---
title: "Medicare Late Enrollment Penalties"
description: "Learn how Medicare late enrollment penalties work for Parts A, B and D, how to avoid them and how programs like Extra Help can reduce your costs."
url: "https://www.sutterhealth.org/billing-insurance/medicare/late-enrollment-penalties"
---

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4.  Late enrollment penalties

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# Medicare late enrollment penalties  

It’s important to understand your Medicare options and the late enrollment penalties that may apply to you.   

[Compare Medicare plans](https://www.ehealthinsurance.com/medicare/partner/sutter/?allid=sut5527000)

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**Section menu**

-   [Medicare](https://www.sutterhealth.org/billing-insurance/medicare "Medicare")
    -   [Annual Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/aep "Annual Enrollment Period")
        
    -   [Medicare basics](https://www.sutterhealth.org/billing-insurance/medicare/medicare-basics "Medicare basics")
        
    -   [Medicare wellness visits](https://www.sutterhealth.org/billing-insurance/medicare/medicare-wellness-visits "Medicare wellness visits")
        
    -   [Special Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/sep "Special Enrollment Period")
        
    -   [Initial Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/iep "Initial Enrollment Period")
        
    -   [Late enrollment penalties](https://www.sutterhealth.org/billing-insurance/medicare/late-enrollment-penalties "Late enrollment penalties")
        

-   [Medicare](https://www.sutterhealth.org/billing-insurance/medicare "Medicare")
    -   [Annual Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/aep "Annual Enrollment Period")
        
    -   [Medicare basics](https://www.sutterhealth.org/billing-insurance/medicare/medicare-basics "Medicare basics")
        
    -   [Medicare wellness visits](https://www.sutterhealth.org/billing-insurance/medicare/medicare-wellness-visits "Medicare wellness visits")
        
    -   [Special Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/sep "Special Enrollment Period")
        
    -   [Initial Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/iep "Initial Enrollment Period")
        
    -   [Late enrollment penalties](https://www.sutterhealth.org/billing-insurance/medicare/late-enrollment-penalties "Late enrollment penalties")
        

Medicare late enrollment penalties: how they work

**Medicare Part A – Hospital insurance coverage**

**Late enrollment penalty**

If you don’t sign up Medicare Part A when you’re first eligible, your monthly premium may increase by 10%. Note, this may not apply if you’re eligible for premium-free Part A or if you meet certain conditions and can sign up for Part A during a special enrollment period.

**How much is the penalty?**

You’ll have to pay the higher premium for twice the number of years you could have had Part A but didn’t sign up.  

**What does that mean?** 

Here’s an example: If you were eligible for Part A for two years but didn’t sign up, you’ll have to pay the higher premium for four years. 

[Medicare part A late enrollment penalty](https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties "Please note you are now leaving the Sutter Health website")

**Medicare Part B – Medical insurance coverage**

**Late enrollment penalty**

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay an extra 10% for each full 12-month period you could have signed up for Part B but didn’t. You’ll have to pay this penalty for as long as you have Part B, in addition to the standard Part B monthly premium ($202.90 in 2026).

**How much is the penalty?**

It depends. Here’s an example: If you waited 2 full years (24 months) to sign up for Part B and didn’t qualify for a Special Enrollment Period, you’ll have to pay a 20% late enrollment penalty (10% for each full 12-month period that you could have signed up), plus the standard Part B monthly premium.

**Here’s the math:**

$202.90 (2026 Part B standard premium) + $40.58 (20% of $202.90 late enrollment penalty) = $243.48

$243.50 will be your Part B monthly premium for 2026. This amount is rounded to the nearest $0.10 and includes the late enrollment penalty. 

[Medicare part B late enrollment penalty](https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties "Please note you are now leaving the Sutter Health website")

**Medicare Part D – Prescription drug coverage**

**Late enrollment penalty**

This penalty is added to your monthly Medicare prescription drug plan premium as long as you have prescription coverage. 

**How much is the penalty?**

The penalty is 1% (per month) of the national base beneficiary premium ($38.99 for 2026), times the number of full, uncovered months you didn’t have Part D or creditable coverage. This penalty is added to your monthly Medicare prescription drug plan premium for as long as you have prescription coverage. It may decrease or increase as the national base beneficiary premium changes.

**Here’s an example:** 

Here’s an example: It’s December 2026. Jane is eligible for Medicare, and her Initial Enrollment Period ended on May 31, 2025. Since Jane didn't have creditable prescription drug coverage for 19 months (from June 2025 – December 2026), her penalty in 2027 is 19% (1% for each of the 19 months) of $38.99 (the national base beneficiary premium for 2026). Since the monthly penalty is always rounded to the nearest $0.10, she pays $7.40 each month in addition to her plan’s monthly premium.

**Here’s the math:**

.01 (1% penalty) x 19 months = .19 penalty (19% penalty)  
.19 × $38.99 (2026 base beneficiary premium) = $7.41  
$7.41 rounded to the nearest $0.10 = $7.40  
Jane’s monthly late enrollment penalty for 2027 = $7.40

[Medicare part D late enrollment penalty](https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty "Please note you are now leaving the Sutter Health website")

**Ways to avoid Part D late enrollment penalty** 

1.  **Don’t go 63 days or more without Medicare prescription drug coverage or other creditable coverage.**  
    Your current plan should tell you each year if your prescription drug coverage is creditable. This information may come in a letter or newsletter, so hang onto it in case you enroll in a Medicare prescription drug plan later.
    
    Creditable coverage is prescription drug coverage — like from an employer — that pays at least as much as Medicare prescription drug coverage. If you have it when you become eligible for Medicare, you can usually delay enrolling in a Medicare prescription drug plan without a penalty.
    
    Medicare prescription drug coverage is available through Medicare Part D, a prescription drug plan or through a Medicare Part C - Medicare Advantage Prescription Drug Plan. These plans are offered through Medicare-approved private insurance companies.
    
2.  **Let your plan know if you had prescription drug coverage.**  
    When you join a Medicare prescription drug plan, they may send you a letter asking if you had creditable prescription drug coverage. Complete the form and return it by the deadline in the letter. If you don’t tell them about your creditable coverage, you may have to pay a late enrollment penalty.

## Explore Medicare plan options

Sutter works with eHealth, a licensed insurance agency, to help you find the right plan for you.

[Compare plans](https://www.ehealth.com/Sutterwebsite)

This is not an advertisement on behalf of any Medicare plan or plans. For information about Medicare, visit [medicare.gov](https://medicare.gov/ "medicare.gov") or call [1-800- MEDICARE](tel:+1-8774862048) 24 hours a day, seven days a week. TTY Users should call [1-877-486-2048](tel:+1-8774862048). eHealth is an insurance agency offering plans from many insurance companies and is not affiliated with the government. Sutter Health co-hosted events are not affiliated with eHealth or the government. For accommodation of persons with special needs at events, call [1-800-478-8837](tel:+1-8004788837) (TTY 711). Enrollment in a plan may be limited to certain times of the year unless you qualify for a special enrollment period or you’re in your Medicare Initial Enrollment Period.

MMR-4521-2026

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