Could Medicare Delays Cost You?
Medicare Late Enrollment Penalties: Part B & Part D
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What Are Medicare Penalties?
Medicare is designed to be there when you need it. But if you don’t sign up when you’re first eligible—and you don’t have other qualifying coverage—you may face lifetime penalties. These are extra amounts added to your monthly premium.
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Part B Penalty (Medical Insurance)
When it applies: If you delay enrolling in Medicare Part B (doctor visits, outpatient care, preventive services) and you don’t have creditable coverage through active employment (your own or a spouse’s).
How it’s calculated:
Your premium goes up 10% for every full 12-month period you could have had Part B but didn’t enroll.
This increase lasts as long as you have Part B.
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Jackie’s Story (2026):
Jackie turned 65 in 2021 while she was freelancing and thought, “I’m healthy—I’ll just wait.” Because she did not have creditable coverage through active employment, she delayed enrolling in Medicare Part B for 3 full years.
When Jackie enrolled in Part B, she incurred a 30% late enrollment penalty (10% for each full 12-month period she delayed).
The standard Medicare Part B premium in 2026 is $202.90 per month.
Because of her penalty:
30% of $202.90 = $60.87
Jackie’s total monthly Part B premium in 2026 is approximately $263.77 instead of $202.90.
This 30% penalty is permanent and applies for as long as Jackie has Medicare Part B.
Important: If the standard Part B premium increases in 2027 or future years, Jackie’s penalty increases as well. She will always pay 30% more than the standard Part B premium in effect for that year.
Devon’s Story - 2026:
Devon had retiree coverage that did not include prescription drug coverage. He assumed he wouldn’t need medications, so he skipped enrolling in Medicare Part D. As a result, he went 24 consecutive months without creditable prescription drug coverage.
When Devon eventually enrolled in Part D, Medicare applied a 24% late enrollment penalty (1% × 24 months).
The national base beneficiary premium for 2026 is $38.99.
24% of $38.99 = $9.36
Rounded to the nearest $0.10 = $9.40
That $9.40 is added to Devon’s Part D premium every month, and this penalty is permanent for as long as he has Part D coverage.
Part D Penalty (Prescription Drug Coverage)
When it applies:
If you don’t join a Medicare Part D plan (or a Medicare Advantage plan with drug coverage) when first eligible, and you go 63 consecutive days or more without creditable prescription drug coverage.
(Prescription drug coverage is considered creditable if it is expected to pay, on average, at least as much as Medicare’s standard drug coverage.)
How it’s calculated:
Medicare charges 1% of the national base beneficiary premium for each full month you were without creditable prescription drug coverage after you were first eligible.
For 2026, the national base beneficiary premium is $38.99.
The penalty is rounded to the nearest $0.10 and added to your monthly Part D premium (even if your plan premium is $0).
This penalty is permanent and applies for as long as you have Medicare Part D coverage.
Why These Penalties Matter
They last forever. Once Medicare adds a penalty, you pay it every month for as long as you have that coverage. You can’t pay it off and make it go away.
They can grow each year. Medicare premiums often go up each year. Since penalties are based on those premiums, the monthly dollar amount you pay can increase over time.
They can be avoided. Signing up on time or having the right kind of coverage can help you avoid penalties and save money and stress.
How to Avoid Penalties
Enroll on time. Your Initial Enrollment Period lasts 7 months —
3 months before your 65th birthday, the month of your 65th birthday, and 3 months after your 65th birthday.
Keep proof of coverage. Save letters or notices that say your employer or prescription drug coverage is creditable. You may need them later.
Act quickly when coverage ends. If your job-based coverage ends, you usually have:
8 months to enroll in Part B
63 days to enroll in Part D
Missing these time limits can cause monthly penalties.
What To Do Next
Check your coverage.
Talk with your HR department, benefits office, or plan provider to understand what coverage you have.
Ask one clear question.
“Is my prescription drug coverage creditable for Medicare?”Save your paperwork.
Keep any letters or emails that explain your coverage. You may need them later.
Get help if you’re unsure.
Reach out to me if you want help reviewing your timing or understanding your options.
