How does the Part B penalty work?
When you first become eligible, you have a seven-month Initial Enrollment Period around your 65th birthday month. If you don't sign up for Part B then, and you don't have group health coverage from your own or your spouse's current job, Medicare counts the months until you do sign up. Each full 12 months adds 10% of the standard premium. A 30-month gap is two full periods, so 20%. In 2026 that is 20% of $202.90, about $40.58 a month on top of your premium.
The penalty follows the standard premium, so it rises when the premium does, and you generally pay it for as long as you have Part B. Coverage that doesn't protect you from the Part B penalty includes retiree coverage, COBRA, Marketplace plans and VA health care.
State Group Insurance retirees: the Division of State Group Insurance says that if you're eligible for Medicare, the State plan pays claims after Medicare even if you don't sign up for Part B. Without Part B you pay the portion, about 80%, that Medicare would have paid, and the State's group MA-PD plans require Parts A and B before People First can enroll you. A gap in Part B can cost you both those bills and a lifelong penalty. See Florida state retirees and Medicare.
If you're still working at 65 and have group coverage through your own or your spouse's job, you can usually wait without a penalty and use a Special Enrollment Period, which lasts 8 months after the job or the coverage ends, whichever comes first. COBRA doesn't extend it. See working past 65. Military retirees should know that TRICARE For Life requires Part A and Part B; see military, veterans and TRICARE in Florida.
A hurricane can matter too. Medicare.gov says that if a disaster or emergency kept you from signing up for Part B or premium Part A, you might have a Special Enrollment Period to sign up; call 1-800-MEDICARE. See hurricanes and Medicare in Florida.
How does the Part D penalty work?
The Part D penalty applies if, after your Initial Enrollment Period, you go 63 days or more in a row without a Medicare drug plan or other creditable drug coverage. Creditable coverage is drug coverage expected to pay at least as much as standard Part D; your employer, union or other plan sends a notice each year saying whether yours is. Keep those notices: they are your proof if Medicare later asks. VA drug coverage counts as creditable, and so does care from the Indian Health Service, a tribe or an urban Indian organization, which includes the health programs of the Seminole Tribe of Florida and the Miccosukee Tribe; see the Seminole and Miccosukee Tribes and Medicare.
The penalty is 1% of the national base beneficiary premium for each full month without coverage. In 2026 the base premium is $38.99, so a 24-month gap adds 24% of it to your monthly drug plan premium: $9.36 before Medicare rounds it to the nearest 10 cents. The base premium changes every year, so the penalty does too. More on drug plans is on Medicare Part D in Florida.
The State Group Insurance program says its secondary PPO and HMO plans include prescription coverage that Medicare approves as creditable, so you don't need a separate Part D plan while you keep it. If you leave a job or a group plan, check that your next coverage includes drugs, or add a Part D plan within 63 days.
How can Floridians get the penalties removed?
Medicare says that if you enroll in a Medicare Savings Program you won't pay a Part B late penalty, and if you qualify for Extra Help you don't pay a Part D late penalty.
- QMB, SLMB and QI (Florida's Medicare Savings Programs). Florida Medicaid pays your Part B premium through QMB (which also covers Medicare deductibles and coinsurance), SLMB or QI1. DCF sets the income limits at 100%, 120% and 135% of the federal poverty level, and assets in 2026 must be no more than $9,950 for one person or $14,910 for a couple. Apply through ACCESS Florida, and check your numbers with the savings programs screener. Read Medicare Savings Programs in Florida.
- Extra Help. If you are in a Medicare Savings Program, have full Florida Medicaid or get Supplemental Security Income, you get Extra Help automatically. Otherwise you can apply with Social Security. Its asset limit is higher than the Medicare Savings Program limit. See Extra Help in Florida.
- Special Enrollment Periods. Besides the one for people with coverage from current work, there are others for specific situations. See enrollment periods.
Sources
- Medicare.gov — Avoid late enrollment penalties
- Medicare.gov — Part D costs and the late enrollment penalty
- Medicare.gov — Creditable prescription drug coverage
- Medicare.gov — When does Medicare coverage start? (Special Enrollment Period for current work)
- Medicare.gov — Getting care in a disaster or emergency
- eCFR — 42 CFR 423.286, Rules regarding premiums (late enrollment penalty)
- eCFR — 42 CFR 423.56, Procedures to determine and document creditable status (Indian health coverage)
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Florida DCF — Appendix A-9.1, Medicare Savings Programs and LIS financial standards, effective April 2026 (PDF)
- Florida DCF — Public assistance (ACCESS Florida)
- Florida Division of State Group Insurance — Frequently asked questions: retirees
- Florida Division of State Group Insurance — Medicare Advantage and Prescription Drug (MA-PD) plans
- TRICARE — TRICARE For Life
Frequently asked questions
How is the Part D late enrollment penalty calculated?
Medicare multiplies 1% of the national base beneficiary premium ($38.99 in 2026) by the number of full months you went without Part D or other creditable drug coverage, and rounds to the nearest 10 cents. It is added to your drug plan premium, and the amount changes each year with the base premium.
How much is the Part B late penalty in 2026?
10% of the standard Part B premium for each full 12-month period you could have had Part B but didn't, with no group coverage from current work. In 2026 each 10% is about $20.29 a month, and you generally pay it for as long as you have Part B.
Can Florida Medicaid make my Part B penalty go away?
Yes. Medicare says you won't pay a Part B late penalty if you enroll in a Medicare Savings Program. In Florida those are QMB, SLMB and QI1, and the Department of Children and Families (DCF) decides eligibility. Apply through ACCESS Florida, and check your numbers first with the savings programs screener.
Does State Group Insurance retiree coverage protect me from the Part B penalty?
No. Retiree coverage isn't group coverage from current work, so it doesn't give you a Special Enrollment Period for Part B. The State also pays as if you had Part B whether or not you enroll, so you would owe the share Medicare would have paid. Sign up when you're first eligible.
What if I think my penalty is wrong?
For Part D, you can ask for a reconsideration; your plan's penalty letter explains how and gives a deadline. For Part B, contact Social Security, especially if you had group coverage from your own or your spouse's current work during the months counted.
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