If you do not enroll in Medicare Part B when you are first eligible and you do not have qualifying employer coverage, you will face a late enrollment penalty. Unlike some penalties, this one never goes away. It is added to your Part B premium for as long as you have Medicare.
How the Penalty Is Calculated
The penalty is 10% of the standard Part B premium for each full 12-month period you were eligible but did not enroll. The penalty is recalculated each year when the standard premium changes.
| Years Without Part B | Penalty % | Monthly Penalty Amount | Total Monthly Premium |
|---|---|---|---|
1 year | 10% | +$20.29 | $223.19 |
2 years | 20% | +$40.58 | $243.48 |
3 years | 30% | +$60.87 | $263.77 |
5 years | 50% | +$101.45 | $304.35 |
The Penalty Is Permanent
There is no way to remove the Part B late enrollment penalty once it is applied, except in limited cases where you successfully appeal based on misinformation from a federal employee. The penalty stays with you for life.
Who Can Avoid the Penalty?
You can delay Part B without penalty only if you have active employer-sponsored group health coverage through your own or your spouse's current employer, and that employer has 20 or more employees. When that coverage ends, you have an 8-month Special Enrollment Period to enroll in Part B penalty-free. COBRA, retiree insurance, and VA benefits do not qualify.
Can You Appeal the Penalty?
You can request a reconsideration if you believe the penalty was applied in error, or if you were given incorrect information by a federal government employee that caused you to miss your enrollment window. Submit a written request to your local Social Security office with supporting documentation.
Does the Part B penalty apply to Medicare Advantage?
Yes. If you enroll in a Medicare Advantage plan, you must still have Part B. Any Part B late enrollment penalty you owe will be added to your Part B premium, which you continue to pay even with Medicare Advantage.
What if I delayed Part B because I had COBRA?
COBRA does not protect you from the Part B penalty. If you delayed Part B relying on COBRA coverage, you will owe the penalty when you eventually enroll.
Is there a Part A late enrollment penalty too?
Yes, but it only applies to people who owe a Part A premium (those with fewer than 40 work quarters). Most people get Part A for free and are not subject to a Part A penalty.
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