By Christian BrinkleyLicensed NC Insurance Agent, NPN 22217190, NC Life & Health · Updated October 14, 2026 · 4 min read
Medicare has deadlines. Miss them and you can owe a late enrollment penalty. Some penalties last a year. Others last as long as you have Medicare. Know the deadlines before you turn 65 or before you leave employer coverage.
Why Penalties Exist
Penalties encourage people to enroll when first eligible. The key idea is creditable coverage. If you have other coverage at least as good as Medicare, you can delay without a penalty. If not, and you wait, the penalty applies.
Part A Penalty
Part A is hospital insurance. Most people get Part A premium free because they or their spouse paid Medicare taxes for at least 10 years. If you qualify for premium free Part A, there is no late enrollment penalty. You can enroll late and owe nothing extra.
If you pay a premium for Part A, the penalty is 10 percent of the Part A premium, and you pay it for twice the number of years you delayed. Most people never face a Part A penalty because they qualify for premium free Part A.
Part B Penalty
Part B is medical insurance for doctor visits, outpatient care, and preventive services. Almost everyone pays a monthly premium for Part B.
The Part B late enrollment penalty is 10 percent of the standard Part B premium for each full 12 month period you went without Part B or creditable coverage. It is added to your Part B premium every month, for as long as you have Part B. It does not go away.
Part D Penalty
Part D is drug coverage. The penalty applies if you go 63 days or more without Part D or other creditable drug coverage after you are first eligible.
The penalty is 1 percent of the national base beneficiary premium for each month without creditable coverage. It is added to your Part D premium every month, for as long as you have Part D.
How Penalties Interact
You can owe more than one penalty at once. Delay both Part B and Part D without creditable coverage and you can owe both. Each is added to the relevant premium.
Penalties are separate from IRMAA, the income surcharge for higher earners. IRMAA is income based. Penalties are coverage based. You can owe both at the same time.
Penalties do not replace coverage. If you delay and get sick, you face medical bills without Medicare to help, plus the penalty on top.
How to Avoid Penalties
Know your Initial Enrollment Period: three months before the month you turn 65, your birthday month, and three months after. Seven months total. Enroll in Part A and Part B in that window unless you have confirmed creditable coverage that lets you delay.
If you are working at 65, ask your benefits office whether your coverage is creditable for Part B and Part D. Get it in writing. Rules differ for large and small employers.
What If You Already Owe a Penalty?
A penalty generally follows you as long as you have that part of Medicare. Switching plans does not remove it.
In limited cases it can be reconsidered. If you can show you had creditable coverage and an error was made, you can ask for a review. If you qualify for Extra Help, the Part D penalty may be removed.
Getting Help
Your state SHIP program offers free, unbiased counseling. In North Carolina, it is called SHIIP. You can also call 1-800-MEDICARE or talk to a local licensed insurance agent.
The message is simple: enroll when first eligible, or confirm in writing that your other coverage lets you delay. A few minutes of checking now can save extra premiums for years.
This article is general information only. It is not personal advice or a recommendation about any specific plan.
Questions people ask me about this
Why penalties exist?
Penalties encourage people to enroll when first eligible. The key idea is creditable coverage. If you have other coverage at least as good as Medicare, you can delay without a penalty. If not, and you wait, the penalty applies. What counts as creditable depends on the part.
How do I avoid penalties?
Know your Initial Enrollment Period: three months before the month you turn 65, your birthday month, and three months after. Seven months total. Enroll in Part A and Part B in that window unless you have confirmed creditable coverage that lets you delay.
What if you already owe a penalty?
A penalty generally follows you as long as you have that part of Medicare. Switching plans does not remove it. In limited cases it can be reconsidered. If you can show you had creditable coverage and an error was made, you can ask for a review. If you qualify for Extra Help, the Part D penalty may be removed.
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