If I don’t sign up for Part B when first eligible, what happens?

Medicare and You 2020 #10050  
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Medicare and you

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In most cases, if you don’t sign up for Part B when you’re first eligible, for Medicare, as you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B.  you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B.

Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it.

Also, you may have to wait until the General Enrollment Period (from January 1 to March 31) to enroll in Part B. Coverage will start July 1 of that year. See page 11 Publication 11036 Enrolling in Medicare for full details Usually, you don’t pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period. If you have limited income and resources, your state may help you pay for Part A, and/or Part B. You may also qualify for Extra Help  LIS  to pay for your Medicare prescription drug coverage.


Your Initial Enrollment Period ended September 30, 2009. You waited to sign up for Part B until the General Enrollment Period in March 2012. Your Part B premium penalty is 20%. (While you waited a total of 30 months to sign up, this included only 2 full 12-month periods.) You’ll have to pay this penalty for as long as you have Part B.


Jeremy turned 65 in 2011. He did not sign up for Medicare Part B until 2017.

His penalty is: 10% x 6 years = 60 His penalty is thus 60% on top of the premium 0.6 X $134 (2017 Part B premium) = $80.40 penalty $80.40 + $134= $214.4

Jeremy will pay $214.4 on a monthly basis as his penalty Part B premium.  United Medicare Advisors


The New York Times: Why You Shouldn’t Wait To Sign Up For Medicare Part B [George Zeppenfeldt-Cestero] should have signed up for Medicare Part B three years earlier when he turned 65. By delaying, he had missed the best window — the so-called Initial Enrollment Period — to apply for Part B, which covers much of what we consider health care: doctor visits, tests, injectable drugs (including chemotherapy), ambulances, physical therapy and other non-hospital services.

As a result, he has to pay permanently higher premiums, and he had to endure an unsettlingly long period — from December to July — before the coverage actually kicked in. (Span, 10/26)


Find out what Part B covers.

Part B Premium

14 comments on “Part B Late Enrollment Penalty

  1. I won’t have 40 quarters until I’m 68. When is my initial enrollment period? I don’t want any penalties.

    • Use this tool to determine when you are eligible for Medicare.

      Medicare Eligiblity Tool

      Your Initial Enrollment Period based on your age Your Initial Enrollment Period based on your age contextual help
      October 1, 2019 – April 30, 2020

      Am I eligible to enroll?

      Medicare is for people age 65 and older and those who have special condition or disability. You’re not eligible to enroll in Medicare now because you don’t meet the special condition/disability requirements.

      If you’re a U.S. citizen or you meet the lawful presence and residency requirements, the Initial Enrollment Period (IEP) is your first chance to sign up for Medicare. It starts 3 months before your 65th birthday, includes the month you turn 65, and ends 3 months after the month you turn 65.

      Sign up for Medicare

      Costs for Medicare since you won’t get it for free…

      Costs for Medicare… How does that compare to the under 65 plan you have now?

  2. The “SSA international operations” number (in Baltomore) was 410-965-2356. Zero wait time. It seemed to me that because my application had an overseas address, it could only be handled by this office.

  3. Presumably, if you cancel your Part B, if you to reinstate Part B later it will not come with guaranteed issue rights for MediGap?

  4. If I have Part B and move out of country or go back to work and have employer coverage, how do I cancel Part B?

    • Voluntary Termination of Medicare Part B

      You can voluntarily terminate your Medicare Part B (medical insurance). It is a serious decision. You must submit Form CMS-1763 to the Social Security Administration (SSA).
      You’ll need to have a personal interview with Social Security before you can terminate your Medicare Part B coverage. To schedule your interview, call the SSA or your local Social Security office.

      USA.Gov ssa.gov

    • Here’s what Anonymous reported to us in an email about cancelling a pending application for Part B

      1) I called the SSA domestic line, waited for half an hour, and was told that the person on that line couldn’t help me because we had an international application. She gave me a number for “international operations” (in Baltimore).

      2) I called the “international operations” number and connected directly (no answering machine) to a very helpful young woman who cancelled the Part B application for myself and my wife in about 5 minutes.

      3) I strongly suspect that it is policy that you can withdraw an application for which Medicare coverage has not year come into force. In any event, it worked for us.

  5. How do I compare, since I’m not currently residing in the USA, the Part B late enrollment penalty, having to enroll in January – March and not having coverage till July, then being able to get a Medi-Gap plan guaranteed issue


    paying $134/month now for Part B and say $180/month for a Medi Gap Plan F or $61/month for Hi F?

  6. If I live outside of the USA, do I need to sign up for Part B when I turn 65 or is there a guaranteed enrollment period when I return to USA – California?

    • Living outside the U. S.
      (Excerpt copied from publication 11036 Enrolling in Parts A & B)

      I live outside the U. S., and I don’t have Part B. Can I get Part B and will I pay more?

      It depends on your situation:

      Situation #1: If you’re over 65, currently getting Social Security benefits and Part A, and you didn’t take Part B when you were first eligible, (our webpage on eligiblity) (Medicare Eligiblity Tool) you may only apply for Part B during the General Enrollment Period. This period runs from January 1 – March 31, and you may have to pay a late enrollment penalty for as long as you have Part B.

      Situation #2: If you live outside of the U.S., you’re over 65, and you’re eligible for Social Security benefits, you may file an application for monthly benefits and Part A. You’ll have to file for Part B during the General Enrollment Period. This period runs from January 1 – March 31, and you may have to pay a late enrollment penalty.

      Situation #3: If you’re a U. S. citizen, you’re over 65, you’re not eligible for Social Security benefits, and lived in a foreign country when you turned 65, you must live in the U. S. to file for Part B. You’re first eligible to enroll in Part B the month you return to the U. S. to establish your new residence.

      You won’t have to pay a late enrollment penalty if you enroll in Part B when you first return to the U. S. Although you may be able to enroll, in most cases, you won’t be able to get Medicare-covered services while living outside the U.S. Medicare generally can’t pay for any of your hospital or medical bills unless you get your medical care in the U.S. (including Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa). Under certain limited circumstances, medical services provided in outside of the United States also may be covered by Medicare, but only if you’re living in the U.S.

      • Excerpt of Email from Ted W

        Steve —

        I learned a few things today that I thought I might share with you.

        1) Because I enrolled for Part A from abroad (Italy), and declined Part B, I became a candidate to receive an unsoliticed phone call from a US government employee in Rome who handles SS/Medicare issues!! This person wanted to make sure I understood the issues with respect to Part B penalties. This person was very helpful, but knew nothing about MediGap. He didn’t even know what it was.

        2) Medicare Part B penalties increment after each full year in which you could have had Part B but chose not to. What then is the date in which you could have had Medicare? You can sign up for Medicare for 3 months before eligibility, and since if you do so your coverage date begins on the first day of the month of your birthdate (unless your birthday is the 1st of the month). For example, if you decline Part B in your initial enrollent period in 2018 but opt for Part B in the first general enrollment period of 2019, your coverage will start July 1, 2019. If your birthday is in July, your full-year penalty clock will start on July 1 and will have traversed a full year. If your birthday is in August, the clock will start on August 1 and it will have been only 11 months … hence no penalty for that year.


        Ted W

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