Can I defer enrolling in Medicare?

A person may wish to defer or delay enrolling in Original Medicare in certain circumstances. However, this may incur penalties and additional costs.

Medicare is a federal health insurance program for people ages 65 and older. It may also provide benefits for people with disabilities.

This article discusses reasons for deferring enrollment in Original Medicare, when a person can defer, and the possible penalties. It also looks at Medicare coverage and costs.

Glossary of Medicare terms

We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:

• Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.

• Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.

• Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.

• Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

Why would a person defer enrolling in Medicare?

A person may want to defer enrolling in Original Medicare Part A and Part B if they feel it is in their best interest. For example, if a person has a medical insurance policy, they may feel it is not necessary to have two policies.

However, in some situations, people who defer enrolling in Original Medicare may pay a penalty on the premium.

Since many people do not pay a premium for Medicare Part A, a person may decide to enroll in Part A, even if they want to defer Medicare Part B.

When can a person defer enrolling in Medicare?

In some situations, Medicare allows people to defer enrolling in Original Medicare without paying a penalty, such as if a person or their spouse is working and their employer has 20 or more employees and offers a group health plan as defined by the IRS.

There are two other times when a person can defer enrollment.

If a person chooses COBRA health coverage after their employment ends, they keep their employer group health plan for 18 months, though at a higher cost. A person then has 8 months to sign up for Medicare, with or without COBRA. People who wait longer pay a penalty related to the time they have Part B.

Learn more about COBRA and Medicare.

A person with a Health Savings Account (HSA) may want to defer enrolling in Medicare, as contributions to the HSA stop after they enroll. A person should stop contributing to their HSA at least 6 months before they enroll in Medicare.

Learn more about HSAs and Medicare.

What are the Medicare enrollment periods?

A person is first eligible for Original Medicare in their initial enrollment period (IEP), which starts 3 months before the month they turn 65, continues during their birthday month, and ends 3 months after the month they turn 65, lasting 7 months in total.

People who wait to enroll in Medicare after the IEP and do not qualify to defer may pay a lifetime late enrollment penalty. The penalty increases the longer a person waits to enroll.

The general enrollment period happens every year from January 1 to March 31. People can sign up during this time if they did not enroll during their IEP or if they are not eligible for a special enrollment period (SEP).

After a person’s IEP ends, they may qualify for a SEP. Generally, people do not pay a late enrollment penalty when they qualify for and enroll with a SEP.

People covered by a group health plan through their employer will have a SEP if the person or their spouse is working or if the person is covered by a group health plan through the employer or union.

Learn more about Medicare enrollment.

What are the penalties for not enrolling in Medicare?

A person who qualifies for premium-free Medicare Part A can enroll during their IEP, and they will not pay a premium.

Part A

If a person has to buy Part A, they may have to pay a late penalty of a 10% increase on their monthly premium if they do not enroll during their IEP.

The penalty is calculated as a percentage of the premium and is generally twice the number of years a person delayed enrolling.

Part B

A person who delays enrolling in Medicare Part B may also pay a 10% penalty if they do not qualify for a SEP.

The late enrollment premium lasts for as long as a person has Medicare Part B. The penalty increases 10% for every full 12-month period a person delays enrolling.

Learn more about Medicare late enrollment penalties.

How much are the premiums for Medicare?

A person may qualify for premium-free Medicare Part A if they or their spouse has paid Medicare taxes for a certain amount of time.

In addition, a person may qualify for premium-free Part A if:

• they already get retirement benefits from Social Security or the Railroad Retirement Board (RRB)

• they are eligible for benefits from Social Security or the RRB but have not filed

• they or their spouse were government employees

If a person does not qualify for the premium-free Part A, the monthly premium depends on how much Medicare taxes they paid. If a person paid the taxes for less than 30 quarters, the standard Part A premium in 2025 is $518. However, if a person paid the taxes for 30-39 quarters, the standard Part A premium is $285.

If a person chooses to buy Part A, they must also have Part B and pay premiums for parts A and B.

The standard Medicare Part B monthly premium in 2025 is $185. The premium is paid to Medicare unless a person gets certain benefits, in which case the premiums may be automatically deducted. The benefits include:

• Social Security

• RRB

• Office of Personnel Management

There are other costs to Original Medicare, including deductibles, coinsurance, and copays.

• Part A deductible is $1,676 per benefit period. This begins the day of admission and ends when a person has not received any inpatient care for 60 days.

• Part A coinsurance is $0 for the first 60 days and $419 per day for days 61 to 90.

• Part B deductible is $257 per year.

• Part B coinsurance is 20% of the medically approved charges, and Medicare pays the remaining 80%.

A person can also get a Medicare supplement insurance policy called Medigap. Private companies offer these policies, and they help cover additional costs such as copays, deductibles, and coinsurance.

Summary

Under some conditions, a person can defer or delay enrolling in Original Medicare without a late penalty enrollment charge, including if an IRS-approved group health plan covers them.

A person may enroll during their IEP in the 7 months around their birthday. If they qualify for a SEP, they may not be charged a penalty for late enrollment.

View the original article on Medical News Today