Medicare Basics: Late Enrollment Penalties

October 25th, 2019

When Medicare Open Enrollment begins, beneficiaries have the chance to add or modify their coverage. Each year, Open Enrollment begins on October 15. Beneficiaries then have 54 days—until December 7—to join or change plans. However, what happens if you turn 65 outside of that time frame? What if you miss that window? 

We’re here to answer all of your questions about what happens when you enroll outside of the Open Enrollment period.

What if I become eligible for Medicare outside of the Open Enrollment period?

Don’t worry if you turn 65 during a month that isn’t October, November, or December. When you turn 65, you’ll get a special enrollment period that begins three months before your birthday month. It will last the entire duration of your birthday month plus three months after, for a total of seven months. 

What happens if I don’t enroll during that time OR during Open Enrollment?

If you enroll late, you’ll likely incur some penalties.

Medicare Part A Penalty

Once people turn 65, most get Medicare Part A for free. If you don’t meet the qualifications to get Part A free, you can still buy coverage. If you don’t buy coverage when you become eligible, you may receive a penalty.

Wondering if you’re eligible for Medicare? Learn more in our “Do I qualify for Medicare?” guide.

The penalty is typically 10% of your current Part A premium. Medicare will add this amount to your premium. This higher rate lasts double the number of years you were eligible for but did not sign up for Part A. So, if you avoided signing up for 3 years, you will pay higher premiums for 6 years.

Medicare Part B Penalty

Unlike the Part A penalty, the Part B penalty lasts for however long you have Part B. (Meaning this could be a lifelong penalty.) The initial penalty is 10% of the standard premium if you go a full 12 months without signing up after you become eligible. For every 12-month period you go after that, your penalty could increase another 10%. 

For example, let’s say your Initial Enrollment ended in August 2017. You decide not to sign up until October 2019, and your coverage starts January 1, 2020. Your Part B premium could be 20% of your premium because you went more than 24 full months without coverage.

Medicare Part D Penalty

If you already have creditable drug coverage, you might not need Medicare Part D. Find out more about creditable drug coverage in our Medicare Part D, explained.

If you decide not to enroll in Medicare Part D within 63 days of your Initial Enrollment Ending, you may end up with a Part D penalty if and when you do decide to enroll. The penalty is calculated by multiplying 1% of the “national base beneficiary premium” and the number of full months you went without Part D or other creditable drug coverage. 

Ready to find the perfect Medicare plan? Head over to our Medicare center to compare plans and save!

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