Who this window is for
Most people meet Part B at 65, in a seven-month window around their birthday month. Some do not sign up then: they thought they did not need it, they misread a retiree plan or COBRA as employer coverage, or nobody told them. If they also have no special enrollment period, the General Enrollment Period is the door that is left.
It is not for switching plans, and it is not the fall window. It is for getting Part B at all, and Part A for the smaller group of people who have to buy it.
The special enrollment period that most people do have is the one after current employer coverage ends, their own or a spouse’s, at an employer with 20 or more employees. It runs for eight months after the employment or the coverage ends, whichever comes first, and it carries no penalty. Retiree coverage and COBRA do not count as current employer coverage. If you are not sure which situation you are in, find that out before January. The Medicare timing at 65.
When coverage starts now
The rule changed on January 1, 2023, and a lot of older advice still describes the old one.
| You sign up in | Part B starts |
|---|---|
| January | February 1 |
| February | March 1 |
| March | April 1 |
Under the old rule, everyone who used this window waited until July 1, which could leave half a year without medical coverage. That wait is gone. Signing up on January 2 rather than March 30 still gains you two months of coverage, so there is no reason to wait for the end of the window.
What the penalty costs
10% of the standard Part B premium for each full 12-month period you could have had Part B and did not. It is added to your premium every month, for as long as you have Part B.
Two years late means 20% more, every month, permanently. Because it is a percentage of the standard premium, it grows when the premium grows. The standard premium for 2026 is $202.90 a month; the 2027 figure had not been announced when we checked.
Drug coverage has its own penalty on a different formula: 1% of the national base premium for each month you went without creditable drug coverage after a gap of 63 days or more. For 2027 that base premium is $41.33. If you are fixing Part B, fix drug coverage in the same season.
The route around it: a Medicare Savings Program
This is the part most people are never told. Medicare’s own rule is that, generally, you will not have to pay a Part B penalty if you enroll in a Medicare Savings Program. The savings programs pay the Part B premium for people with limited income, and when the state pays, it can add you to Part B outside the usual windows.
In New York these programs are unusually open. QMB reaches 138% of the federal poverty level and QI reaches 186%, which for 2026 means $1,836 a month for one person under QMB and $2,474 under QI. There is no asset test. And qualifying for one also qualifies you for Extra Help with drug costs. One limit: from October 1, 2026, these programs are open only to citizens, green card holders past or not subject to the five-year bar, Cuban and Haitian entrants and citizens of the Compact of Free Association nations. The savings programs in detail.
So if your income is anywhere near those lines, the first call is not to wait for January. It is to apply for a savings program.
The order that works
- Check for a special enrollment period first. If you had current employer coverage at an employer with 20 or more employees, you may not need this window or pay any penalty.
- Check the savings programs next. If your income is near 138% or 186% of the poverty level, apply at HRA. It can remove the penalty and the wait.
- Otherwise, sign up for Part B in January, through Social Security. Coverage starts the first of the next month.
- Arrange drug coverage in the same season, so the drug penalty does not grow alongside.
- Then choose how to receive Medicare: Original Medicare, with a supplement that New York insurers must sell you in any month, or an Advantage plan. The comparison.
Questions people ask
When is the Medicare General Enrollment Period?
January 1 to March 31 every year.
When does coverage start if I sign up in the General Enrollment Period?
The first day of the month after you sign up. That rule has applied since January 1, 2023; before then, coverage started on July 1.
How much is the Part B late penalty?
10% of the standard Part B premium for each full 12 months you could have had Part B and did not, added for as long as you have Part B.
Can I avoid the penalty?
Generally yes, if you qualify for a special enrollment period or enroll in a Medicare Savings Program. In New York the savings programs have no asset test and reach 186% of the poverty level.
Is COBRA or retiree coverage enough to delay Part B?
No. Only coverage from a current employer, yours or your spouse’s, at an employer with 20 or more employees protects you from the penalty.
Who can help me work out whether I missed anything?
HIICAP, New York’s free Medicare counseling program, at 1-800-701-0501.
Sources
- Medicare.gov — when does Medicare coverage start (checked 2026-09-29)
- Medicare.gov — avoid late enrollment penalties (checked 2026-09-29)
- Federal Register — CMS-4199-F, coverage start dates for the General Enrollment Period (effective January 1, 2023) (checked 2026-09-29)
- Medicare Rights Center — Medicare Savings Programs and the Part B buy-in (checked 2026-09-29)
More in The Health Coverage Calendar for New Yorkers, October 2026 to April 2027
- January to March in a Medicare Advantage Plan: The One Change You Still Get — From January 1 to March 31, people in a Medicare Advantage plan get one more change. What it allows, what it does not, and why New York makes going back easier.
- What Resets on January 1, 2027, and the First-Week Checklist — Deductibles, out-of-pocket counters, drug lists and networks start over on January 1. What else changes in 2027 in New York, and what to check in the first week.
- Form 1095-A From NY State of Health: What It Is and Why the 2026 Return Is Different — Had a marketplace plan in 2026? Form 1095-A arrives by January 31 and feeds Form 8962. Why the 2026 return is the first with no cap on repaying the credit.
This page explains how the system works. It is not medical advice. More.