What Medicare penalties are most common?

Question

Gary Church · Accepted Answer

Questions came in: What Medicare penalties are most common? Probably the most common is somebody who has been working and either retires or gets laid off from their job, and their employer is going to offer them health insurance for the first year. If that employee decides to stay with their Cobra plan and their coverage, they realize that they have to enroll in Medicare. When you're notified by your employer and you know that your employment is ending, it's important that as soon as you know when your end date is, that's when you're going to apply for your Medicare. Now, your arm has already been in place, but it's activating your Part B. This is very important.

Other people will say, "I don't take medications, I don't need a drug plan." Well, you're required to have a drug plan, and a care only covers Part B hospital and your medical services. So if you don't have a drug plan, you are going to get a penalty.

And the other thing is changing your plans. It's important that you understand what you need to do either when you're aging into Medicare at 65 or when you actually have to do your roaming, and also when you're leaving your employer. It's very, very important that when you're leaving your employer, you sit down with a licensed Medicare agent. Don't try to do it on your own unless you know what you're doing. It's important to know when you have a qualifying event. So hopefully that answers your question.

Mike Alexander · Answer

IRMMA, LATE ENROLLMENT PENALTIES FOR PART B & D are common, but you can appeal them if you have had a change in life status

Daniel Brechin · Answer

The main penality is on the Prescription Drug Program. When, you turn 65 or leave work. If you take out a Supplement and do not take out a PDP. You will receive a penality that you will pay for life.

Answered by Daniel Brechin on September 18, 2025

Agent Licensed in AL, FL, KY, MS & TN

Answered by Daniel Brechin Medicare Insurance Agent

William Lawler · Answer

Hello, Bill Lawler here. The question is, what penalty is most common on Medicare plans? Well, I would say the most common penalty is not enrolling in Part B when you first become eligible.

For instance, if you are covered by group health coverage through an employer and that coverage ends, you have 60 days to enroll in Part B without penalty. Once you enroll in Part B, you could look for additional health care plans such as a Medigap or Medicare Advantage.

The penalty is for every month that goes by that you are eligible to enroll in Part B but you did not. There is a 1% penalty, and once imposed, that penalty continues forever. Here to help!

Mark Maliwauki · Answer

Part B and D not being taken when they should have been or kept active. Sadly, many people are giving the worst advice and they end up paying more because of it.

Robert Lukasik · Answer

The 2 most common penalties are not enrolling in part B in the timeframe required. Part D penalties are also common as many people do not know you are required to have this coverage even if you are not taking any prescriptions.

Answered by Robert Lukasik on September 18, 2025

Broker Licensed in NY, FL & PA

Answered by Robert Lukasik Medicare Insurance Agent

Steven DiPaolo · Answer

Part B penalty I would say is the most common significant one. This is a 10% penalty for a 12-month period that you are not enrolled or have other qualifying coverage when eligible. It is significant because it is a lifetime penalty.

So if you go 2 years without it and then enroll when Part B would be around 200/mo you would be paying about 240/mo instead, for life. 

The most common may be the Part D penalty, which is 1% for each month you go uncovered after being eligible for 63 days. Even after 2 years, this penalty would not be too much of an increase so not as significant in my view, but I would avoid if possible as it is also a lifetime penalty.

The part A penalty would be the least common and least significant, as most people get A for free and if you are penalized it eventually goes away.

John Burke · Answer

The most common penalties are for late enrollment in Medicare Parts B and D , which is why we urge people to do this ASAP when their eligibility period begins.

Gary Smith · Answer

Here’s a clear breakdown of the most common Medicare penalties people run into:

1. Late Enrollment Penalty for Part B (Medical Insurance)

When it happens: If you don’t sign up for Part B when you’re first eligible and don’t have other “creditable” coverage (like group insurance through a job).

The penalty: Your Part B monthly premium goes up 10% for each full 12-month period you were eligible but didn’t enroll.

Duration: You pay this higher premium for as long as you have Part B.

2. Late Enrollment Penalty for Part D (Prescription Drug Coverage)

When it happens: If you go 63 days or more without Part D coverage (or other creditable drug coverage).

The penalty: Your Part D premium increases by 1% of the “national base beneficiary premium” for each month you didn’t have coverage. (This amount can change each year.)

Duration: You pay the penalty for as long as you have Part D.

3. Medicare Advantage (Part C) Late Enrollment Issues

No direct “penalty,” but if you miss your enrollment periods, you may have to wait until the Annual Enrollment Period (Oct 15–Dec 7) to join a plan.

During that wait, you may be left without the coverage you want.

✅ In short:

Part B Penalty = 10% higher premium for every year late.

Part D Penalty = 1% higher premium for every month late.

Part C (Advantage) = Not a penalty, but missed timing can leave gaps in coverage.

Andrew Zurbuch, MBA · Answer

Here are 2 of the Medicare penalties to be aware of. I don't have exact information as of now of the most common. The late enrollment penalty for Part B & the Medicare Part D Late Enrollment Penalty. Usually, you don't have to pay a penalty if you meet certain conditions that allow you to sign up for Part A.

Source: www.medicare.gov.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Steven A James, MBA · Answer

Social Security "expects" a Medicare Beneficiary to enroll in their Part B within the 7-month window of their Medicare Initial Enrollment Period (IEP) (3mo before birth month, birth month, and then three months after birth month).  If not, a Late Enrollment Penalty (LEP) shall apply.

If one goes without enrolling in Part B, the penalty is a 10% increase above the current Medicare Part B premium.  One would then be restricted to enroll in Part B during the General Enrollment Period (Jan - Mar).  In the past, Part B would then start that July 1st, but I believe that's been updated, so it may start on the 1st after enrollment.

 Social Security also "expects" a Medicare Beneficiary to be enrolled in a qualified Prescription Drug Plan (PDP).  If not enrolled in a PDP, no penalty.  The penalty occurs once the beneficiary enrolls in either a standalone PDP or a Medicare Advantage Plan with PDP included.

The PDP (LEP).  There's a calculation of 1% x the national rate of an average PDP.  If the national average is $30 and one goes 5 years without coverage, the penalty w/b $1.50.  Unfortunately, this penalty is for life or until one is no longer enrolled with prescription drug coverage.

So, enrolling in Part B and prescription drug coverage during IEP is the soundest advice.  There are circumstances that are special circumstances which help to avert an LEP, such as retiring and/or losing group coverage.  Those who qualify for Low Income Subsidy ("Extra Help") from Social Security would also be eligible for a PDP LEP.

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Marnie Applegate · Answer

Late enrollment penalties for Part B and Part D. Part B penalty is an increase of 10% for each full 12 month period that you delayed enrollment or went without creditable coverage after turning 65 or if you were eligible earlier due to disability. Part D is a 1% increase (of the national average) for each month you went without creditable prescription drug coverage. Both are lifelong penalties.

Answered by Marnie Applegate on October 26, 2025

Agent Licensed in TN, AL, GA & TX

Answered by Marnie Applegate Medicare Insurance Agent

Leslie Santos · Answer

The most common is the Part B one when you turn 65 and do not claim your benefits on time, that will trigger a penalty for life

Darlene Cerezo Swaffar · Answer

Delaying Part D prescription drug plan is the most common penalty I see as an agent. I find that many beneficiaries are not aware of potential penalties for delaying Part D drug coverage. Most say they do not take medications so why do they need a drug plan? There are many opportunities for a low premium to zero premium plans available.

Answered by Darlene Cerezo Swaffar on October 5, 2025

Broker Licensed in FL

Answered by Darlene Cerezo Swaffar Medicare Insurance Agent

Juan Osborn · Answer

There are several penalty possibilities with Medicare:
1. Part D, which includes 1% of the average premium for every month without credible coverage
2. Part B has a 10 percent minimum increase for each 12-month period of delayed enrollment without minimal coverage.
3. Part A has a penalty of 10 percent of the premium for twice the number of years you delayed enrollment.

Dixie Obbink · Answer

The most common Medicare penalties are Part B late enrollment penalty, along with Part D. Timely enrollment is important to avoid these penalties. There are certain circumstances where you can delay signing up for Medicare without penalties, but it may require specific forms. Talk to a licensed Medicare agent to help you navigate the deadlines and determining if your current coverage is creditable.

Answered by Dixie Obbink on March 30, 2026

Broker Licensed in SD, AZ, IA, MN & NE

Answered by Dixie Obbink Medicare Insurance Agent

Mark Boone · Answer

The most common Medicare penalties are the Late Enrollment Penalties for Part B and Part D, which apply if you don't sign up when you're first eligible and don't have other creditable coverage

Eizel Mere · Answer

Medicare penalties that are moest common are Part B and Part D penalties. Both are based on time and coverage. When you turn 65 and are first eligible for Medicare you must enroll unless you have creditable coverage. If you dont you will incur on a monetary penalty for the rest of your life.

Answered by Eizel Mere on September 29, 2025

Broker Licensed in FL

Answered by Eizel Mere Medicare Insurance Agent

Abigail Turner · Answer

The most common one we run into would be the LEP (late enrollment penalty) for Part D prescription coverage. Most of the time it's due to someone who is self employed or on COBRA thinking the marketplace or COBRA coverage is considered creditable by Medicare but it's not. Every now and then we run into someone who delayed enrollment into Medicare Part B and had no other coverage options (which is the second most common penalty) but the Part D LEP is by far the more common penalty we see.

Answered by Abigail Turner on February 2, 2026

Broker Licensed in KS, AR, AZ & 13 other states

Answered by Abigail Turner Medicare Insurance Agent

Kim Mitchell-Hargis · Answer

So the question is, what Medicare penalties are most common? As far as I can tell, the most common penalty is if you don't sign up for Part D when you get your A and B. So say you go into the Social Security office, you sign up for Part A and Part B. It's not their job necessarily to tell you you have to have Part D. So a lot of people don't know that, and they don't apply.

So Part D is your drug plan. Part A is your hospital coverage. Part B, as in Bravo or Boy, is your doctor coverage. There is a fee for Part B, but there is no fee for Part A. If you start with original Medicare and go right to a Medicare Advantage plan, your Part D is included in almost all of the Medicare Advantage plans. You just have to make sure you get into one that has no plan included. Otherwise, you have to make sure you get Part D.

So if you stay on original Medicare, you will have to call an agent for Humana, United, or whoever you like, or whoever has your prescriptions that you're on. You call them directly and you get on a Part D plan there. Anywhere from, and this is 2025, Part D plans are anywhere from $13 to $113, just based on what prescriptions you take. But yeah, the Part D penalty is probably one of the more popular penalties.

Lori Marion` · Answer

The most common penalty i see is due to people who don't enroll in a prescription drug plan when they first become eligible for Medicare. This happened to my dad and it really hurt him. He was paying 40 to $50 a month for drugs he would have been able to get for free. He also refused to fill prescriptions that would have greatly improved his quality of life because they would cost him about $300. If he had prescription coverage, he could have gotten the expensive drugs for the amount he was paying for the cheaper drugs.

Answered by Lori Marion` on October 27, 2025

Agent Licensed in MS, AL, AR & 17 other states

Answered by Lori Marion` Medicare Insurance Agent

Tosha Morell · Answer

Hello. The most common Medicare penalties are the late enrollment penalties for Part B and Part D, which add permanent monthly surcharges if you delay signing up without qualifying coverage. Another frequent penalty is the Medicare Advantage Part C late enrollment issue, where delayed enrollment can limit plan options or cause gaps in coverage.

Answered by Tosha Morell on December 4, 2025

Agent Licensed in GA & FL

Answered by Tosha Morell Medicare Insurance Agent

Dorthea Hughes · Answer

The most common medicare penalty is when a consumer doesn't sign up for part b during the initial enrollment period sometimes they wait until and because of the waiting period there assessed a penalty because of that I'm not having any creditable coverage during that waiting period

Answered by Dorthea Hughes on September 20, 2025

Agent Licensed in MS

Answered by Dorthea Hughes Medicare Insurance Agent

Michelle Turner · Answer

The penalties when you don't pick up part b Medicare when you were first eligible  and going 63 days or more without having creditable coverage.

Lyndsee Woods · Answer

One of the biggest issues I’m seeing lately, besides the Part B late enrollment penalty, is the Part D penalty. Many beneficiaries feel healthy, aren’t taking any medications, and assume they don’t need a stand-alone Part D plan but that choice often leads to costly penalties later.

Answered by Lyndsee Woods on November 29, 2025

Agent Licensed in AR, MO, OK & TX

Answered by Lyndsee Woods Medicare Insurance Agent

What Medicare penalties are most common?

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