Your Situation
Missed Your Medicare Enrollment Window? Here's What to Do
It happens more than you'd think — someone assumes COBRA or a Marketplace plan was enough, or simply didn't know they had to sign up. You can still get Medicare. The questions are when your coverage can start, and whether you'll owe a penalty.
Common Ways People Miss the Window
They had COBRA or retiree coverage and thought it let them delay Part B. It doesn't — only coverage from current employment does.
They kept a Marketplace (ACA) plan after turning 65. Marketplace coverage doesn't let you delay Part B without a penalty.
They use VA health care. VA coverage counts for Part D, but not for Part B — skipping Part B can still mean a penalty later.
They weren't collecting Social Security yet, so nothing happened automatically at 65 — and they didn't know they had to apply.
When You Can Still Sign Up
General Enrollment Period — January 1 to March 31
Anyone who missed their first chance can sign up for Part B (and Part A, if you have to buy it) during these three months each year. Coverage starts the first day of the month after you sign up. Once Part B is active, you can join a Medicare Advantage or drug plan.
Special Enrollment Period for work coverage
If you (or your spouse) had coverage through a current job, you have 8 months after the job or coverage ends to sign up with no penalty. If you're still in that window, you haven't missed anything.
Special Enrollment Periods for exceptional situations
Medicare also allows enrollment outside the usual windows if something kept you from signing up, such as:
- A natural disaster or emergency
- Wrong information from your employer or health plan about when to sign up
- Release from jail or prison
- Losing Medicaid
If you missed enrollment because of wrong information from a federal employee (for example, at Social Security), you can ask for equitable relief.
How the Late Penalties Work
Part B penalty
10% of the standard Part B premium for each full 12-month period you could have had Part B but didn't. It's added to your premium for as long as you have Part B.
Example: 2 full years late = 20% extra, or about $40.58/month on top of the 2026 standard premium of $202.90.
Part D penalty
1% of the national base premium for each month you went without creditable drug coverage after your first chance to enroll. It's added to your drug plan premium for as long as you have Medicare drug coverage.
Example: 24 months without coverage = 24% of $38.99, or about $9.40/month in 2026.
Both penalties are figured on the base amount for the current year, so they change a little each year along with the premium.
Ways to Reduce or Remove a Penalty
Appeal if you had qualifying coverage
If you had work coverage or creditable drug coverage you think was missed, send proof. For Part D, you can ask your plan for a reconsideration — generally within 60 days of the letter telling you about the penalty.
Check for Extra Help
If you qualify for Extra Help with drug costs, you don't pay the Part D late penalty.
Check for a Medicare Savings Program
If you qualify for a Medicare Savings Program, Wisconsin pays your Part B premium — including the penalty.
Under 65 on disability?
If you're paying a penalty because of disability-based Medicare, it ends when you turn 65 and get a fresh enrollment period.
Don't forget your Medicare Supplement window. If you're 65 or older, your 6-month Medicare Supplement open enrollment starts the month your Part B begins — even if you signed up late. During those 6 months, Wisconsin insurers can't turn you down for health reasons.
Part B – Medical
Enrollment, costs, and late penalties →
Part D – Drug Coverage
How drug plans and penalties work →
Still have questions? Talk with Marit.
Licensed Wisconsin agent in downtown Appleton. No cost to talk, no pressure to enroll.
Or send us a message →