose your budget accordingly but expect adjustments.

Tips to Manage the Cost Increase

1. Estimate your 2024 MAGI now — knowing whether you might cross an IRMAA threshold will help with tax planning or withdrawals.
2. Delay or stagger income where possible — if legally and financially feasible, deferring income from 2024 may help you stay lower in the IRMAA tiers.
3. Choose the right supplemental plan — some Medigap policies cover the Part B deductible or reduce your coinsurance burden.
4. Stay within the initial enrollment windows — avoid late enrollment penalties, which add to cost burdens.
5. Appeal IRMAA where applicable — if you experience life-changing events, you may qualify for exceptions.
6. Watch your investments and gains — high capital gains or distributions in 2024 could unexpectedly push your MAGI upward.

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Bottom Line

Based on current projections:

• The standard Part B premium in 2026 may reach $206.50 per month, up from $185 in 2025.
• The deductible is expected to rise to about $288.
• Income-based surcharges (IRMAA) may add considerably more for higher earners.
• The increase is sizable and could erode a portion of any Social Security increase.
• Planning ahead; particularly regarding your 2024 income, can help reduce the surprise.

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Common Medicare Beneficiary Mistakes

Medicare can be confusing, especially with its many rules and enrollment periods. Unfortunately, even small mistakes can lead to coverage gaps or lifetime penalties. Here are some of the most common Medicare beneficiary mistakes and missteps to avoid.

Missing Your Initial Enrollment Period

Your Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. It starts three months before your 65th birthday, includes your birthday month, and ends three months after. Waiting too long to sign up can delay your coverage and lead to permanent late enrollment penalties — especially if you don’t have other creditable insurance.

Watch a YouTube video on Medicare enrollment periods

Assuming COBRA or Retiree Coverage Lets You Delay Medicare

If you have COBRA or retiree insurance, don’t assume it allows you to postpone Medicare. COBRA is not creditable coverage for delaying Part B or Part D. Failing to enroll when first eligible can leave you uninsured and subject to lifetime penalties once you do sign up.

Not Enrolling While Working for a Small Employer

If you’re still working and your company has 20 or fewer employees, Medicare becomes your primary insurance, not your employer plan. Failing to enroll in Medicare on time could mean denied claims and unexpected bills.

Ignoring the Need for a Part D Drug Plan

Even if you don’t take prescriptions, you should enroll in a Part D plan when first eligible. Without it, you’ll face a permanent late enrollment penalty once you do sign up, and you’ll have to wait until the next enrollment period for your coverage to start. Many beneficiaries choose an inexpensive plan simply to avoid future penalties.

Confusing Medigap Enrollment Rules

Unlike Medicare Advantage or Part D, Medigap doesn’t have an annual election period. Your one-time Medigap Open Enrollment Period begins when you enroll in Part B. During these six months, you can get a Medigap plan with no health questions — miss it, and medical underwriting could apply later.

Paying the Part B Deductible Too Soon

Some providers mistakenly request the Part B deductible before Medicare processes your claim. Always wait until Medicare applies the deductible to the correct bill to avoid confusion or overpayment.

Bottom Line

Understanding Medicare’s timelines and coverage rules can save you from penalties, gaps and unnecessary stress. Taking the time to review coverage options and asking your agent questions before you enroll helps you get the most out of your benefits.

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2026 Medicare IRMAA Amounts 2026: What Beneficiaries Should Expect

If beneficiary income is above certain thresholds, they’ll pay more for Medicare Part B and Part D through an IRMAA; the Income-Related Monthly Adjustment Amount. Because IRMAA is based on your tax return from two years earlier, 2024 income will determine what you owe in 2026. It is important to understand Medicare IRMAA amounts 2026 to budget for the year.

What Is IRMAA

IRMAA adds a surcharge to your Part B and Part D premiums if your Modified Adjusted Gross Income (MAGI) exceeds the set limits. For Part B, it’s usually withheld from Social Security; for Part D, it’s billed directly. If your income has recently dropped due to retirement, marriage, divorce, or another life-changing event, you can request a reconsideration using SSA Form 44.

Projected 2026 Costs

The standard Part B premium is projected to rise to $206.50/month in 2026, up from $185 in 2025. Even those who don’t pay IRMAA will see higher costs.

For higher-income beneficiaries, surcharges are added in brackets. Here are projected 2026 totals for Part B:

• Income of up to $109,000 (single) / $218,000 (married): pay $206.50 (the standard monthly rate)
• Income levels from $109k–$137k (single)/ $218k–$274k (married): pay $289 for Part B
• Those with income levels $137k–$171k (single)/ $274k–$342k (married): pay $413 for Part B
• Income levels of $171k–$205k (single) / $342k–$410k (married): pay $537
• Beneficiaries who make $205k–$500k (single) / $410k–$750k (married): will pay $661
• Those with income levels over $500k (single) / $750k (married): must pay $702

Part D IRMAA surcharges will also rise, from about $14.50/month in the first bracket up to $91/month for the highest incomes. CMS adds these amounts to the beneficiaries plan premium.

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What This Means for Beneficiaries

• Premiums are climbing, as they do most years. Even without IRMAA, 2026 Medicare costs are higher.
• IRMAA is a “cliff.” Going just $1 over a threshold bumps you into a higher bracket.
• Tax planning matters. Roth conversions, investment sales, and IRA withdrawals can all affect your MAGI.
• Life changes can help reduce an IRMAA. If income drops, beneficiaries may appeal to reduce or eliminate an IRMAA.

Planning Ahead

• Review 2024 tax returns to gauge your 2026 bracket.
• Be aware of income timing; shifting taxable money can prevent reaching income thresholds.
• Keep documentation ready if you need proof for a reconsideration.
• Stay updated on Medicare’s official income release in late 2025 for confirmation of final numbers.

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The projected 2026 IRMAA increases could mean significantly higher Medicare costs for high-income beneficiaries. By planning around your 2024 income now, beneficiaries may avoid unnecessary surcharges and keep more of their retirement income.

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