The penalties for signing up late for Medicare or Medigap can be confusing and quite serious. If you want to avoid lifetime late fees, check out this article and use our ‘Medicare Deadline Calculator‘ to make sure you don’t miss any key Medicare enrollment dates.
What is a Medicare Late Enrollment Penalty?
Unfortunately, since Medicare has many parts, there are many penalties that you could face. The penalty varies depending on which part of Medicare you missed, and they tend to be recurring lifetime monthly charges. It will also depend on how much time has passed since your enrollment period ended and when you actually signed up.
Late Enrollment in Medicare Part A:
Medicare Part A Late Penalty:
If you are required to pay a Part A premium but don’t enroll when you first qualify for Medicare, your monthly premium could increase by 10%. You’ll pay this higher premium for double the number of years you missed signing up. For instance, if you were eligible for Part A for 3 years but didn’t enroll, you’ll face a higher premium for 6 years.
Medicare Part A Background:
As you approach 65, it’s important to know whether you’ll get Medicare automatically or need to sign up. If you’re already receiving Social Security or Railroad Retirement benefits, you’ll automatically get Medicare Part A and Part B when you turn 65. If you’re still working and not yet receiving these benefits, you’ll need to enroll in Medicare yourself.
You’ll get Part A without a premium if you or your spouse paid Medicare taxes for at least 10 years. If you’re unsure whether you qualify, you can log into your secure Social Security account to check if you’ve paid enough Medicare taxes. If you don’t qualify for premium-free Part A, you can still buy it.
Your first chance to sign up is during your Initial Enrollment Period, which lasts 7 months—starting 3 months before your 65th birthday and ending 3 months after. If your birthday is on the first of the month, your enrollment period starts 4 months before and ends 2 months after.
You won’t face any penalties for signing up late if you or your spouse have contributed to Medicare for 10 years. However, if you haven’t worked the required 40 quarters, and you are late, you might have to pay the Part A penalty outlined above.
Late Enrollment in Medicare Part B:
Medicare Part B Penalty
If you miss the chance to sign up for Part B, you’ll end up paying an extra 10% on the standard premium ($174.70 in 2024) for each 12-month period you waited. This penalty will continue to apply as long as you’re on Medicare Part B.
Medicare Part B Penalty Background
Your Initial Enrollment Period lasts 7 months: it starts 3 months before you turn 65, includes your birthday month, and ends 3 months after. If you didn’t sign up on time, not all is lost! You might qualify for a Medicare Special Enrollment Period.
As we mentioned earlier, you might not need to sign up for Medicare Part B because it could happen automatically. However, if you’re still working and your 65th birthday is coming up, you’ll likely need to enroll yourself.
It is our understanding from hearing from our clients is if your Part B late period is less than 12-month you may not have to pay a penalty. We have yet to find that in writing but more than one of our clients said they were not charged a penalty because they signed up before a year had passed. Please confirm this with the CMS (send us the source in writing if you find it!)
Late Enrollment in Medicare Part D / Medicare Advantage:
Medicare Part D Penalty
If you don’t sign up for Part D on time, you’ll pay a penalty of 1% for each month you were without coverage. For 2024, the national base beneficiary premium is $32.74. So, if you’re 10 months late, you will pay 10% of $32.74 extra for as long as you have a Medicare Part D plan. The same penalty applies if you enroll late in a Medicare Advantage plan with a prescription drug plan.
Medicare Part D Penalty Background
The enrollment window for Part D is the same as the one for Medicare. It starts three months before you turn 65, includes your birthday month, and ends three months after. This gives you a total of seven months to enroll without facing any penalties. Learn more in our “Medicare Part D Drug Overview“.
Medicare Advantage has the same Initial Enrollment Period of 7 months in total. If you need more details, you can find complete information in our Medicare Advantage Overview article.
If you have credible drug coverage from work, you will not be subject to the Part D Penalty. Learn more about new rules for Part D that may affect your credible coverage.
Late Enrollment in Medigap:
Medigap Penalty Background
The ideal time to sign up for Medigap is when you’re 65 or older and already have Medicare Part B. You get a six-month window starting from your Medicare Part B start date to enroll in Medigap, during which you’re guaranteed approval at the best rate, no matter your health history. During this period, you can’t be denied or face waiting periods due to pre-existing conditions.
Medigap Penalty
You won’t face a financial penalty for enrolling late in Medigap, but you might need to go through medical underwriting if you enroll too late. This means you could be denied coverage or end up paying higher rates. Missing the Medigap deadline might mean you can’t get Medigap at all which could be the ultimate penalty. So call our team at Senior65.com (800-030-7956) and we can help you sign up for coverage without missing key enrollment deadlines.
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Use our Deadline Calculator
If you’re not a fan of doing the math or just want to know when your enrollment period starts or ends, Senior65.com has got you covered. Our deadline calculator can help ensure you don’t miss your enrollment dates and can even send you reminders.
Check out our Deadline Calculator here.
Please note: The deadlines given using our calculator are general guidelines and might not apply to everyone, especially if you’re delaying Medicare due to work coverage. If you think you might have unique circumstances, give us a call to confirm your deadlines.