Do I Really HAVE to Enroll in Medicare:  Late Enrollment Penalties Explained

We believe the better educated you are on Medicare, the better you'll be able to make good decisions about it. So you may ask, "Do I really have to enroll in Medicare?"


  1. If you turn 65 and are still working, you should enroll in Part A (inpatient hospitalization) in most cases.  Then Medicare will be either primary or secondard for payments in conjunction with your employer's group insurance plan depending on the number of employees on that employer's plan.
  2. If you turn 65 and are still working as mentioned above, you can delay Part B with no penalty.
  3. If you turn 65 and are no longer working you must enroll in Medicare Parts A, B, and D to avoid Late Enrollment Penalties (LEP).   However, if you have coverage through a spouse's employer coverage you can delay Part B and Part D(if you have creditable prescription drug coverage). The LEPs are levied by Medicare accordingly:

 Part A - Inpatient Hospitalization 

  • If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, your monthly premium may increase 10%.  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.

Part B - Outpatient Services

  • The penalty is 10% for each full 12 months in the period that you could have had Part B but didn’t.

Part D - Prescription Drug Plan

  • If your enrollment period is over and there’s a period of 63 or more days in a row when you didn’t have Medicare drug coverage or other creditable drug coverage, you’ll need to pay 1% of the “national base Medicare beneficiary premium” of $32.74 times the number of months you didn’t have creditable drug coverage.  This amount is then added to your premium each month and may increase each year.


So the simple answer is YES; that is, if you want to avoid penalties for not enrolling when you were first eligible.  There are many people that get caught unaware.


Please contact us if you have questions.  We will gladly answer them with no obligation!