Cat DeFazio Smith
August 18, 2025
Don’t let Medicare penalties drain your wallet. Enrolling in Medicare isn’t just about checking a box; it’s about timing. And if you miss that window, the consequences can be costly.
At Advocator Advantage, new enrollees are often surprised by penalties that could have been avoided with just a little foresight. Here’s a quick breakdown to help you or your clients stay ahead of the curve.
The Initial Enrollment Period (IEP) begins three months before the month you turn 65 and ends three months after. That seven-month window is your best opportunity to enroll without penalty.
Most people qualify for premium-free Part A. But if you don’t and delay enrollment, expect a 10% monthly penalty for twice the number of years you were eligible but didn’t sign up.
If you delay Part B and don’t have what’s considered “creditable coverage” (such as from an employer), your monthly premium will increase by 10% for each 12-month period you didn’t enroll. That increase is permanent.
For those without prescription drug coverage for more than 63 days after becoming eligible, the penalty is 1% of the national base premium for each month you go without coverage. That amount is recalculated annually.
You may qualify for a Special Enrollment Period (SEP) if you’re transitioning from employer coverage or meet other criteria. This can help protect you from penalties under Part A and Part B.
Individuals with limited income may be eligible for Extra Help for Part D, which can significantly reduce or eliminate penalties.
Medicare penalties are avoidable, but only if you understand the rules and act within your eligibility window. Whether you’re approaching Medicare age yourself or advising someone you care about who is, a little awareness now can lead to lasting peace of mind later. For Medicare assistance, please contact us today.
Nothing in this post is intended as advice or a suggestion to elect or not elect to claim benefits of any kind, including Social Security or Medicare benefits, nor is it intended as financial advice in any way. The decision to claim benefits is a personal one that is contingent upon each individual’s unique circumstances. Nothing herein is considered medical advice, diagnosis, or treatment.
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