Paying for Care
The Part B Late Enrollment Penalty: How It Works and Who Is Protected From It
The Part B penalty adds 10% to your premium for each full 12 months you could have had Part B and did not. Job coverage can protect you. See who is safe and who is not.
Key takeaways
- Your premium goes up by 10% for each full 12-month span you could have had Part B but did not sign up.
- The charge lasts for as long as you have Part B. It is not a one-time fee.
- The standard Part B premium is $202.90 per month in 2026 (Ledger A1). A 20% penalty makes it $243.50 per month in 2026.
- Health coverage from your own job, or your spouse's job, can protect you if it is based on current work.
- When that job coverage or the job ends, you get 8 months to sign up with no penalty.
- COBRA and retiree coverage do not protect you. The 8-month clock starts when the job or the job coverage ends, not when COBRA ends.
- In most cases, a person in a Medicare Savings Program does not have to pay this penalty.
Part B is the part of Medicare that pays for doctor visits and care you get as an outpatient. Most people sign up when they first can, at age 65. Some people wait because they still work. That can be safe. Some people wait for other reasons. That can cost them for the rest of their lives. This guide shows how the penalty is set, who is kept safe from it, and the trap that catches many workers. Our Paying for Care section holds more guides on Medicare costs.
How the penalty is set
Medicare counts full 12-month spans. If you could have had Part B for one full span of 12 months and you did not sign up, your premium goes up by 10%. Two full spans give a 20% rise. Three give 30%.
A part span does not count. If you were late by 8 months, that is not a full 12-month span, so it adds no step. But the months with no Part B are still months with no Part B cover.
Medicare gives a clear case on its own page. A person who waited 2 full years to sign up, and did not qualify for a special window, pays a 20% penalty. On the 2026 standard premium of $202.90 (Ledger A1), the penalty adds $40.58. The total is $243.50 per month for 2026. That sum is rounded to the nearest $0.10.
The penalty is a share of the standard premium. That share stays with you. As the standard premium changes in new years, the dollar sum of your penalty changes with it.
You still owe the Part B deductible of $283 for the year (Ledger A2) for your care. The penalty does not change the deductible. It changes the premium you pay each month to hold Part B.
Who is protected: people who still work
You can delay Part B with no penalty if you have group health coverage based on current work. That can be your own job or your spouse's job. The word that counts is current. You, or your spouse, must still be working.
While that coverage lasts, you can sign up for Part B at any time. When the job ends, or the group coverage ends, you have 8 months to sign up. That span is called a Special Enrollment Period. If you sign up in it, no penalty applies for the months you had the job coverage.
Ask your job for proof of your coverage dates. There is a form your employer fills in to show when you had group coverage and when you worked there. Keep that proof. Social Security uses it to confirm that your delay was protected.
One more check matters for small firms. At a firm with few staff, Medicare may pay first and the job plan second. In that case, delaying Part B can leave you with bills the job plan will not pay in full. Ask your benefits office how your plan works with Medicare before you decide to wait.
The trap: COBRA and retiree coverage
This is where many people get caught. COBRA lets you keep a job plan for a time after you leave a job. It feels like the same coverage. For this rule, it is not the same. COBRA is not coverage based on current work.
Your 8-month clock starts the month after your job ends, or your group coverage ends, whichever comes first. It does not wait for COBRA to end. If you stay on COBRA for a long time and then sign up for Part B, the months past your 8-month span count toward a penalty.
Retiree coverage from a past job has the same flaw. It is not based on current work, so it does not protect your delay. A plan you buy on your own does not protect it either.
If you have COBRA now and you are past 65, do not wait for it to run out. Ask Social Security about your dates at once. Each full 12-month span past your protected time adds a step you will pay for life.
If you miss both windows
If you did not sign up in your first window and you do not have a protected delay, you can sign up in the General Enrollment Period. That runs from January 1 to March 31 each year. Your Part B starts the month after you sign up.
Signing up then does not erase the penalty. The full 12-month spans from your late time still count. That is why the first choice matters so much.
Our guide on the Part D late enrollment penalty covers the drug side of this issue. That penalty counts by the month, not by the year. The two rules are not the same, and a person can owe one, both, or neither.
Our guide on Medicare Savings Programs shows the state plans that can pay the Part B premium for people with low incomes. Medicare notes that, in most cases, a person who signs up for one of those programs does not have to pay this penalty.
If you think your penalty is wrong
Check the dates first. Were you in a job plan based on current work in the months Medicare counted? Do you have proof of those dates? A letter from your employer or the filled form can change the count.
If the proof shows you were protected, ask Social Security to look at your case again. Bring the dates of your job, the dates of your coverage, and the date you signed up. Clear dates are what decide this issue. A claim with no dates is hard to fix.
Who pays for what
- Original Medicare is the cover Part B gives you. You pay the premium to hold it. With a penalty, your premium is the standard $202.90 per month (Ledger A1) plus your penalty share.
- Medicare pays its share of covered Part B care once you are signed up. It does not pay the penalty for you and it does not cover care in months when you had no Part B.
- A Medigap policy pays toward the costs Original Medicare leaves. It does not remove a Part B penalty.
- A Medicare Advantage plan still rests on Part B. You keep paying the Part B premium, with any penalty on it, while you are in such a plan.
- Medicaid, through a Medicare Savings Program, can pay the Part B premium for people who qualify through their state.
- Private pay covers care you got with no Part B in place and any premium sum you owe with no help.
Sample situation
Dan worked until age 67 at a firm with a group health plan. His wife was on the same plan. He did not sign up for Part B at 65 because his job plan covered him and it was based on his current work. When Dan retired, he had 8 months to sign up for Part B with no penalty. He signed up in the second month after he retired and gave Social Security the form from his employer that showed his coverage dates. His Part B premium is the standard $202.90 per month (Ledger A1), with no penalty. His friend Paul took COBRA for 2 years after he retired at 65 and waited for it to end. Paul's 8-month clock ran while he was on COBRA. Paul now pays a penalty on his Part B premium, and he will pay it for as long as he has Part B.
What to check about your own case
If any of these answers is not clear, ask Social Security now, not later. A short call today can save a charge you would pay each month for the rest of your life.
- Did you sign up for Part B when you first could? If not, why not?
- Was your delay covered by a job plan based on current work, yours or your spouse's?
- If that job or coverage has ended, how many months have passed since it ended?
- Are you on COBRA now? If so, treat your clock as already running.
- Do you have written proof of your coverage dates from your employer?