Will I be penalized if I do not enroll in Medicare when I turn 65?

Question

Luis Daza · Accepted Answer

Yes, you may be penalized in two ways or reasons. If you don't have credible health insurance coverage, you will be punished for not having Part B once you turn 65; this is called the Part B enrollment penalty, applicable if you don't have credible health insurance in place. Second, you will be penalized if you don't have credible health insurance with prescription drug coverage in place by the time you qualify for Medicare. You must pay these penalties each month for the rest of your life.

Answered by Luis Daza on March 7, 2025

Agent Licensed in FL, CA, CO & 8 other states

Answered by Luis Daza Medicare Insurance Agent

Larry Dalton · Answer

Yes for most of us! However, if you are on a qualified Medicare group insurance plan through your employment or retired under a Medicare-recognized retirement health insurance group plan, such as a Fedblue retirement plan, there are no penalties until you leave these circumstances. Again, a trustworthy agent can explain this in detail.

Answered by Larry Dalton on March 26, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Brian Moore · Answer

If you don’t enroll in Medicare at 65 without qualifying employer coverage, you’ll face a 10% Part B premium penalty per year delayed, and it’s permanent. It’s unfortunate that Medicare doesn’t do more to clarify these consequences or provide better access to this info, leaving it to folks like me in the industry to educate clients. Without an active group plan, that Initial Enrollment Period is your window to avoid the hit.

Answered by Brian Moore on March 26, 2025

Broker Licensed in OH

Answered by Brian Moore Medicare Insurance Agent

Melonie Wood · Answer

No, If you are still on an employer plan, otherwise a person turning 65 MUST sign up for Medicare. You can sign up 3 months before, the month of your birthday & 3 months after. You have 7 months to sign up for Medicare

Answered by Melonie Wood on March 25, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent

Joseph Bachmeier · Answer

You will not incur a penalty as long as you have credible coverage such as an employer group plan. If you turn 65 and do not have credible coverage for over 60-days then you will incur a penalty.

Christopher Boyd · Answer

You may be penalized in you don't meet certain criteria such a active credible coverage in your state, which may exempt you from enrolling into Medicare while employed and receiving group insurance. Never assume one way or the other. If in doubt, call 1(800)MEDICARE.

Answered by Christopher Boyd on March 4, 2025

Agent Licensed in IN, KY, MI, OH, PA & TN

Answered by Christopher Boyd Medicare Insurance Agent

James Carlson · Answer

Yes!  There are penalties for not enrolling at age 65 in both medical and the drug plans.  
Thes can be life time penalties that raise your cost of care.

Christopher Palazzini · Answer

Not if you are disenrolling from you or your spouses credible employer coverage. 

If you do not enroll when first eligible and you have no proof of credible work coverage, you will be penalized.

William Lawler · Answer

You will only be penalized if you do not enroll in Part B when first eligible and then try to enroll at a later date. You can postpone enrolling in Part B if you maintain creditable health coverage through your employer.

Answered by William Lawler on March 29, 2025

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

Answered by William Lawler Medicare Insurance Agent

Bryan Smith · Answer

Yes and No. It all depends on your current situation. If you don't have creditable coverage, delaying Medicare at 65 may lead to permanent late enrollment penalties.

Mark Maliwauki · Answer

You certainly could be. You must be able to either prove you have medical and prescription drug coverage or get bothPart A and B and a drug plan Part D

Frank Souk · Answer

As long as you have insurance coverage deemed creditable by Medicare, you can delay your Medicare enrollment past 65 without a penalty.

William Kravit · Answer

It depends.  If you are currently covered under an employer group health plan (EGHP) that's larger than 20 full-time employees or part time equivalents, then no you will not be penalized as long as when you lose that EGHP you then sign up for Medicare Parts A and B.  

If you are covered under a small group less than 20 in size, or coming off an individual plan like Marketplace, then yes you may be penalized by not enrolling in Medicare during the time period that you have to do it.

Pamela Camey · Answer

Yes, you will most likely face a penalty if you do not enroll in Medicare Part B medical insurance when you are first eligible, which is during your Initial Enrollment Period (IEP).  Initial Enrollment period starts 3 months before your birthday, month of your birthday and then 3 months after your birthday.   There are some exceptions to this rule.   If you continue to be employed and your employer is providing you creditable health Insurance, you may waive signing up for Part B.

If you do not enroll in Part B during your initial enrollment period, or have creditable coverage, you will be required to pay a penalty for each 12-month period that you delay enrollment.  The penalty is 10% of the standard monthly premium for each 12-month period of delay.  You will pay this penalty as long as you have part B coverage.

There is a similar penalty for Part D (prescription drug coverage) if you do not have creditable drug coverage and delay enrollment.

There are also a few situations where you may have to pay a penalty for part A (hospital insurance) also called premium-Part A.

Mary Turner · Answer

You can be penalized if you don't take Medicare at 65.  If, however, you have what's considered "creditable coverage" through an employer, you will NOT be subject to a penalty if you enroll later.

Deborah Lee · Answer

If you have current, credible coverage through a group health plan, you will not incur a penalty. However, there are variables, so check with an advisor to establish your situation.

Edward Allen · Answer

That all depends on your individual situation and whether or not you are enrolled in a credible health insurance plan in which you would not be required to enroll in Medicare Part B. or involuntary or voluntary disenrolled from a health plan at the time you turn 65 you have a 8 month period to enroll into Medicare Part without having a Part B late enrollment penalty accessed

Answered by Edward Allen on March 4, 2025

Broker Licensed in CA & TN

Answered by Edward Allen Medicare Insurance Agent

Nolan Popel · Answer

Yes, you could face penalties if you don’t enroll in Medicare Part B when you turn 65 unless you have other qualifying health coverage like through an employer, group or union.

Tonya Bell · Answer

That depends on if you are still working or if you have other creditable coverage through an employer or spouses employer. You don't want to enrol in A or B if you still have an HSA you are contributing to.

Answered by Tonya Bell on March 25, 2025

Agent Licensed in SC

Answered by Tonya Bell Medicare Insurance Agent

Charles Wheeler · Answer

A big concern for people as they turn 65 is if they DO NOT enroll in Medicare they will be penalized. It is a common misnomer. The truth is someone will be penalized if (1) They do not enroll in Medicare when first eligible AND (2) They DO NOT have credible coverage from another source (employer, spousal coverage, etc). If you continue to work, or have insurance through your spouse, (as long as it is creditable) you WILL NOT be penalized.

Answered by Charles Wheeler on February 11, 2025

Broker Licensed in MA, CT, FL & 7 other states

Answered by Charles Wheeler Medicare Insurance Agent

Marc Carr · Answer

It depends...once you leave employer health insurance from the workplace, you have an 8 month window to enroll into Medicare without a late enrollment penalty for Medical, Part B coverage. But if your 65, still working and have employer coverage, you may delay your Medicare enrollment in order to stay on employer health insurance.

Answered by Marc Carr on March 11, 2025

Broker Licensed in OH, IL & MS

Answered by Marc Carr Medicare Insurance Agent

Gregg Matheny · Answer

Yes. Unless you have what Medicare considers “credible coverage” (coverage at the providers office and coverage at the pharmacy) from an employer plan. If you turn 65 and have employer coverage, you will still get Medicare part A (in most cases for free) But will not have to pay for Medicare part B And your Employer coverage will be primary.

Answered by Gregg Matheny on March 25, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

John L Herman Jr · Answer

There are many possibilities to such an open question...every individual has a different situation and therefore you should consult a Medicare Broker as you approach that milestone birthday. Trying to navigate MEDICARE on your own is dangerous to your health plan. You may be working and have a Health Care Plan...you may not qualify due to your wok history...ar you may face penalties by making the wrong choices at 65. Contact an Independent Broker who WILL NOT CHARGE YOU and will make sure you get this right.

Answered by John L Herman Jr on March 25, 2025

Broker Licensed in MD, DE & PA

Answered by John L Herman Jr Medicare Insurance Agent

Tasha Riggs · Answer

Yes 
Part A is free and it is a 10% penalty if you don't sign up for that 
Part B cost 185 a month.  
Part D for Drugs : The fine is 1% each month so 12% each year 
I would go to www.ssa.gov 3 months before apply for A and B 
If you want to keep your work plan  you do not have to sign up for B. However, even though you can keep your work plan and it maybe no cost, Medicare has stronger coverage and your costs when you use it will be lower. 
I would find a local broker you can trust and talk to them. 
I am also always available so you can talk through it to see which way is best for you

Michael Pyers · Answer

Depends, If, you work for an employer that has more than 20 employees and coverage as good as Medicare. That would be considered Creditable coverage, and you could hold off until that coverage ends. However, if you have 40 quarters of paying into Medicare, it would be wise to go ahead and sign up for part A since there would be no premium.

Answered by Michael Pyers on March 26, 2025

Broker Licensed in OH & MI

Answered by Michael Pyers Medicare Insurance Agent

Michael Kim · Answer

That depends on if your going to continue to work, and if you have insurance through your company then no you will not be penalized. But if you do turn 65 and you have no insurance coverage then yes you will be penalized, but you have 6 months three months prior, 3 months after your birthday.

Answered by Michael Kim on March 25, 2025

Agent Licensed in NV, AR, AZ & 18 other states

Answered by Michael Kim Medicare Insurance Agent

Sean Davis · Answer

Yes, you may face penalties if you do not enroll in Medicare when you turn 65 and do not qualify for a Special Enrollment Period. Specifically, if you delay enrolling in Medicare Part B without having other creditable coverage, you could incur a late enrollment penalty of 10% for each full 12-month period you were eligible but did not enroll. This penalty lasts for as long as you have Part B. For Part D, the late enrollment penalty applies if you go 63 days or more without any creditable prescription drug coverage after your Initial Enrollment Period. It's important to understand these timelines and penalties to ensure you have the necessary coverage without incurring extra costs.

Answered by Sean Davis on March 26, 2025

Broker Licensed in NY, LA, MD & 6 other states

Answered by Sean Davis Medicare Insurance Agent

Gretchen Morris · Answer

Only if you do NOT have creditible coverage according to Medicare.  Your human resources dept should be able to tell you this.

Helena Foutz, RSSA · Answer

If you have some form of creditable coverage (medication coverage at least as good as that from a Medicare prescription drug plan), then you can stay on your plan if you like and not incur a penalty. If you do not have an employer group plan with creditable coverage, you could incur a Late Enrollment Penalty for Part B after 12 months and Part D for every month after your Initial Enrollment Period!

Answered by Helena Foutz, RSSA on March 4, 2025

Broker Licensed in CA, AK, AR & 12 other states

Answered by Helena Foutz, RSSA Medicare Insurance Agent

Lea Ayres · Answer

If you turn 65 and still working for a company that has at least 20 employees you will not be penalized for enrolling in Mediare. A penality will occur when you are 65 and go with out enrolling in medicare and at least having prescription drug plan.

Answered by Lea Ayres on March 12, 2025

Broker Licensed in PA, CT, MD & 8 other states

Answered by Lea Ayres Medicare Insurance Agent

Ryan Raphael · Answer

You will not be penalized if you are a spouse is still working and are a part of 20 or more employees. Then there are no penalties.

DeeDee Whitlock · Answer

Everyone's situation is different, If you are enrolled in an employer group plan with more than 20 employees no penalty will be accessed

Paul Dzierzanowski · Answer

Possibly. If you do not enroll in Medicare typically around the 7 months surrounding your 65th birthday you may have to pay a penalty. This depends on factors such as whether or not you have other health insurance coverage that is similar to the coverage Medicare provides. Since you may be assessed a penalty for not having the proper coverage you should consult with a qualified Medicare insurance specialist to weigh all of your options.

Answered by Paul Dzierzanowski on March 27, 2025

Agent Licensed in FL

Answered by Paul Dzierzanowski Medicare Insurance Agent

Peter Yeh · Answer

Yes, you may face penalties for late enrollment in Medicare Part B if you don't enroll when first eligible and don't have creditable coverage from another source. The penalty is typically 10% of the Part B premium for each 12-month period you were eligible but didn't enroll, and you'll likely have to pay this penalty each month for as long as you have Part B.

Answered by Peter Yeh on March 21, 2025

Agent Licensed in CA & TX

Answered by Peter Yeh Medicare Insurance Agent

Brian Krantz · Answer

Maybe. It depends if you’re still working and your employer has 20 or more employees. If not, you could face late penalties — so it’s important to review your situation before delaying.

Aisha Saleem · Answer

If you don't sign up for Medicare when you're eligible, you might have to pay a higher premium when you do sign up.

Linda Bolan · Answer

There are penalties involved if you do not have health insurance through an employer and you wait to enroll in Medicare.

If you do have an employer sponsored health insurance, you will not be penalized if you can provide proof of insurance when you decide to retire and go onto Medicare.

Barbara Barnes · Answer

Maybe.  It depends on WHY you choose to delay your enrollment.

If you delay your Medicare enrollment because your have coverage at work, possibly including a Health Savings Account that you contribute to for the tax benefits, you will likely be able to delay enrollment in Part A, Part B or both A and B, and then enroll for those benefits at a later date, when the employee benefits expire - usually due to retirement in some form.  But don't delay when that coverage ends - you will have a limited amount of time to enroll without a penalty.

However, if you work for a small employer with fewer than 20 employees, you should not delay your Medicare benefits because your group health plan will be secondary to Medicare and you will need Medicare Parts A and B as your primary insurance, even if you continue with the group plan at work.

If you choose not to enroll for Medicare Parts A and B simply because you don't want it, or you don't think you need it, or you don't want to pay for it, then you will owe a penalty if you sign-up for it later, and you can only sign-up at a certain time of the year.  That will be bad if you get a cancer diagnosis and then must wait another 10-months to get Medicare coverage.

Every situation is different, so it is important to consult with a Medicare professional to get answers to your questions and help you decide what option is best in your particular situation.

Jamie Herrick · Answer

Good question! Double check with your nearest social security office to get the most up to date information. Make sure you have a part D plan as well to avoid penalties even if you don’t take a medication!

Answered by Jamie Herrick on March 29, 2025

Agent Licensed in WI

Answered by Jamie Herrick Medicare Insurance Agent

Abbie Choate · Answer

If you don’t sign up for Medicare at 65 and don’t have other creditable coverage, you could get stuck with lifelong penalties. Part B costs go up 10% for every year you wait, and Part D has a penalty too if you go without drug coverage. But if you have insurance through work, you might be able to delay without a penalty. It’s best to check ahead of time so you don’t end up paying more later!

Answered by Abbie Choate on March 4, 2025

Broker Licensed in CA & NY

Answered by Abbie Choate Medicare Insurance Agent

Deborah Bates · Answer

You can be penalized if you don't have a creditable coverage plan.  Most employer group healthcare plans are creditable.  So there is no need worry if you work past 65.

Jackson Cassibry · Answer

If you don't have credible prescription drug coverage Whren you turn 65, you will be responsible for a penalty every month you don't have that credible coverage