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I originally refused Medicare Part B when I turned 65. Can I enroll now?

I Originally Refused Medicare Part B When I Turned 65. Can I Enroll Now?

Deciding to defer Medicare Part B—which covers outpatient services like doctor visits, lab tests, and screenings—is a common choice for those who are still working at age 65. However, life circumstances change, and you may now find yourself needing that coverage. The short answer is yes, you can still enroll, but the timing, process, and potential costs depend entirely on why you waited.

Understanding Your Path to Enrollment

If you missed your Initial Enrollment Period (IEP)—the seven-month window around your 65th birthday—you generally have two primary pathways to sign up for Part B later: a Special Enrollment Period or the General Enrollment Period.

1. The Special Enrollment Period (SEP)

The most favorable way to enroll is through an SEP. This is available if you delayed Part B because you (or your spouse) were still working and had “creditable” group health coverage through an employer or union.

 

  • When to enroll: You can sign up any time you are still covered by the group health plan or during the 8-month period that begins the month after the employment ends or the group health coverage ends, whichever happens first.

     

  • The Benefit: If you qualify for an SEP, you will not have to pay a late enrollment penalty, and your coverage can start as early as the month you apply.

2. The General Enrollment Period (GEP)

If you do not qualify for an SEP—for instance, if you simply chose not to enroll or your previous coverage was not considered “creditable” (like COBRA or retiree health plans)—you must use the GEP.

 

  • When to enroll: The GEP runs every year from January 1 to March 31.

     

  • Coverage Start Date: If you sign up during the GEP, your coverage will begin the first day of the month after you enroll. For example, if you sign up in February 2026, your coverage starts March 1, 2026.

     

The Cost of Waiting: Late Enrollment Penalties

One of the most critical aspects of enrolling late is the Part B late enrollment penalty. If you did not have creditable coverage based on current employment, Medicare adds a permanent surcharge to your monthly premium.

 

  • The Calculation: You will pay an extra 10% for each full 12-month period that you could have had Part B but didn’t.

     

  • Example: In 2026, the standard Part B premium is $202.90. If you waited two full years (24 months) without creditable coverage, your penalty would be 20%. This adds $40.58 to your monthly bill, bringing your total premium to $243.48 for as long as you remain on Medicare.

     

How to Apply

The enrollment process is handled by the Social Security Administration (SSA), even though the program is Medicare.

 

  1. Online: The fastest way to apply is through the SSA website.

  2. By Mail or Fax: You will need to complete Form CMS-40B (Application for Enrollment in Medicare – Part B).

     

  3. If using an SEP: You must also submit Form CMS-L564 (Request for Employment Information), which your employer must sign to prove you had creditable coverage.

     

Helpful Resources

Navigating Medicare can be complex. Use these official resources to ensure you have the most accurate information for the 2026 plan year:

  • Official Medicare Site: Medicare.gov – The primary portal for all coverage details.

  • Social Security Administration: SSA.gov/medicare – Where you actually file your application.

  • SHIP (State Health Insurance Assistance Programs): shiphelp.org – Provides free, unbiased one-on-one counseling.

  • Medicare & You Handbook: Download the 2026 Handbook – The official government guide to Medicare benefits.

  • Part B Enrollment Forms: CMS-40B Form and CMS-L564 Form.