Key Takeaways

• Delaying Medicare Part B enrollment can lead to lifelong late enrollment penalties and gaps in medical coverage.

• Unless you have qualifying employer coverage, you may pay more later and face restricted enrollment windows.

Why People Consider Delaying Part B

Medicare Part B covers outpatient care, preventive services, durable medical equipment, and some home health services. While it’s a vital part of your healthcare coverage, it comes with a monthly premium, which leads many people to consider delaying enrollment—especially if they’re still working or covered by a spouse’s plan.

But the monthly premium alone shouldn’t be the deciding factor. The consequences of delaying Part B can extend far beyond a few saved payments.

The Cost of Waiting Can Be Higher Than You Think

You might assume that delaying Part B until you really “need it” is a cost-saving move. In reality, it can backfire if you don’t meet very specific conditions. If you’re not covered by creditable group health insurance through current employment—either yours or your spouse’s—then you risk paying:

• A 10% penalty for each 12-month period you delay Part B without qualifying coverage

• That penalty every single month for as long as you have Part B

The penalty isn’t a one-time late fee. It sticks with you for life, and it’s added to your monthly premium.

What Counts as Creditable Coverage

To delay Medicare Part B without penalty, your current health insurance must meet Medicare’s standards for creditable coverage. This typically includes:

• Group health insurance from a current employer with 20 or more employees

• Coverage through your spouse’s active employment that meets the same criteria

Retiree insurance, COBRA, and individual marketplace plans do not count as creditable coverage for delaying Part B. If you rely on any of these after you turn 65, the clock starts ticking toward penalties.

Timelines That Matter

Understanding the timing of your Medicare decisions is critical. Here’s what you need to know:

Initial Enrollment Period (IEP)

• Starts 3 months before the month you turn 65

• Includes the month of your 65th birthday

• Ends 3 months after your birth month

This is your first opportunity to enroll in Part B. If you’re not actively working and don’t have creditable employer coverage, you should enroll during this time to avoid penalties.

Special Enrollment Period (SEP)

If you do have creditable coverage when you turn 65, you can delay Part B and enroll later during a Special Enrollment Period, which lasts:

• 8 months after your employment or group coverage ends, whichever happens first

During this SEP, you won’t incur a late penalty. But if you miss it, you’ll have to wait for the General Enrollment Period.

General Enrollment Period (GEP)

• Runs from January 1 to March 31 each year

• Coverage begins July 1 of that year

If you enroll in Part B during the GEP, you may face late enrollment penalties and a gap in coverage from when your employer plan ended to when Medicare begins.

How the Penalty Is Calculated

The late enrollment penalty is:

• 10% of the standard premium for every full 12-month period you could have had Part B but didn’t

• Added to your premium every month as long as you have Part B

Example:

If you delayed enrolling in Part B for 3 full years without creditable coverage, your premium would be 30% higher for life.

Keep in mind that the standard Part B premium in 2025 is $185, so a 30% penalty would add an extra $55.50 monthly, totaling over $660 annually, and compounding over time.

Medicare and Employer Coverage: What If You’re Still Working?

If you’re still employed at 65 and your job provides health insurance, you may qualify to delay Part B without penalty. However, make sure:

• The employer has 20 or more employees

• You are actively working (not retired)

• Your plan is the primary payer before Medicare

If your employer has fewer than 20 employees, Medicare becomes your primary coverage at age 65, and the employer plan becomes secondary. In that case, delaying Part B could result in coverage gaps and out-of-pocket expenses, since your employer insurance may not pay for services Medicare would have covered.

If You Have COBRA or Retiree Coverage

Many assume that COBRA or retiree benefits are a sufficient substitute for Medicare Part B. That’s a dangerous assumption.

• COBRA is not considered creditable coverage for delaying Part B

• Retiree health insurance from your former employer doesn’t count either

If you delay Part B while relying on either of these, you risk penalty accrual and gaps in coverage. Worse, if you miss your Special Enrollment Period, you may be stuck waiting months for your Medicare coverage to begin.

What About TRICARE, VA, and Other Programs?

Some government or military retirees rely on TRICARE or Veterans Affairs (VA) benefits. Here’s what you need to know:

• TRICARE for Life requires enrollment in both Medicare Part A and B

• VA benefits do not replace Medicare

If you plan to use these programs alongside Medicare, you generally need to enroll in Part B when you become eligible to avoid losing access to full coverage.

Long-Term Risks of Delaying Part B

Delaying Part B might seem like a smart decision if you’re healthy, but there are long-term consequences that can impact both your finances and your access to care:

• Higher costs for life due to the penalty

• Coverage delays if you miss the right enrollment window

• Limited access to doctors who require Medicare coverage to accept new patients

• Difficulty qualifying for supplemental coverage without continuous enrollment

You may feel fine today, but unexpected health issues can arise quickly—and Medicare doesn’t begin retroactively. If you wait too long, you may find yourself uninsured just when you need care the most.

Weighing the Costs and Coverage

Here’s a breakdown of what you should consider before deciding to delay Medicare Part B:

• Do you have creditable employer coverage? If not, don’t delay.

• Are you still actively working at a job with 20+ employees? If yes, you can safely delay Part B and enroll during your SEP.

• Will you need frequent outpatient care, specialist visits, or preventive screenings? If yes, enrolling in Part B sooner could save you money.

• Is the savings from skipping the premium worth the long-term penalty? In most cases, the answer is no.

Understanding your timeline and current coverage status is essential to avoid mistakes that can’t be reversed.

When Delaying Might Make Sense

In limited cases, delaying Medicare Part B may be a rational choice:

• You’re still working and covered by an employer plan that meets Medicare’s criteria

• Your spouse’s active job provides qualifying coverage

• You clearly understand your Special Enrollment Period rights and won’t miss the 8-month window

Even in these situations, it’s wise to consult with a licensed agent to evaluate your options. Medicare is highly personal, and decisions should be based on your medical needs, financial resources, and future plans.

Avoid Surprises—Get the Facts First

One of the most common Medicare mistakes is assuming that you can delay Part B without consequence. Unfortunately, many people only realize their error after they’ve already missed critical deadlines. By that time, penalties are locked in, and gaps in coverage can become financial liabilities.

Don’t base your decision on what friends or family did. The rules are strict, and even small missteps can have lasting impact. Take the time now to understand what applies to you—and act accordingly.

Delaying Part B Might Sound Smart—But It’s Often a False Economy

If you’re turning 65 and considering delaying Medicare Part B, think carefully about what you might be giving up. The short-term savings may not outweigh the long-term costs, especially once penalties and delayed coverage are factored in. It’s not just a paperwork decision—it’s a health and financial choice.

If you’re unsure whether your current coverage qualifies or when you should enroll, speak with a licensed agent listed on this website. They can walk you through your situation and help you avoid costly mistakes.