Is there a penalty for not enrolling in medicare part a at age 65

En español | You face serious consequences if you miss your deadline for signing up for Part B. That deadline could be the end of your initial enrollment period (IEP), which expires at the end of the third month after the month in which you turn 65. Or it could be the end of a special enrollment period (SEP) that you’re entitled to if, beyond your IEP, you receive health insurance from an employer for which you or your spouse actively works. This SEP lasts for up to eight months after the employment or coverage ends — whichever occurs first.  

In either case, missing your deadline means that: 

• You’d be able to sign up for Part B 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’d be liable for late penalties, amounting to an extra 10 percent for each full 12-month period that had elapsed between the end of your IEP and the end of the GEP in which you finally sign up — minus any months that you had health insurance from active employment (either your own or your spouse’s).  

Here are some additional points that you need to consider:

• Any late penalties that you receive will be added to your monthly Part B premiums for as long as you remain in the program. For example, if you signed up five years after missing your deadline, you’d always pay 50 percent more for your Part B coverage than if you’d signed up on time. 
• If you had health insurance from a current employer beyond age 65, but then, when it ended, failed to sign up for Part B within the allowed eight-month special enrollment period, the late penalties would be calculated on the time since the employment ended, not from the end of the eight-month SEP. 
• Be aware that you can delay Part B enrollment beyond 65 without risking late penalties only if you have health insurance from current employment (your own or your spouse’s). COBRA insurance (which extends employer coverage for up to 18 months after the job ends) is not, by definition, based on active employment. Therefore, if you wait until COBRA runs out to sign up for Part B, you face the delayed coverage and late penalties explained above. Similarly, you’d meet the same consequences if you declined Part B enrollment because you have retiree health benefits from a former employer and then sometime in the future you decided you needed Part B (for example, if your retiree benefits came to an end or became too expensive).  
• If you fail to sign up for Part B because you thought you hadn’t paid enough Medicare payroll taxes to “qualify,” be aware that earning 40 credits through paying those taxes only ensures that, after age 65, you don’t pay monthly premiums for Medicare Part A (hospital insurance).  You don’t need any work credits to qualify for Part B (coverage for doctors’ services, outpatient care and medical equipment) or for Part D (prescription drug coverage); you just pay premiums for them. In these circumstances, if you don’t enroll in Part B on time, you will still be liable for delayed coverage and late penalties.

Generally, no. In most cases, if you missed your Part B enrollment window, which runs from the three months before the month of your 65th birthday through the three months after the month of your 65th birthday, you will face a late enrollment penalty once you do enroll, which will be added to your premium costs for the remainder of your enrollment. The penalty equals 10% of the standard monthly premium for each 12-month period that you delayed enrollment.

If you did not enroll for Part B during your initial enrollment period, you may qualify for a Special Enrollment Period (SEP) to sign up for Part B (and/or Part A) anytime as long as you or a spouse is working and you’re covered by a group health plan through that employment. For people age 65 or over who have coverage through a group health plan, there is also an 8-month SEP which starts the month after the employment ends or the group health plan coverage ends. If you sign up during an SEP, the late enrollment penalty will not apply.

If you missed your initial enrollment period when you first became eligible for Medicare, you can only sign up for Part A and/or Part B during the General Enrollment Period, which runs from January 1 to March 31 each year. Your coverage will begin the first of the month following the month you enrolled during the General Enrollment Period. You cannot use the annual open enrollment period that runs from October 15 to December 7 to enroll in Medicare Part A or Part B. That enrollment period can only be used by people with Medicare to sign up for drug coverage or Medicare Advantage coverage, or switch coverage that you already have.