Only two Part D plans, insurers in parts of Pennsylvania and western New York, made the top grade for 2026. Both had fewer than 10,000 enrollees in 2025.
I don’t have Part D or Medicare Advantage. Now what?
You have several chances to sign up outside of open enrollment:
- During your seven-month initial enrollment period for Medicare, the three months before the month you turn 65 until three months after your birthday month.
- Within two months of losing employer or union health insurance.
- Within two months of losing drug coverage considered at least as good as Part D, called “creditable coverage.” This creditable coverage may be from an employer, a retiree plan, Tricare or another source.
What do I do if I never signed up for Part A or Part B?
Open enrollment season is not meant for new Medicare enrollees, even if TV ads make it seem as if everyone 65 and older should be participating.
If you’re working or insured through a spouse who has a job now, as long as you sign up within eight months of losing that employer or union medical insurance, you will avoid a Part B late enrollment penalty. If you’re beyond the two-month window to sign up for Medicare Advantage or Part D, you’ll have to wait until Oct. 15, the start of the next open enrollment period, and could face a Part D late enrollment penalty if you don’t have creditable coverage in the meantime.
If you missed your initial enrollment period at age 65 or any special enrollment period you might have qualified for, you’ll have to wait to sign up from Jan. 1 to March 31, the general enrollment period.
After your coverage for Parts A and B begins, or just Part B if you already have Part A, you’ll have two months to pick a Part D plan or a Medicare Advantage policy with drug coverage without penalty. If you choose original Medicare, the month your Part B begins, you’ll start your six-month, once-in-a-lifetime Medigap open enrollment period when you can buy any policy in your area at the best rate for someone your age.
Be aware: You may have to pay late enrollment penalties for Part A or Part B, depending on your circumstances.
Does Medicare have any exceptions?
If you can’t sign up for Part A or Part B because of an exceptional condition, such as being unable to complete your registration in time because of a natural disaster, misinformation from your employer or losing Medicaid coverage, you’ll have two months after you enroll to join a Medicare Advantage plan or a Part D prescription plan. Coverage will start on the first of the month after the plan receives your request to join.
If you don’t apply for prescription drug coverage from a Part D or Medicare Advantage plan within these time frames and don’t have other creditable drug coverage, you may have to pay a lifetime Part D late enrollment penalty when you sign up.
Still confused? Counselors who work for State Health Insurance Assistance Programs, known as SHIP, are available in every state and the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. They provide free, unbiased, one-on-one advice about Medicare.
This story, originally published Dec. 6, 2022, was updated with information for the 2026 Medicare plan season.
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