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Medicare Part B Penalty

Summary: While automatic for most, Medicare Part B is optional. Should you decide to forgo signing up as soon as you are eligible, you’ll face a Medicare Part B penalty without creditable coverage. The Part B penalty doesn’t ever go away, but some beneficiaries can delay enrollment without facing it. You can also appeal the decision. Estimated Read Time: 12 mins

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Table of Contents:

  1. What Is the Penalty for Canceling Medicare Part B?
  2. Common Scenarios to Avoid Where the Medicare Part B Penalty May Apply
  3. Is There a Cap on the Medicare Part B Penalty?
  4. How To Avoid the Medicare Part B Penalty
  5. When Does the Medicare Part B Penalty Apply?
  6. When Does the Part B Penalty Not Apply?
  7. What if I Don’t Sign Up for Medicare Part B Because I Have Other Health Insurance?
  8. How Do I Appeal the Medicare Part B Penalty?
  9. What Is the Penalty for Not Taking Medicare Part B?
  10. Medicare Plan B Penalty
  11. How to Avoid the Medicare Part B Late Enrollment Penalty

If you are newly eligible for Original Medicare and do not enroll in Medicare Part B, you may have to pay the Medicare Part B penalty. The Part B penalty results in a higher premium every month you have Part B benefits, and unfortunately, it never goes away.

For some beneficiaries, you can delay enrollment while also avoiding the Part B late enrollment penalty. However, you’ll need to qualify. Others may be tempted to avoid paying for coverage, but because the Medicare Part B late enrollment penalty lasts forever, it’s typically better to sign up as soon as possible.

But it’s essential to keep in mind that everyone’s healthcare needs are different. Below, we’re breaking down how to calculate Medicare Part B penalties, how to avoid them, and the considerations you’ll want to remember to make an informed decision for your coverage.

What Is the Penalty for Canceling Medicare Part B?

The Medicare Part B penalty increases your monthly Part B premium by 10% for each full 12-month period you did not have creditable coverage. The Part B penalty is based on the standard Medicare Part B premium, regardless of the premium amount you actually pay.

Calculate Your Medicare Part B Penalty

Use the calculator below to determine how much your Medicare Part B penalty will cost.

Medicare Part B Penalty Calculator

If you do not enroll in Medicare Part B when you first become eligible, and you don’t have other creditable coverage, you may face a late enrollment penalty. The penalty is added to your monthly premium.

 

For example, if you pay a higher Part B premium based on your previous tax returns, your penalty will only be 10% of the base Part B premium. The penalty will not be 10% of your Income-Related Monthly Adjustment Amount premium.

For most, the Part B Medicare penalty never goes away. You must pay the additional premium cost as long as you have coverage. The only time the late enrollment penalty for Part B goes away is if you are eligible for Part B prior to age 65 and pay the penalty before turning 65. Once you turn 65, the Medicare Part B penalty is reset, and you will no longer be responsible for the additional premium.

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How to Calculate Your Medicare Late Enrollment Penalties

Common Scenarios to Avoid Where the Medicare Part B Penalty May Apply

Once you are eligible for Original Medicare, knowing how to avoid additional costs is essential. Medicare Part B penalties are an additional cost that no one plans for, and everyone hopes to avoid, especially when it comes to healthcare.

Education is key, and by preparing yourself, you can avoid the late penalty for Medicare Part B. Here are some examples of scenarios to avoid if you do not want to pay the Medicare Part B Penalty:

  • You retire at 65 and continue retiree coverage until 70, then decide to enroll in Medicare Part B. Doing so will delay Part B enrollment and face the penalty.
  • You lose employer coverage and wait longer than eight months to enroll in Medicare Part B.
  • You do not have insurance coverage and wait until you are 67 to enroll in Original Medicare.
  • You delay Medicare Part B coverage enrollment because of VA benefits past age 65.

These scenarios are just a few examples of how you can be stuck paying the Medicare Part B penalty for life. If you avoid these scenarios or similar ones, you can avoid paying the penalty altogether.

Is There a Cap on the Medicare Part B Penalty?

As of now, there is no cap when calculating the Medicare Part B late enrollment penalty. However, legislation has been introduced to cap the Medicare Part B penalty at 15% of the current premium, regardless of how many 12-month periods the beneficiary goes without coverage.

H.R.1788 is an example of legislation introduced to reduce the Part B penalty, but so far, nothing has passed. Bills are either under review, expired, or simply failed to pass so far. However, a cap would save thousands of beneficiaries from the high cost of the penalty for Medicare Part B.

How To Avoid the Medicare Part B Penalty

There are many ways to avoid the Medicare Part B penalty, most of which include the time in which you enroll in coverage. When it comes to Medicare, timing is everything. Thus, enrolling on time helps eliminate paying a late enrollment penalty. Here are a few tips to avoid the Medicare Part B late enrollment penalty.

Enroll During Your Initial Enrollment Period

The best time to enroll in Medicare coverage is during your Initial Enrollment Period. If you’re turning 65, you can enroll in Medicare Part B during this enrollment period.

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Your Initial Enrollment Period is the first chance you get to enroll in Medicare coverage. Thus, making you ineligible for a penalty is you enroll during this time.

Enroll During the General Enrollment Period

If you do not enroll in Medicare Part B during your Initial Enrollment Period, you’ll usually need to wait for the General Enrollment Period before you can enroll in coverage.

When you use this Medicare Part B enrollment window, your coverage will be active on the first day of the month following your enrollment. The General Enrollment Period is available to those who delayed Medicare Part B benefits without creditable coverage.

If you wait to enroll until the General Election Period to enroll in coverage, and you do not let an entire 12-month period go by without Medicare Part B coverage, you will avoid the penalty.

Enroll During a Special Enrollment Period Due to Creditable Coverage

If you delay Medicare Part B due to creditable coverage, you will be eligible for a Special Enrollment Period. This will allow you to bypass any penalty for Part B benefits.

can-i-delay-medicare-part-b-updated

Additionally, if you are approved for a Medicare Savings Program, this will erase the Medicare Part B penalty even if you would otherwise be responsible for the additional premium. Keep in mind that to qualify for a Medicare Savings Program, you must meet specific income criteria. Not every beneficiary will qualify for this program.

You may also be able to delay Medicare Part B enrollment without a penalty if you receive healthcare benefits from the military. However, the relationship between TRICARE, the U.S. Department of Veterans (VA), and Medicare is complex. Before making any decisions, you’ll need to contact your local VA to be sure.

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Just to recap how you may be able to avoid a penalty:

  • Enroll in Part B benefits as soon as you are eligible.
  • You or your spouse receive benefits that are considered credible coverage.
  • You qualify for a Special Enrollment Period.

When Does the Medicare Part B Penalty Apply?

The Medicare Part B penalty applies when you delay Part B benefits without creditable coverage.

The video below shows Bob, who chose to delay his Medicare Part B enrollment. Shortly after Bob retired at 65, his wife fell ill. Due to her medical costs, Bob decided to delay his Medicare Part B coverage in order to help pay their medical bills. Little did he know that the longer he waited to enroll, the more his Medicare Part B late enrollment penalty grew. Watch the video to see how things turn out for Bob.

When Does the Part B Penalty Not Apply?

Those who miss their initial enrollment deadline but sign up during the next General Enrollment Period will not pay the Part B premium penalty if less than 12 months have passed. When you enroll during the General Enrollment Period, coverage goes into effect on on the first day of the month following enrollment.

So, imagine your Initial Enrollment Period ends on November 30. If you do not enroll until February, the General Enrollment Period, only three months will pass before your coverage becomes effective on March 1. Thus, the penalty will not apply.

Also, those under 65 with Medicare who are paying the penalty will not pay after 65. Further, those with Medicaid need not worry about Medicare Part B premiums and penalties because their state will cover those costs.

Finally, anyone who delayed Medicare Part B and did have creditable coverage can avoid the Part B penalty by qualifying for a Special Enrollment Period. Once you have a Special Enrollment Period, you have a set amount of time to enroll and avoid the Medicare Part B penalty.

Enrolling during this time means you are not liable for late penalties. You may also qualify for equitable relief if a federal employee told you that you did not need to sign up for Medicare Part B when you were supposed to enroll.

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

There are situations where you can keep your current health insurance. You can keep your plan if you have creditable coverage through your employer, spouse’s employer, or a union. You will not have to pay the penalty for delaying Medicare Part B coverage.

However, if your coverage is not creditable or you lose coverage (voluntarily or involuntarily), the clock begins to tick.

Usually, you will be able to sign up for Medicare Part B right away during a Special Enrollment Period. This is an eight-month window beginning when your employer coverage ends. If you do not enroll during this period, you will have to pay the Medicare Part B penalty. You will pay a 10% premium increase for each full 12 months you wait beyond the date the Special Enrollment Period began.

If you retire before age 65 and choose to extend your coverage using COBRA, you must end COBRA coverage once you are eligible for Medicare. COBRA is not creditable coverage to avoid the penalty.

How Do I Appeal the Medicare Part B Penalty?

If you feel that the Medicare Part B penalty should not apply, you may request a review. Medicare has reconsideration request forms to appeal your penalty.

Unfortunately, you will still pay the penalty while waiting for your appeal to process. Additionally, there is no timeline for processing your Medicare Part B late enrollment penalty appeal.

The Office of Medicare Hearings and Appeals (OMHA) collaborates with the Social Security Administration (SSA) to handle the processing of Medicare Part B late enrollment penalty appeals. Your first step is to contact SSA to reconsider, which can be done by calling 1-800-772-1213.

It should be noted that SSA has had reconsideration forms online available in the past, but as of this writing, the process seems to have moved in a different direction. To inquire about the forms and to appeal your Part B penalty, remember that calling SSA is the initial route you’ll want to take.

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What Is the Penalty for Not Taking Medicare Part B?

Technically, you’ll only incur the Medicare Part B penalty if you delay enrollment. You don’t have to enroll in Part B should you choose not to. However, when you delay Part B enrollment, you need to remember the following:

  • The Part B penalty never goes away. Therefore, once you’ve made the decision to delay enrollment, you’ll have the penalty forever should you sign up in the future.
  • Not only does that mean adding healthcare costs, but you’ll also need to face your outpatient costs through other means.
  • Healthcare costs continue to rise, and these expenses also become more predominant, statically, for beneficiaries who qualify for Medicare.
  • Finally, healthcare needs change over time. Even if you’re healthy now, you may face the penalty later on because you’ll enroll in the coverage you need.

Planning ahead, staying educated, and working with a licensed insurance agent are great ways to avoid making the wrong decision. For most, enrolling in Medicare Part B as soon as possible is typically advised.

Medicare Plan B Penalty

A common mistake beneficiaries often make is mixing up Medicare Part B and Medicare Plan B. This can be important when speaking about the penalties, coverage, and costs. Here are a few important things you’ll need to know about the Medicare Plan B penalty:

  • Medicare Part B is the outpatient portion of Original Medicare. These benefits come from the federal government.
  • You can incur the Medicare Part B sign-up penalty, as mentioned above when enrolling late if you don’t qualify for delaying enrollment. However, there is no “Medicare Plan B penalty” because Medicare Supplement plans don’t have penalties for late enrollment.
  • You may, however, pay higher premiums or be denied coverage if you don’t enroll in a Medicare Supplement plan as soon as you are eligible.

At the end of the day, there are several considerations when it comes to your healthcare. There are also several individual factors because everyone has different healthcare and budget needs. Working with a licensed insurance agent can help you explore your options and make an informed decision while keeping costs low.

How to Avoid the Medicare Part B Late Enrollment Penalty

The best way to avoid the Part B penalty is to plan ahead. You have several Medicare options from which to choose, including Medicare Advantage or a Medicare Supplement plan.

MedicareFAQ can help you through these decisions by answering your questions and helping you prepare for your new coverage. Call the number above to find out more information on how to stay covered for less and avoid the Medicare Part B penalty or press the compare rates form button below to see all the options available in your area.

Sources

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

David Haass

David Haass

David Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council and stay up-to-date with the latest Medicare trends and changes. He holds a Bachelor of Science in Business Administration and Management from the University of Florida.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

116 thoughts on "Medicare Part B Penalty"

  1. I enrolled in Medicare Part A & B a couple of years ago. I have a HSA account and a MSA account that has some savings in them. I am thinking about dropping part B and just pay those costs out of savings. If I decide to subscribe to part B again after a few years will have a penalty?
    Can I continue to contribute to my MSA if I don’t chose part B or an advantage plan?

    1. Hello Jim,

      Unfortunately, if you decide to drop your Part B coverage, you will incur a penalty if you enroll again. Furthermore, you can contribute to your MSA if you don’t have BOTH Parts of Original Medicare or an Advantage plan. In other words, even if you elect not to have Part B but keep Part A coverage, you still cannot contribute to your MSA.

  2. I retired from the VA at 60, kept my FEHB BCBS coverage and continued to work in the private sector. At 65 I enrolled in Medicare A&B with BCBS as my secondary. But due to my income, I have a substantial IRMAA for Part B. Now that I am doing a phased exit from the workforce, my income is dropping year to year. Will the IRMAA be recalculated and reduced accordingly?

    1. Hello Frank,

      IRMAA is calculated based on your income two years prior. Therefore, while you can expect to see a drop, you’ll have to wait two years to see a decrease.

  3. Hello,
    I have VA coverage and did not want Medicare. I sent the card in stating so, 2 weeks before the deadline, but I did not have the original envelope. I carefully addressed it and mailed it and they are taking the deduction out of my check anyway. What to do

    1. Hi Dave, sorry to hear this! I would contact your local Social Security office as soon as possible. You can do so in person or over the phone. They will be able to handle this situation for you.

  4. I retired from Civil Service and continued my government-subsidized Health care Insurance. When I reached 65 I did not sign up for Part B because my insurance covers all and more than Part B. I am now 82 and want to be covered by all that I can afford. Will I still have to pay the penalty? Thank you for your response.

    1. Peggy, you may be required to pay the Medicare Part B late enrollment penalty if you enroll in Medicare at this time. You will need to contact your local Social Security office to determine your penalty amount.

  5. I am covered under my work insurance however when the general enrollment starts I will be 67 years old. During the general enrollment would I be penalized for signing up for part B Medicare?

    1. Hi Donna! If your employer coverage is considered creditable, you will not be required to pay the Medicare part B late enrollment penalty.

  6. Hi, Jagger. So many questions on this complicated topic!
    Are the periods (plural) you went without part B coverage cumulative?
    For example: Let’s say someone enrolled in Part B when turning 65.
    That person then stops part B coverage on Dec 1. Then re-enroll in the General Enrollment period for coverage starting July 1. That means 7 months without creditable coverage so no penalty.
    If he does the same thing later that year, another 7 months without coverage. Is he now at 14 months? Or do they start counting again?

    1. Hi John, this is a great question. The periods without creditable coverage would be cumulative. They would not reset in this scenario.

  7. My husband and I signed up for Part A when we turned 65. I am still working at 66 (he is 72) and we are both currently covered under my employee based health insurance benefit. We are wanting to sign up for Part B but want to know if we will have a penalty. Because we currently have my employment insurance would this be considered a Special Enrollment?

    1. Hi Cathy! Great question. If your employer coverage is creditable to Medicare (meaning it provides at least equal benefits) you will NOT need to pay a late enrollment penalty and will receive a Special Enrollment Period to apply for Part B coverage.

  8. My father-in-law is 87. He has FEHB coverage via United HealthPartners as an annuitant (retired in 2010). He does have Medicare Part A, but not B. We recently had to move him into a memory care facility that is requiring us to change his insurance from FEHB to standard Medicare Part A/B/D. I have two questions. First, is there any way to avoid paying the part B penalty? Second, if the penalty does need to be paid is it 10% x 22 (i.e. from the time he turned 65) or 10% x 12 (i.e. from the time he retired)?

    1. Christian, unfortunately if your father was only on FEHB, there is no way to avoid the Part B late enrollment penalty as it is not considered credible. The penalty will be paid from the last time he had creditable coverage. FEHB is no longer credible after retirement. Thus, the penalty will be 10%x12.

  9. I am turning 65 and my wife is active-duty military. I understand I have to sign up for Medicare Part A but can delay enrolling in Part B and use Tricare Prime until she retires. I understand there is no penalty for not selecting Part B in this circumstance. I also understand there is a form I would need to file in order to have the penalty waived. Are my assumptions correct? And if so what form should I use and when should I file it?

    Thanks!

    1. John, if your spouse is still working, TRICARE Prime is creditable and will allow you to delay Part B. When doing so, you will want to complete the L564 form found here.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

    Thanks

    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.

  15. 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:

      https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/
      https://www.medicarefaq.com/faqs/medicare-and-employer-coverage/

  16. 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?.

    1. Hi Jesse, your husband’s Part B premium may be higher due to higher income. Additionally, if he has creditable coverage through work (meaning there are at least 20 employees), he can delay without penalty for as long as he has the coverage. We have included some helpful links below.

  17. 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.

      1. Hello, I’m 61yrs old and I’m on SSD. I just enrolled in Pt. B Dec of 2021.. I’ve been retired from NYC Debt of Correction since 2015 and retired with Emblem Health Hip Insurance. I received Disability in the latter part of 2020. I want to opt out of pt b. My premium is $238.10 a month. I also got tax papers for IRMA. I want to keep my Emblem health insurance as my primary.. If I opt out of pt.b will I automatically be enrolled in part B when I turn 65 with no penalties for the next 4yrs after I opt out at the age of 61.

      2. Rhonda, before opting out of Part B, you need to speak with your carrier to ensure they will work as your primary coverage if you do decide to drop Part B at this time. When you turn 65, you will be able to re-enroll in Part B without a penalty. When turning 65, no matter your previous Medicare status, you are given an Initial Enrollment Period to enroll without penalty.

  18. 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.

  19. 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.

  20. 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.

  21. 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.

  22. 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.

  23. 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.

    2. i was told the same as was what jerry said. the clock starts to click the month after the end of your initial enrollment period and ends the final month of the general enrollment period. so iep was dec 2020 through june 2021. clock starts july 2021 and ends march 2022. 9 months. that’s what i was told. is this wrong jerry/

  24. 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.
    Best,
    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.

      1. so to confirm: if medicare is primary, your insurance is not creditable./ this is what happens when you retire.medicare is primary insurer and your health insurance is secondary.
        but, the exact same coverage is considered creditable if you are employee. if employee, medicare is secondary and your insurance is primary.

      2. If your employer has fewer than 20 employees, you must enroll in Medicare Part B at age 65 regardless of employment status because the coverage is not creditable. Medicare will pay primary in this situation. If your employer has more than 20 employees, the coverage is creditable while you are employed. You do not need to enroll in Part B until you retire or lose group coverage.

  25. 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?

    Thanks
    Jim

    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.

  26. 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.
    Michele

    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!

  27. 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?

        Thanks

      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.

  28. 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.

  29. 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!

  30. 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?

  31. 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.

  32. 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.

  33. 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.

  34. 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!

  35. 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!

  36. 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.

  37. 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!

  38. 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.

  39. 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!

  40. 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.

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

  42. 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.

    2. I ABSOLUTELY agree with you, there is zero reason that disabled veterans should have to pay for medicare! We already have to fight, scrape and scratch for every benefit we have earned and to have to pay for medicare…….nope I refuse.

  43. 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.

  44. 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.

  45. 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?

  46. 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.

  47. 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.

  48. 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.

      1. I am retired and I pay a three year penalty because I did not sign for Medicare Part B until I was 68. I had Federal BCBS at that time and I still have it in retirement. Currently, I’m doubting that I should be paying this penalty. Please advise.

      2. Hi Susan. Unfortunately, Federal BCBS is not creditable coverage to Medicare. So, if you delayed Medicare coverage due to your BCBS benefits and you were not working during this time, you would be required to pay the penalty.

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