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Medicare Part B Late Enrollment Penalty

If you’re new to Medicare and don’t sign up for Part B when you’re first eligible, you may end up having to pay the Part B late enrollment penalty. The late enrollment penalty is imposed on people who do not sign up for Part B when they’re first eligible. If you have to pay a penalty, you’ll continue paying it every month for as long as you have Part B.

What is the Penalty for Not Taking Medicare Part B?

The Part B penalty increases your monthly Part B premium by 10% for each full 12-month period you waited before signing up. The penalty is based on the standard Part B premium, regardless of the premium amount you actually pay.

Here are some examples of the way the penalty works:

  • Suppose your IEP ended on November 30, but you waited and signed up on January 25th, during the next General Enrollment Period. Because you didn’t let a full 12-month period go by, you will not pay a penalty.
  • Suppose your IEP ended on December 30, 2013, but you did not sign up for Part B until March 31, 2017. You waited 40 months, or 3 years and 5 months, to enroll. This counts as three full 12-month periods, and you will pay a 30 percent penalty every month.
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How Can I Avoid the Medicare Part B Penalty?

If you’re turning 65, you can enroll in Part B during your Initial Enrollment Period. Your IEP begins three months before your birth month and ends three months after your birth month. This means that if your 65th birthday is June 15th, you can enroll between March 1st and September 30th.

If you don’t enroll in Part B during your IEP, you usually will have to wait for the General Enrollment Period before you will be allowed to sign up. General Enrollment runs from January 1st to March 31st each year.

If you enroll at this time, your coverage will not start until July 1st. Meaning you may be without insurance if you have a sudden illness or injury. You can also apply for a Medicare Savings Program to avoid the Part B late enrollment penalty.

When Does the Part B Penalty Not Apply?

Those that miss the enrollment deadline but end up signing up during the next General Enrollment Period within fewer than 12 full months won’t pay a penalty. So, if the Initial Enrollment Period ends on June 30, only 9 months will have passed before the end of the General Enrollment Period on March 31.

Also, those under age 65 with Medicare disability and paying a Part B late enrollment penalty won’t pay the penalty after turning 65. Further, those with Medicaid won’t worry about Part B premiums and penalties since the state pays those.

Finally, anyone living outside the United States that doesn’t get premium-free Part A, can’t enroll in Part A or Part B abroad. But, these people will get a Special Enrollment Period for three months after returning to the United States.

Enrolling during those three months means you’re not liable for late penalties. You may also be able to qualify for equitable relief if a federal employee told you that you didn’t need to sign up for Part B when you were supposed to enroll.

How Do I Appeal the Medicare Part B Penalty?

If you feel that the Part B penalty shouldn’t apply to your current situation, ask for a review. Medicare has reconsideration request forms to file an appeal. Unfortunately, you’ll still have to pay the penalty while waiting for your review to be processed.

Is there a Cap on the Medicare Part B Penalty?

As of now, there is no cap on the Part B late enrollment penalty. Yet, the Medicare Part B Fairness Act or H.R.1788 is a bill that would cap the amount at 15% for the current premium.

What if I Don’t Sign Up for Part B because I Have Other Health Insurance?

If you have health insurance through your employer, your spouse’s employer, or a union, you can keep your coverage. You won’t have to pay a penalty for waiting to sign up for Part B. But, if you lose your coverage or stop working for that employer, the clock begins to tick.

Usually, you will be allowed to sign up for Part B right away, during a “Special Enrollment Period.” This is an eight-month period beginning when the employment coverage ends. If you do not enroll during this period, you’ll have to pay a Part B penalty for each full 12 months you wait, beyond the date, the SEP began.

For example, if you’re still working when you turn 65, you can keep your employer health insurance instead of signing up for Part B. If you then retire at age 67, you can avoid a penalty by signing up for Part B during your eight-month SEP. If you instead decide to wait until age 70 to enroll, you will pay a 30% penalty every month. 10% for every 12-month period you delayed.

How to Avoid the Medicare Part B Late Enrollment Penalty

The best way to avoid Part B penalties is to plan ahead. You have several Medicare options to choose from, including Original Medicare plus a Medigap Plan. MedicareFAQ can help you through these decisions by answering your questions and helping you prepare for Medicare. Call the number above or fill out our online rate form to see all the options available in your area.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

86 thoughts on “Medicare Part B Late Enrollment Penalty

  1. I am retiring at age 73 from my full-time job and want to elect COBRA to maintain medical coverage for my wife and children. Is COBRA creditable for Medicare coverage to prevent the Part B penalty? Does it matter whether I plan to continue to provide services to my former company under a consulting agreement?

    1. Bernie, once you are eligible for Medicare, it is important to enroll in Part A and Part B to avoid penalties. Although in some cases COBRA is considered credible coverage with Medicare, it is important to speak with your benefits administrator as each case is different. Often you will find it is more cost-effective to leave COBRA and enroll in Original Medicare anyway. As for your wife and children, it would be best to review Marketplace plans for affordable healthcare coverage.

  2. We retired outside of USA. He has railroad retirement if that makes a difference. If I remember correctly hubby automatically was enrolled in Medicare part b, and after a couple of months un-enrolled due to moving outside USA. We have been outside usa for about 8 years. If he returns, is there a penalty? He may consider doing this since a diagnosis of a serious nature may be better treated state-side. We both have coverage in our land of immigration. Does the penalty apply? Can he be covered immediately to cover his serious illness?

    1. Valerie, I am very sorry to hear about your husband’s diagnosis. If you plan to move back to the United States, you would both be eligible for a Special Enrollment Period. This will allow you a two-month period to enroll into Medicare without penalty upon return to the US

  3. I am a retired federal employee and have FEHB through BCBS. If I keep FEHB and do not take Medicare B, will I be penalized? I have conflicting answers that I won’t be penalized because I still have FEHB, and that I will be penalized because I am retired and not working. Which is correct? Where is this officially stated?

    1. Hi Dan – FEHB is creditable for prescription drug coverage, but not for Part B medical insurance through Medicare.

  4. It seems that ignorance is expensive. Except for 4 years in the military, I worked for a municipal employer for 30 years that did not collect Social Security and Medicare taxes. I retired from that employer with a disability pension and health insurance that terminated at age 65. When I turned 65, my wife was 58 and we purchased insurance through the Affordable Care Act and continued with AFC insurance through this year. My wife applied for and received Medicare A and B when she turned 65 this year and I discovered that I could apply under her work record, which I did except that they only gave me Part A, with the option to enroll in Part B in January when I’ll be 73. My question; Why do they penalize those with quality AFC insurance?

    1. Hi Bob – we are sorry to hear about your situation. That is why we try to educate as many people about Medicare as possible. Health insurance through the Affordable Care Act is not creditable for Medicare, so those who enroll are vulnerable to penalties. Additionally, it is illegal for someone to try to sell a plan through the Marketplace to a Medicare beneficiary.

    2. Hi Bob – we are sorry to hear about your situation. That is why we try to educate as many people about Medicare as possible. Health insurance through the Affordable Care Act is not creditable for Medicare, so those who enroll are vulnerable to penalties. Additionally, it is illegal for someone to try to sell a plan through the Marketplace to a Medicare beneficiary.

  5. Hi Jagger,

    I turn 65 in Feb 2022 and qualify for free Medicare Part A. But as I will be retiring to the EU for a few years, I am wondering whether it is better to enroll in Part B now or enroll later and pay the penalty. My calculations seem to show I would save — but I need expert advice.

    For example If I pay the current $148 over ten years, that equals $17,760. [($148 x 12) x 5]

    If I don’t pay for five years and enroll five years later, then the the premium would be $216/month.($148 + 10% = 162.8 + 10% = 179.08 + 10% = 196.98 + 10% = 216.68)

    Enrolling late and paying the penalized rate for the next five years, I would pay $12,960. So that seems to be a savings of $4800 over the same ten year period.

    Is that a correct way to look at the problem?

    Also does H. R. 1788, if passed, raise or lower the penalty? The legalese is odd:

    To amend title XVIII of the Social Security Act to limit the penalty for late enrollment under part B of the Medicare Program to 15 percent and twice the period of no enrollment, and to exclude periods of COBRA, retiree, and VA coverage from such late enrollment penalty.


    1. Hi John, that is correct. However, keep in mind that the penalty lasts a lifetime, so there would be no way to reduce it in the future, meaning you could eventually pay more than you saved in the long run. Additionally, the Part B premium is subject to increase each year.

      The bill does propose to put a cap on the penalty amount and consider the three listed types of insurance as creditable coverage. Meaning, if someone has one of these for their health care after they reach Medicare eligibility, they won’t be subject to the penalty.

  6. Hello, my grandmother is 67. She initially only enrolled for Medicare Part A. She wants to applied now for Part B. Does she have to wait until Jan 2022 open enrollment or can she applied for Part B, Medicaid and Medicare Savings program now to minimized potential penalties

    1. Hi Angela, it depends on your grandmother’s current medical insurance. If she is still working and is on an employer group plan, she’ll get a Special Enrollment Period starting when she drops the coverage. If she’s not otherwise eligible for a Special Enrollment Period, she’ll need to sign up during the General Enrollment Period, which lasts the firs three months of the year.

      Here are some links to help you understand these circumstances:

  7. My husband hasn’t retired yet but close. We applied for Medicare so he wouldn’t be penalized when he does yet Medicare is charging him over $400 for part B? We are so lost, why are we being charged when we only wanted to ensure MOT to be penalized? He still has coverage through work and we thought we were following process?.

  8. I became disabled in 2006 and qualified for Part B in 2008 but declined since I was young then. Now it is 2021 and I want to get a Cochlear Implant (CI) to hear again but I will have a 10% late penalty for every year that I didn’t have Part B. Is that correct?
    So that would be 10% of $148.50 ($14.85) X 14 years? (2022 earliest to enroll for Part B.) That makes it $207.90 added to the $148.50 I would have to pay for Part B if I enroll on January 1st?….I would have to have $356.40 deducted from my SSDI every month? Is that right and is there any way to lower it? Thank you.

  9. Hello, Lindsay. I welcome your expertise on my question relating to disenrolling from Medicare.

    Here’s the situation:

    1. My wife left full-time employment on November 30, 2020. Her benefits included excellent health insurance. I enrolled in Medicare Part B to take effect December 1. I was 66, and delayed starting Part B until then due to her job. Being under 65, my wife retained her former employer’s insurance via COBRA for five months, until she turned 65 in May, 2021. So now we’re both enrolled in Medicare A, B, D, and a Medicare Supplement Plan.

    2. My wife’s retirement will be short-lived. Her former employer is bring her back in late September for a new full-time, 2-year job, with full benefits. So we want to disenroll from Medicare once her new insurance takes effect October 1.

    3. When I called SSA about disenrolling, the person told me that if our last day with Part B is September 30, and the first day of employer insurance is October 1, we will be hit with a penalty when we re-enroll in 2023 since SSA will say we didn’t have Medicare during the month when the private insurance started, i.e. there was a lapse in coverage, and to avoid a penalty, we should stay with Part B through October 31.

    4. Of course, this means we’re paying for two kinds of insurance for October, which is a waste of money, especially since we’re also incurring the IRMAA fees.

    So my question(s): Is the SSA person correct? Should we stay with Part B through October 31 and pay for both Medicare and the employee portion of the new insurance?

    Thank you.

    1. This is a great question! The penalty for Part B does NOT kick in until you went a full 12 months without coverage. If the lapse in coverage is only for one month, you won’t be penalized.

  10. Hello.
    I am a US citizen living in Spain, retired and receiving Social Security which includes the Part B deduction. I am covered by a private health insurance plan now, and plan to switch over to the Spain national health insurance plan later this year when I qualify. Currently I am paying monthly for the private plan (I’m not eligible for the national plan until being here 1 year) and it costs quite a bit. I’d like to drop Part B coverage since I do not need it.
    I’ve been reading that I can drop Part B and if/when I return to the US to live the late enrollment penalty will be waived, but I can’t find any official documentation for that on Medicare or SSA websites. You wrote another person on this thread that it is on a case by case basis, but I would like to have more assurance than that.
    Do you know?
    Thanks for your valuable service!

    1. Hi Antonio! We have spent hours trying to find this information or official documentation from CMS. Unfortunately, the only documentation we can find is regarding Social Security benefits, not Medicare benefits. The only thing the documentation mentions about Medicare is that work credits for premium-free Part A cannot be earned overseas. It does not mention anything about creditable coverage under Part B.

  11. Lindsay, your messages have been very helpful. I want to clarify for my situation…I turn 65 on June 20, 2022. I plan to sign up for Part A since it’s free. I want to delay Part B & D since I have coverage under my wife’s employer who offers great BCBS insurance. She will retire 4 years later, in May 2026. When do I need to sign up and have effective Part B & D coverage to avoid penalty?

    1. Hi Brian! So happy the information was helpful for you! Once you leave your current group coverage, you will be eligible for an 8-month Special Enrollment Period. During this time, you can enroll in Part B & Part D. As long as you have proof from the employer that you had creditable coverage, you won’t be penalized.

  12. My father is retired and has health care that covers him and my mother. My mother will lose coverage when he dies. Will my mother be penalized for not signing up for part b when first eligible

    1. Hi Doug! As long as your fathers’ coverage is considered creditable under Medicare, your mother will not be penalized for delaying enrollment into Part B. She just needs to enroll as soon as she loses her current coverage so the penalties don’t start to incur.

  13. I was on my husband’s insurance until November 30 2020. He lost his job and his new job didn’t cover us until February 2021. I was without coverage. Also I just started SS because I didn’t have 40 credits.Will I be penalized for those couple of months, I just applied for Part B.

    1. Hi Valorie! No, you will not be penalized for those few months you went without coverage. You have to hit a full 12-months before the 10% penalty kicks in.

  14. Is the 12 month period for the 10% penalty based on the time you enroll or the time you start receiving the benefits.
    Example enroll march 31st, receive benefits July 1st.

    1. Hi Jerry! The 12-month period for the 10% penalty would be based on your Part B effective date. So, if you became eligible for Medicare in March of 2020, but your Part B effective date was July of 2021, you would have one 12-month period that would add on 10% to your monthly premium. The penalty is 10% for every 12-month period you went without creditable coverage. If you went 18 months, you would still only have a 10% penalty. Once you went 24 months, then you would have a 20% penalty. Hopefully, that makes sense!

      1. Thanks Lindsay,
        Just to clarify, I turned 65 March 2021, the end of my initial enrollment period is June 2021 , I will be enrolling in part B by march 2022 during Medicare open season, am I correct in assuming I would avoid the penalty since its 9 months until I enroll.
        Thanks Again

      2. Hi, again Jerry! So, when you enroll during the General Enrollment Period, your effective date for Part B is not until July 1st. Medicare sees this as you were eligible for Part B in March of 2021, but your Part B effective date was not until July 2022. This means you would pay a 10% penalty since you went 16 months without creditable coverage. It doesn’t matter when you enrolled, it matters when your Part B went into effect. If your Part B does not go into effect before the end of this month, you will be penalized since you will not be able to start your Part B coverage until July of 2022.

  15. Hi Lindsay,
    I’m still working on my part B penalty problem. I have read more of your writings and they have been helpful.
    To clarify in my own mind a way through this situation (see my past correspondence) can you tell me is there any tie in between creditable coverage when working and not working i.e. creditable coverage carried into retirement as is my situation. I haven’t seen any information on this in my investigation.
    Hope you can clarify this for me, seems to be a pivotal point.
    Jim McGown

    1. Hi, again Jim! Yes, there are some types of coverages that are only considered creditable if you’re actively working. Once you retiree, that coverage is no longer considered creditable under Medicare. An example would be coverage through the Federal Employee Health Benefits Program. FEHB is only considered creditable if you’re actively working.

  16. Hi Lindsay,
    My wife is turning 65 at the end of October this year. She will be covered by my work medical insurance for another 6-8 months. If I understan correctly, she won’t pay any penalties for Part B or D? We also heard if you don’t elect coverage as soon as eligible, you have to medically qualify. Is this for all parts of just Part A?


    1. Hi Jim! Correct, your wife will not face any penalties since she delayed enrolling due to having creditable coverage at the time. There are no pre-existing conditions when it comes to Part A & Part B to stop you from being eligible. You only have to medically qualify for supplemental coverage if you’re outside your Medigap Open Enrollment Period. Her OEP won’t begin until her Part B becomes in effect. So, once your wife has Part A & Part B, she will have 6-months to enroll in a Medigap Plan without having to medically qualify.

  17. Hi Lindsay,
    I turned 65 this past August and was automatically enrolled in Medicare Part A and B. As a retired school teacher I’ve known for 40 years when I turned 65 I would need part A and B as my private insurance required. I was thrilled it was so easy. It almost seemed to good to be true and unfortunately for me it was.

    My Part B fees were very high based on my husband precious income but in April he suffered a serious heart attack and lost his income. After a few months and more than one failed attempt to fix this I asked my husband for help.

    He called SS and they asked him to download the change of income form which they said they never received from me and so he did and I signed the papers without hesitation and we immediately mailed them in. Sounds easy and simple, right?

    Two weeks later a letter arrives from our local SS security office saying they had received our forms indicating I no longer wanted Part B.

    We both were in total shock over this and naturally upset. I asked my husband why he downloaded and filled out this form and he swore up and down HE DID NOT!

    I called SS several times and talked to several representatives who did not seem to know how to help me. In the mean time I have lost my coverage as my private insurance will only pay after Medicare does

    Naturally this was very upsetting, not to mention being torn between believing my husband or SS. Plus we looked very hard but could find any forms to change PART B downloadable on the website.. It all made no sense.

    So I kept calling SS and I pleaded for an appointment to go into the local office and straighten this mess out but I was told due to COVID they would not accept any appointments.

    So then I asked them on the phone to PLEASE send me a copy of this form they said we filled out and signed saying I no longer wanted Part B coverage, but they said “they could not send me a copy, that it was ILLEGAL.

    So I asked them to check my signature and was told it was a ‘perfect match.’ And yes I am guilty of trusting my husband and not even glancing at the forms I hurriedly signed to get to the PO before it closed. Totally regrettable but not one of us can change the past.

    I long time passed but I kept calling and finally located someone at SS who said I could fill out a form to plead my case like your informative video just stated. This supervisor said something like ” This happens all the time, people download and fill out the wrong forms. We know and understand.” I felt so much better.

    So I did what she said, and wrote down everything I told you plus humbled myself (realizing we may be unknowingly to blame) as my husband’s mind has not been the same since his heart attack last year and sometimes I think he does get confused or misunderstand things and frankly at his point I can see no other logical explanation!

    So checking the mail each day I anxiously awaited a reply. Two months have passed now and still no response. Pure torture. In the meantime, I’ve had no doctor insurance coverage the last 4 or 5 months after having had it all my adult life for 45 years.

    Yesterday I received a form and pamphlet from SS that said there is a ‘free enrollment period from Jan 1st to March 31st., but no cover letter, and no response to my form pleading my case. So here I am still not knowing ( what really happened) and if I will get stuck paying a penalty for the rest of my life or not. And I’m getting this enrollment form’ two weeks before’ the deadline of a three month free enrollment period!. HOLY COW.

    My big question to you is, am I going to have to pay a late fee for the rest of my life or not and aside from mailing this in and hoping they receive it what do you recommend I do?

    Normally I’m an optimist but because of my previous experience I’m afraid if I simply fill it out and mail it in I may get ‘no response’ and no Part B insurance or the office will later respond to me that they never received it. So I’m thinking I should mail it in with a request for ‘a receiver’s signature but what if they reject the ‘signature requirement’ due to COVID and send back to me and I miss the free enrollment period?

    See my conundrum? And today I thought, I’ll try to go online to take care of it but have been locked out of my account for what truly seems like a decade and I find it is totally impossible to get back on. It asks for my email and phone number and then ‘the code’ they send you but they send me NOTHING, and yes I check my phone and email and spam repeatedly until I give up. I guess this is what nightmares are made of.

    I’m hoping you can advise me as I’m at the end of my rope. Thank you kindly in advance for any advise or help you can lend.

    1. Hi Michelle! The Part B penalty does not kick in until you’ve been without coverage for a full 12-months. As long as you enroll before August, you won’t have any late enrollment penalties. I hope this helps!

  18. Hi Lindsay, I have another question. I do not collect social security only my Government CSRS retirement. I still have BCBS for my health insurance. I am currently 67 and only signed up for Medicare Part A. I just talked to my local social security office and they told me if I sign up for Medicare Part B, I will pay the 20% penalty only until I reach age 70. Is that correct? I seem to keep getting conflicting information. thanks

    1. Hi Diana! If you didn’t take Part B at age 65 because you were covered under FEHB as an active employee, you may sign up for Part B (generally without an increased premium) within 8 months from the time you stop working or are no longer covered by the group plan. If your current group coverage is for whatever reason not considered creditable coverage under Medicare, then you would be penalized 10% of the current Part B premium for every 12-month period you went without creditable coverage. That may be where the representative at your local social security office is getting the 20% from since you aged into Medicare two years ago. However, the penalty does not go away, it stays with you forever. It will stop increasing once you enroll in Part B, but it won’t go away when you turn 70. If you currently have Blue Shield Service Benefit Plan from BCBS, it’s not considered creditable coverage. Refer to page 5 on their pdf brochure. I hope this helps!

      1. Hello Lindsay,
        I have a couple of questions. Regarding a federal employee who does not sign up for Medicare Part B when he reaches 65 and continues to work until 67 and maintains coverage under the FEHB program, when does the 12 month period without creditable coverage begin? Does the 12 months begin at the expiration of the 8 month special enrollment period or does it begin from the date that the eligible employee stops working or loses creditable coverage? Also, is the late enrollment penalty based literally on a “full” 12 month period without creditable coverage? Or, for example, does 14 months without creditable coverage amount to two 12 months periods even though it is clearly less than 24 months?


      2. Hi Garey, great questions! The 12-month period begins the date the employee lost creditable coverage through their employer. The LEP is based on a full 12-months. So, if they went 14 months without creditable coverage, the penalty would be based on only 12-months. Once they went a full 24 months, then they would have two 12 month periods where they would be penalized.

    1. Hi Bonnie! The Part D penalty is 1% of the average premium for every month you went without coverage. If you went 11 years without coverage, that equates to 132 months. If you multiply 132% x the current average premium, that would give you an additional $44 to pay on top of the $33.06. However, you could find a Part D plan that is less. The math I did was based on the average premium.

  19. I retired at 50. I did not sign up for Medicare Part B at 65 because I was told that the BCBS Federal Employee Plan (FEP) was considered creditable insurance and I didn’t have to sign up for Medicare Part B and I would not incur a penalty later on if I decided to sign up for Medicare Part B. I am now 68 and would like to sign up for Medicare Part B and keep my BCBS FEP. Am I going to have to pay the penalty?

      1. Hi Lindsay! I’m confused. The webpage says that “it’s not mandatory to take Part B when you have FEHB benefits, but you have the option. But, if you don’t take Part B when first eligible, and then you decide to enroll, you do face penalties.” I signed up for Part A when I was 65. I continue to be an FEHB participant (Aetna) and may retire this year. If I continue with FEHB (Aetna) for the next 5 years and decide 5 years from now to enroll in Part A, there will not be a late enrollment penalty? Does the fact that I had signed up for Part A when I first became eligible (age 65) preclude the penalty? thanks!

      2. But elsewhere on your website you say that “Examples of Coverage that is NOT Creditable Under Medicare” include FEHB! I am totally confused. I am a current federal employee participating in FEHB and also signed up for Part A when I turned 65. If I retire today, and continue with FEHB for a few years, will I be able to enroll in Part B without a late enrollment penalty? Sorry for my confusion, but there seem to be inconsistencies in what you are saying versus other statements on your site. Thanks@!

      3. Hi Andy! Yes, FEHB and how it works with Medicare can be confusing! When you have FEHB benefits and retire, it’s not required to sign up for Part B to keep your FEHB benefits once you’re eligible for Medicare. You can enroll in just Part A, choose to delay Part B, and still be able to keep your FEHB benefits. However, you will be penalized later if you choose to enroll in Part B for delaying since FEHB benefits are not considered creditable coverage. Basically, it’s not mandatory to enroll in Part B to keep your FEHB benefits, but you will still be penalized for not enrolling when you were first eligible since Medicare does not consider FEHB benefits creditable under Part B. I hope this helps!

  20. Lindsay: I am 77 years old and have had Medicare Parts A and B since retirement in 2009 as well as BC/BS Supplemental, covering among other things prescription drugs. Because I sold my house in 2019 with a substantial capital gain, the Social Security Administration informs me that my 2021 Part B Premium will be $475.20, representing the sum of the standard premium of $148.50 and an added $326.70 (“Income-Related Monthly Adjustment Amount). My question: can I NOT sign up for 2021 for Part B, then re-sign up for 2022 at the standard premium for that year? Is that permitted? If permitted, is there a penalty I will have to pay in 2022? Will my BC/BS Supplemental kick in to cover doctors visits in 2021 without the Part B coverage? If the answers are all positive, is there still a reason that would make this course inadvisable. Many thanks for whatever light you can shed.

    1. Hi Nils! If you cancel your Part B without having creditable coverage, you could be penalized 10% of the premium when you re-enroll. Which yes is better than what the IRMAA is. Also, if you cancel your Part B, you can’t have supplemental coverage. You have to have Part B to be enrolled in a Medigap plan. You will end up with no outpatient coverage if you cancel Part B. You’ll be responsible for 100% of your medical costs. You will only have coverage for inpatient services at the hospital under Part A. Also, if you won’t have a guaranteed issue to re-enroll in Medigap. If you have any health issues, you could be denied coverage. I would not advise you to cancel Part B, I would recommend you appeal the Income-Related Monthly Adjustment Amount.

  21. Hi, I am 67 and I did not sign up for Medicare Part B when I turned 65 because I am a federal employee retiree with Blue Cross Blue shield and I was always told to keep my BCBS and didn’t need Medicare but I do not have any proof of that. My husband is 65 as of Feb 15, 2020 and he signed up for Part A only too and is still currently working under my BCBS plan Is there anyway to avoid this hefty penalty?

  22. I am 73 and have received Medicare parts A and B since I was first eligible. But I did not sign up for any Plan or Part D because the one prescription I take, Armour Thyroid, is not on the Medicare formulary. I have taken this since I was 20 years old. Medicare Part D would only pay for a synthetic version of this drug, which has a very different effect on my body. I would have had to pay a premium of about $40 a month for Part D insurance that would do me no good, and ALSO pay out of pocket for my prescription. So I just paid out of pocket, which costs me about $40 a month. I have now signed up for a Medicare Advantage plan that has a zero premium but received a notice that I will have an LEP penalty of about $37 a month and I still take just that one medication. I do not understand the rationale of this law. How did my paying out of pocket for my prescription hurt the Medicare system or the insurance companies that sponsor Medicare Plans? I have filed an attestation to this effect with my new Advantage plan but was told by customer service that my reason for not signing up earlier will not exempt me from paying this penalty, as unfair as that seems. Do you agree?

    1. Hi Ellen! Unfortunately, Part D also comes with an LEP. When you pay out of pocket for your prescriptions it hurts the Medicare system because you were not paying into the system at the time. Premiums for Part D are what help fund the system. If beneficiaries all chose to delay coverage because they want to pay out of pocket instead, there would not be enough funds to keep the system going. At least that is Medicare’s reasoning behind the LEPs.

  23. My dad is 90 years old and has a $73.20 late filing Part B fee. According to his Medicare card, he enrolled for Medicare 25 years ago. I’m assuming he has been getting charged this fee for 25 years (~$25,000 in fees for 25 years). Is this correct that SSA can charge this fee for so long? Is there anything else we can door get this fee dropped?

    1. Hi Paul! More than likely his effective date on his Medicare card is referring to Part A. Unfortunately, Part B late enrollment penalties do stick with you for the rest of your life. You cannot get it dropped. Based on the penalty, it looks like he delayed enrolling in Part B for 4-5 years and did not have creditable coverage during that time.

  24. My husband who is 76 has VA benefits and I have also been covering him under my Employer Health Plan spousal coverage. So we had declined Part B Medicare when he started taking SS in 2008. If we now want to enroll him in Medicare B and an advantage plan, how do we ensure there is no penalty and what time frame is needed to enroll him.

  25. My husband signed up for a Medicare Advantage Plan in time for his 65th birthday, which was on July 31. SSA reduced his social security income by $144 over the last four months to pay for the Part B premium. Two weeks ago, I notified SSA that my husband (and myself) will be receiving health insurance benefits (considered creditable under Medicare) effective November 1 through my employer since our Medicaid coverage is ending, and I am recently eligible for employer sponsored health insurance. Our intention was that SSA would stop the $144 premium payments going forward. Today, we received a notice from SSA that they will stop the $144 premium payment, but in addition to this, they refunded the entire $576 in premiums that we’ve paid over the last four months and basically set the clock back to the point where it looks like my husband never enrolled in Medicare Part B. We’re happy to have the refund, of course, but I’m concerned that if he ever needs to get back on Medicare Part B, he may be liable for the late enrollment fee and penalty. What would you suggest we do, if anything? Thank you.

    1. Hi Mary! I’m not sure why they refunded the whole amount, but I wouldn’t worry about the penalty. The penalty doesn’t kick in until you go a full 12-months without creditable coverage. I hope this helps!

  26. I turn 65 in November of this year and have already enrolled in Part A. Although I work for an employer with 20 or less employees, our group health insurance carrier chooses to pay as primary for Part B claims. Since this is the case am I eligible for a SEP that will allow me to enroll in Part B later when I am closer to retiring (and incur no penalty)? And if so, can I enroll in Part B while still insured under my employer so that there will be no gap in coverage when I leave employment? Thanks for any info you can provide!

  27. A person, age 67, did not know he was no longer covered under his wife’s health insurance when he retired and did not enroll in Part B. The group coverage ended on 12/31/2019 and today is 10/16/2020. If the person requests Part B coverage retroactive to August 1, 2020 will he avoid the late enrollment penalty?

    1. Hi Jeffrey! You would’ve had a Special Enrollment Period that lasted for 63 days after your group coverage ended that would’ve allowed you to enroll in Part B with no penalty. Since that window has passed, you’ll have to wait until the General Enrollment Period in January to enroll in Part B. Your coverage won’t kick in until July 1st. I don’t believe you can retroactively enroll. If you can, then yes you should avoid the late enrollment penalty since it was less than a full 12 months you went without coverage.

  28. My husband had a stroke. He canceled his medicare part b when I had family coverage, but didn’t know he had 1 year to reinstate after my insurance stopped in 2005. What would the penalty be for all these years without medicare part b. He could not find any insurance that would be feasible in price and MA wouldn’t accept him because he qualified for medicare part B. Please help me figure out how I can help him get on medicare part b without going too much into debt.

    1. Hi Theresa. I’m so sorry to hear about your husband. The penalty is 10% for each year you went without coverage when eligible. If your husband went 15 years with no coverage, then his penalty would be the current premium x 150% = $216.90. ($144.60 x 1.5 = $216.90 + current premium) That would give him a monthly premium of $361.50 for Part B with the late enrollment penalty added. The reason he couldn’t enroll in a Medicare Advantage plan is that he has to first be enrolled in Part A and Part B of Medicare. However, he may have some options.

      There are two situations that he may qualify for where the Part B penalty is waived.

    2. 1) If he qualifies for both Medicaid and Medicare, the state pays his Part B premium and any late penalties are waived.
    3. 2) If he qualifies for assistance from your state in paying Medicare costs under a Medicare Savings Program, the state pays his Part B premiums and any late penalties are waived.
    4. I hope this helps!

  29. My mother is 85 years old this year. She’s been on my deceased father’s private insurance through Aetna (through his former employer) for which she pays $900 per month. She now wants to get on Medicare because the rates on her private carrier insurance are increasing However, if I’m ready the Medicare penalty statement correctly, she will have to pay 200% more per month for the Medicare B premium for waiting so long to enroll. It sounds like she like she’s better off staying with the private insurance even if it increases substantially going forward. Is there a cap that can be applied or can she file an appeal to lower that penalty? Any other suggestions?

    1. Hi Tracy! As long as your mother’s current insurance is considered creditable under Medicare, she won’t be penalized for delaying enrollment into Part B. Her benefits administrator will be able to provide you with the proper paperwork to send to Medicare. As long as the former employers have more than 20 employees, the coverage should be considered creditable. Once she enrolls in Part B, she will want to decide between a Medicare Advantage plan and a Medigap plan to fill in the gaps in coverage. Either way, her premiums will be much lower than $900 a month. She will also get a Special Enrollment Period to enroll in a Medigap plan where her health won’t impact her premium.

  30. Hello Lindsay I am a USA citizen currently overseas in the UK I was working in the USA up until I retired and was covered with employers Health Insuranace – I had family in UK my mother and brother and received a call that my brother had 24 hrs to live so I headed of to the UK – he surived but I decided to stay and take care of him and my mother – both have since passed on – as you may well know the UK have their own National Health Services (NHS) and I was covered under the tNHS while in the UK –After the death of my brother in 2019 I began making plans for my return to USA so I applied for medicare Plan B – I’ve had Plan A since 2013 – USA expatsof medicare age and work in the UK and are not covered under their employees health insurance can and do particiapte in the UK’s NHS — then when apply for medicare after 65 they do not get charged a penalty becaue they were coverd with the NHS– I’m puzzled why I was charged an extorionate amount $231.40 from my only source of income S.S. which has now been greatly reduced- My annually income is such that I am not required to file income tax – QUESTION: I don’t understand why US expats working in the UK and not covered under employers health insurance who participate in the NHS are not charged a penalty fee when they eventual sign up for medicare – I particiapted in the NHS yet I am charged a penalty fee I received the letter June 15th – I have 60 days to appeal –I’m having difficulty understanding the Medicare process and the appeals process I would like to appeal thier decision but looking for someone who can help me with the whole medicare process – Due to Covid-19 I am stuck in the UK

    1. Hi Catherine! NHS can be considered creditable coverage. It’s handled on a case by case scenario. CMS may not have had all the information they needed to consider it as creditable coverage, which is why you were penalized. By submitting a determination request form, you may have the penalties removed. I hope this helps!

  31. My husband, Norm, and I were both employed by the State of Wisconsin. He carried our health insurance until he retired 9/11/10, at which time our health insurance transferred to me. One of the benefits of state employment in WI is that accrued sick leave that isn’t used can be converted to a dollar amount and used to continue coverage of the same medical plan we had while employed. Norm was automatically put on Medicare part B when he turned 65 in October of 2015, however, since I was still working he was still covered under our joint insurance, so he declined it. When I retired 12/31/16, we continued the coverage we had while working and used our accrued sick leave benefits to pay the premiums. Those benefits have been used up, so now we are looking at our options, and the SSA is telling us that we will have to pay a penalty because Norm declined Part B at the time he first became eligible, even though he has had full health insurance coverage all this time The challenge here is that, because I am only 60 and did/do not qualify for Medicare, we needed to maintain full coverage of the health insurance we had while employed. He could NOT let that become his supplemental insurance, because then I would not have had coverage, and we were, for most of that time, using HIS sick leave credits that he earned from his employer. We have had telephone conversations with two different SSA rep’s who are both convinced that we have to pay the penalty. How do we go about appealing this decision? From the FAQ’s above, it appears to me that since we had health insurance coverage through Norm’s employer, even though he was retired, we should qualify for a special enrollment period. Is that correct?

    1. Hi Donna! It all comes down to if the group employer coverage was considered creditable coverage. If the employer had less than 20 employees, the coverage would not be considered creditable and your husband would be penalized. Check out our FAQ on employer coverage and Medicare, hopefully it will help answer your question. You can find the redetermination request here, but there’s a good chance your husband will need to fill out 40B and the employer who provided the group coverage for him will need to complete the L564 form.

  32. What form do we fill out to have a medicare penalty decision reconsidered. I can not seem to find that exact form?

  33. I think that it is totally unjust to penalize veterans who have served and earned benefits. It is just another slap in the face of all veterans. To make veterans who use their VA benefits pay for part B when they don’t need it is making life harder on veterans who are on a fixed income. Many veterans barely have enough money to live let alone pay a penalty on top of paying for something they don’t use. The VA doesn’t EVER bill Medicare for anything. I’ll keep paying the government for something I don’t use but will be fighting to get this changed. Just one more way for the government to disrespect the veterans who serve their country.

    1. Ralph, we’re 100% on your side with this! It does not make any sense, all we can do is help inform our veterans in hopes they can better prepare.

  34. What I believe you are missing in Bonnie and Maxine’s situation is they are not getting Social Security benefits from the Federal Government and likely never signed up for Medicare Part B at age 65. Therefore they are both likely to incur the penalty. Look up CSRS for Federal employees.

  35. My question is similar to Bonnie’s question above. I have had conflicting answers to a similar situation. My husband also was a government employee and retired in 2008 We had group insurance with BCBS Federal. After is passing, I continued on the same plan. I did not apply for Part B when I was 65. It would appear that I now would have to pay an additional 100% each month if I enrolled in January. Is that correct?

    1. Hi Maxine! I’m so glad you asked these questions. It will help clarify Bonnies question further as well! BCBS Federal Insurance is insurance for Federal employees. If you’re still working, then BCBS is primary coverage & Medicare is secondary. If you’re retired, then Medicare becomes primary and BCBS becomes secondary. When you turned 65, you should’ve been automatically enrolled in Part B. If you’re collecting Social Security benefits, then the premium would be coming out of your check each month. So, if I’m correct, you’ve probably had Part B since you turned 65 and your BCBS policy became your supplement plan. Therefore, you will not incur a penalty because you are actually enrolled in Part A & Part B. Hopefully that makes sense! However, I would call Medicare and/or BCBS to confirm this.

  36. My husband has insurance through the VA. He did not purchase Medicare Part B when eligible 7 years ago. The VA is not covering everything and their wait times and locations have become unacceptable and inconvenient; so my husband now wants Medicare Part B. Will he be penalized as well for the 7 years without Part B?

  37. My husband and I did not have enough quarters to receive SS and were not eligible for Medicare, Now we are enrolled in an insurance company that is charging a penalty for not enrolling in a timely manner for a service we were not eligible to receive.

    1. Hi Cheryl, I’m so sorry you’re in this situation. Your insurance company is not charging the penalty, Medicare is. This is because you delayed coverage when you became eligible. Even though you did not pay enough quarters, you’re still considered eligible for Medicare. You would just have to pay a premium for Part A vs it being free like it is for most. Therefore, you are eligible to receive it, which is why you’re charged a penalty for not enrolling in a timely manner.

  38. I still am not getting why I have to sign up for Medicare Part B when I’m working and don’t need it. I have Independence Blue Cross so why do I have to pay twice? First for my insurance and also for the Medicare Part B??? I shouldn’t have to pay twice.

  39. My husband has BCBS Federal Insurance and I am also on his medical Insurance. He retired at age 45 and is now 73, I am 72. We kept his government Insurance and never applied for Medicare part B. We plan to keep his Government Insurance but wanted to know what the penalty would be after 8 yrs if we enrolled in Medicare part B at this time.

    1. Hi Bonnie! If you turned 65 8 years ago, and you delayed signing up for Part B until now, your monthly premium would be 80% higher for as long as you have Medicare (8 years x 10%). However, you should not incur a penalty if you’ve had BCBS Federal Insurance. When he retired, you both were enrolled in Part A & Part B. That became your primary coverage, then BCBS became secondary.


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