Why do some seniors end up paying lifelong penalties for Medicare Part B or Part D?

Question

Samantha Jellison · Accepted Answer

Lack of appropriate retirement planning education. One of the foundations I have built my business on is education. Medicare 101 seminars can be really useful to people to learn how to avoid these penalties. 

It is important to know that unless you have what is known as Creditable Coverage, delaying Part B and or Part D can carry lifelong penalties. Each situation is unique so it’s important to consult with a professional to understand if you have Creditable Coverage or not and have a plan in place, months before you turn 65. Sorting out your Medicare coverage is best done up to 3 months before you turn 65.

Lt Col Tim Brown · Answer

Mainly because people don’t know the rules. This is why you need a professional agent/broker. If someone does not have credible coverage and goes past their enrollment period, they have a penalty for life. Or If their income is considered high, they get ugly aunt I.R.M.A. (income related monthly adjustment) attached as a penalty until such time as their income drops. None of this is fair, just what they can do (the rules).

Answered by Lt Col Tim Brown on June 17, 2025

Broker Licensed in TN, AL, CO & 10 other states

Answered by Lt Col Tim Brown Medicare Insurance Agent

William Lawler · Answer

Seniors who end up paying lifelong penalties must do so because they neglected to enroll in Part B when they were originally eligible. There is a monetary penalty for each month they were eligible, but did not enroll in Part B unless they had creditable health coverage through employment.

Answered by William Lawler on April 16, 2025

Broker Licensed in MO, FL, IA & 12 other states

Answered by William Lawler Medicare Insurance Agent

Melonie Wood · Answer

The penalties are based on WHEN a person signed up for Part B/D  this is called Late Enrollment Penalty

Brian Moore · Answer

Some seniors face lifelong penalties for Medicare Part B or Part D because they miss their initial enrollment period—typically the seven months surrounding their 65th birthday—and lack qualifying coverage, such as an employer plan, to justify delaying enrollment. For every year they’re late, Part B adds a 10% premium penalty, while Part D increases by roughly 1% per month missed, and these extra costs stay with you permanently since Medicare enforces timely sign-ups to maintain its structure. I’ve seen this catch people by surprise, especially when they overestimate their existing coverage, making it a costly oversight to avoid.

Answered by Brian Moore on March 27, 2025

Broker Licensed in OH

Answered by Brian Moore Medicare Insurance Agent

Joseph Bachmeier · Answer

If you do not sign up for Part B or Part within a certain period of time of your credible coverage ending you end up with a lifelong penalty for Part D. It is 1% for every month you don't sign up.

Brian Krantz · Answer

Because they either think they don’t need it or they miss the deadlines. If you don’t sign up when you’re supposed to, you can get stuck with a penalty that lasts for life.

Joseph Meyers · Answer

My favorite answer would be because they didn't seek the knowledge and guidance of a licensed Agent. 
But the real answer is because they didn't enroll for coverage when they needed to.
When you are medicare eligible you need to have your Part B start within 3 months of turning 65 or dropping credible employer coverage.
Part D rx coverage is similar but needs to be placed within 63 days of becoming eligible for Medicare

France Stephanos · Answer

Seniors pay lifelong penalties for Medicare part B or part D because they don't receive on time proper information from the right people who are Medicare Certified.

Gary Liesemeyer · Answer

If you fail to enroll in Medicare when you turn 65, or if you are older when you come off group coverage, you will receive a penalty.

Steven Bleicher · Answer

It’s mostly for folks who when they joined Medicare took no prescriptions and were riled up about picking up a Part D(rug) plan. So, they refused to pay for the sometimes free PDP or Prescription Drug Plan. Medicare believes that every senior should have drug coverage since they knew that eventually most everyone’s health deteriorates as they age. There is a lifetime penalty for every month after age 65 that you don’t have a PDP. The actual penalty is not bad but if years go by, that amount when added to your plan’s premium can be a bit off-putting.

Answered by Steven Bleicher on June 4, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Gregg Matheny · Answer

When they were originally eligible for Medicare part B or a part D plan they did not enroll and Medicare starts keeping track after 63 days or more In which you were uncovered. The kicker is that Medicare doesn’t assess that penalty until you get Medicare part B. Same goes with part D, If you didn’t get a prescription plan when you were first eligible for one and 63 days or more has passed then Medicare will keep track of the number of months that you didn’t have a prescription drug plan and a penalty that roughly ends up being about $.35 per month (in AZ) gets multiplied by the number of months that you didn’t have prescription drug coverage. That amount gets added to what your part D premium is.

Answered by Gregg Matheny on March 25, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

Yasmery Vargas · Answer

If you miss your enrollment window for Part B or Part D you are subject to a penalty as it is standard for social security. There are programs that may help with the Part D penalty but it is crucial not to miss your enrollment periods to avoid the penalty.

Answered by Yasmery Vargas on May 15, 2025

Agent Licensed in PA

Answered by Yasmery Vargas Medicare Insurance Agent

Mitchell Jerome · Answer

These are unfortunate situations that could've been avoided if they had reached out to an agent upon getting on Medicare. Knowledge is powerful and some people bypass the free counseling that an experienced agent can provide...then it costs them in the end...sometimes for life! These are penalties for generally late enrollment.

Answered by Mitchell Jerome on March 12, 2025

Broker Licensed in TX

Answered by Mitchell Jerome Medicare Insurance Agent

Nancy Courser · Answer

Some seniors end up paying lifelong penalties for not enrolling in either Part B or D during either their Initial Enrollment Period or Special Enrollment Period. It's very important to understand the enrollment periods and when they apply. Miss an enrollment period and potentially a penalty will be assessed by Medicare unless there is a valid reason/explanation.

Answered by Nancy Courser on March 31, 2025

Agent Licensed in MI & FL

Answered by Nancy Courser Medicare Insurance Agent

Erin Stott · Answer

It's because there is so much information that is misleading. I believe the finding a good agent to work on your side will help seniors not make that mistake!

Fred Manas · Answer

Seniors can incur lifelong penalties for Medicare Part B and Part D due to late enrollment or missing enrollment periods. These penalties are designed to encourage prompt enrollment and discourage waiting until health needs arise. For Part B, the penalty is 10% of the premium for each 12-month period of delayed enrollment. For Part D, the penalty is 1% per month of delayed enrollment. 
Here's a more detailed breakdown:
Why the penalties exist:
Risk Pool:
Medicare's cost-sharing mechanism relies on a balanced risk pool, where healthy people contribute to cover the costs of those who need more care. If everyone waited to enroll until they needed coverage, costs would skyrocket. 
Prompt Enrollment:
The penalties incentivize people to enroll in Part B and D when they become eligible to avoid potential financial hardship later on. 
How to avoid penalties:
Initial Enrollment Period (IEP):
Enroll during your IEP, which is the seven-month period around your 65th birthday. 
Special Enrollment Periods (SEPs):
If you have creditable coverage through an employer or other qualifying coverage, you may be eligible for an SEP, which allows you to enroll without penalty within a certain timeframe after losing that coverage. 
Avoid Creditable Coverage Gaps:
Ensure you have continuous coverage or are enrolled in Medicare when you become eligible to avoid penalties. 
In essence, late enrollment penalties are meant to encourage timely enrollment in Medicare Part B and D, promoting a more balanced and sustainable healthcare system.

Gary Henderson · Answer

Medicare signs a penalty if you do not sign up during your initial enrollment period, which occurs at age 65 or if after 65 after you've left a qualified plan, for example from your employer. If you fail to enroll then you are assigned a 10% penalty per year for part b, which means 10% of the current part b payment which this year is $185. So that would be $18.50 per year and the drug plan is 1% per month of the average cost of a drug plan which is about $0.40 a month. A 
Month these are permanent lifetime penalties and added to your cost of your insurance. Therefore know the rules. If you don't know, contact qualified insurance agent like myself 737-530-4626 pick option 2

Carol Thompson · Answer

There is a 7 months window when turning 65 that allows you time to sign up for Medicare unless you have creditable coverage through an employer. If you do not attain coverage through an employer-retirement or directly through Medicare you can have lifetime insurance and penalties.

Answered by Carol Thompson on May 14, 2025

Broker Licensed in FL, LA, MI & NC, SC, VA & WI

Answered by Carol Thompson Medicare Insurance Agent

Toni Chavez · Answer

Seniors can get lifetime penalties if they don’t sign up when first eligible for Medicare and didn’t have other medical coverage.

Linda Davies · Answer

Seniors may miss their IEP, which is a seven-month period around age 65, or miss a Special Enrollment Period if they continue working past 65. 

Some seniors believe they have adequate coverage through a current employer, retiree plan, or other insurance and delay enrolling in Part B, only to find it doesn't qualify as creditable coverage. 

Some individuals are simply unaware of the importance of enrolling in Part B when eligible, or don't understand the rules surrounding enrollment deadlines. 

If they don't enroll during their Initial Enrollment Period (IEP) or Special Enrollment Period (SEP) and don't have creditable coverage from another source. These penalties are a 10% increase to the Part B premium for each 12-month period they delayed enrollment. The penalty is designed to encourage timely enrollment and maintain a balanced risk pool for Medicare. 

Some seniors pay penalties on Medicare Part D, primarily because they either missed their initial enrollment period or didn't maintain continuous coverage through creditable prescription drug coverage. This penalty is a monthly add-on to their Part D premium, calculated as 1% of the national base beneficiary premium for each month they lacked coverage. 

The penalty aims to encourage individuals to enroll in Part D when they become eligible to ensure they have consistent coverage for prescription drugs.  Without a penalty, some individuals might delay enrolling in Part D until they need costly medications, shifting costs to those who enroll promptly.

The penalty also discourages people from dropping Part D coverage and then re-enrolling later when they need expensive drugs, potentially straining the program.

Andre Cabral · Answer

Because they miss the Enrollment period, which varies significantly according to the individual situation, as far as health coverage. Pass enrollment period + coverage gap = lifetime penalty.

Gary Haft · Answer

Simple - if you enrolled in Medicare late meaning after your Initial Enrollment Period (IEP), which would be within the 7-month enrollment when you are approaching age 65. The 7-month period is the three months before your month you turn 65, the month you turn 65 and the 3 months after you turn 65. If you miss this 7-month period when enrolling in Medicare, then you will be penalized for the rest of your life.

Answered by Gary Haft on May 26, 2025

Agent Licensed in FL, AL, DC & 9 other states

Answered by Gary Haft Medicare Insurance Agent

Debra Weber · Answer

If you do not pick up your part b when first eligible for Medicare you will be charged a penalty whether under 65 or at 65. If you are under 64 and do not pick up part b then, when you turn 65 and pick it up  the penalty goes away.
For part d, if you do not pick up a plan when eligible then you have the penalty

Soledad Ramirez · Answer

Because they didn't enroll in a timely manner for Part B and Part D - they were given poor information from their Plan administrators OR they had NO idea they had to enroll.

Hollie Hittner · Answer

If you don’t have creditable coverage when you turn 65 then you need to activate your Part B and Part D. If you don’t then you will have penalties for the rest of your life when you do activate it.

Answered by Hollie Hittner on March 29, 2025

Agent Licensed in NE, AZ, IA, MO, SD & TX

Answered by Hollie Hittner Medicare Insurance Agent

Morgan Luck · Answer

They did not sign up when they were supposed to for par B or Part D. They will have to pay a penalty

Why do some seniors end up paying lifelong penalties for Medicare Part B or Part D?

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Why do some seniors end up paying lifelong penalties for Medicare Part B or Part D?

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