Medicare Part B Penalty for Late Enrollment

Aug 29, 2019

Is there a Medicare Part B Penalty if I don’t enroll when I am first eligible?

Yes. If you postpone your Part B enrollment, you will incur a late enrollment penalty. That penalty will stay with you for as long as you are enrolled in Part B.

How much is the Part B Enrollment Penalty?

The penalty is assessed according to how long you waited to enroll in Part B. For each 12-month period you postpone enrollment when you become eligible, you will incur a 10% penalty on the standard Part B premium. For instance:

Your Initial Enrollment Period ended December 2016. You waited to sign up for Part B until March 2019 during the General Enrollment Period. Your coverage starts July 1, 2019. Your Part B premium penalty is 20% of the standard premium, and you’ll have to pay this penalty for as long as you have Part B. (Even though you weren’t covered a total of 27 months, this included only 2 full 12-month periods.)

-excerpt from Medicare.gov

The percentage penalty that is assessed at the time of enrollment stays in effect for as long as you have Part B coverage. So, if your penalty is 20%, consider that markup as part of your budget above and beyond the standard premium rates for Medicare Part B for each month thereafter.

What Does Medicare Part B Cover?

According to the Centers for Medicare & Medicaid Services (CMS):

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.

See more details about what Medicare Part B Covers.

When is the Enrollment Deadline?

Have questions on the penalty? Give us a call at 888-552-2412, M-F, 8:30am – 5:00pm PST.

You are eligible to sign up for Medicare Parts A and B over a 7-month window known as the Initial Enrollment Period (IEP):

  • 3 months before the month you turn 65
  • The month you turn 65
  • 3 months after the month you turn 65

Automatic Enrollment in Medicare Parts A and B (Original Medicare)

If you are receiving social security benefits before age 65 or a Medicare beneficiary due to a disability, you are typically automatically enrolled in Original Medicare (Parts A and B) as soon as you are eligible.

Special Circumstances (Special Enrollment Periods) Where the penalty may be waived:

If you were not automatically enrolled in Part B and your IEP is up, your Medicare Part B penalty could be waived if you meet any of the following conditions:

  1. You’ve been covered under a group health plan under a current employer.
  2. You are covered under a group health plan under your spouse or other family member if you are disabled.

If you are not yet enrolled in Original Medicare, need help with additional Medicare coverage, or have questions on any Medicare penalties, we can help.

Speak with one of our professional advisors and get answers quickly.

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