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En español | You will face permanent late penalties if you miss your deadline for enrolling in Part B, unless you’re in a situation where the penalty might be waived. How much you’d pay each month depends on how long you delayed enrollment and on the amount of the standard Part B premium in any given year.

Part B (which covers doctors’ services, outpatient care and medical equipment) is a voluntary benefit. You don’t have to sign up if you don’t want to. However, to avoid late penalties, you need to meet your personal enrollment deadline.  Depending on your situation, this could be one of the following: 

  • The end of your seven-month initial enrollment period (IEP), which begins three months before the month of your 65th birthday and ends at the end of the third month after your birthday month. (For example, if your birthday falls in June, your IEP begins March 1 and ends Sept. 30.) 
  • The end of a special enrollment period (SEP) to which you’re entitled if, after the end of your IEP, you’re covered by health insurance provided by an employer for which you or your spouse actively works. This SEP lasts for up to eight months after the employment ends.  

If you miss either of these deadlines (whichever applies to your own situation), you can still enroll in Part B, but you’d face two consequences: You could sign up only during a general enrollment period (GEP), which runs from Jan. 1 to March 31 each year, with coverage not beginning until July 1 of the same year. And you might be liable for late penalties. 

Part B late penalties are calculated as an extra 10 percent for each full 12-month period when you should have had Part B but didn’t.  

If you should have signed up at age 65, the penalty calculation is made on the time that elapsed between the end of your IEP and the end of the GEP in which you finally sign up. If you delayed enrollment after age 65 because of receiving health insurance through active employment, the penalty calculation is made on the time that elapsed between the end of the employment (not the end of the SEP) and the end of the GEP in which you finally sign up.  

So, for example, in either situation, if that period included five full years, your penalty would always be an extra 50 percent of the standard Part B premium in any given year. This would be added to your Part B premiums for as long as you remain in the program. If the standard premium increases or decreases in any year, your penalty would change accordingly.  

It’s important to understand that having retiree health benefits or COBRA extended coverage from a former employer after age 65 will not save you from Part B late penalties if you don’t meet your enrollment deadline. Neither retiree benefits nor COBRA counts as employer insurance or creditable alternative coverage for purposes of calculating Part B late penalties.

You would not pay Part B penalties in the following situations: 

  • If you miss your enrollment deadline but sign up during the next GEP, and in the meantime fewer than 12 full months have elapsed, you will not pay a penalty. For example, if your IEP ends on May 31, only 10 months will have passed before the end of the GEP (March 31).
  • If you are under age 65 and have Medicare due to disability, and are paying Part B late penalties, you will no longer pay them after you turn 65.  At that point the penalty clock is reset because you become eligible for Medicare based on age instead of disability.  
  • If you have Medicaid as well as Medicare, your state pays your Part B premiums and any late penalties are waived.
  • If you qualify for assistance from your state in paying Medicare costs under a Medicare Savings Program, the state pays your Part B premiums and any late penalties are waived. 
  • If you live outside the United States and are not entitled to premium-free Part A benefits, you cannot enroll in Part A or Part B abroad. Instead, you get a special enrollment period of up to three months after your return to the U.S. to sign up. If you enroll at that time, you are not liable for Part A or Part B late penalties. 

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