Can you choose not to have Medicare Part B?


Editorial team Published on

⚠️ You can skip Medicare Part B only if you have qualifying group health coverage from an active job (yours or a spouse's) at a company with 20 or more employees.

🛑 Major Risks of Skipping Part B Improperly

  • 💸 Permanent Late Penalties: Your monthly premium increases by 10% for every 12-month period you delayed Part B without an exception.
  • ❌ Coverage Gaps: Non-job coverage like COBRA, retiree health plans, VA benefits, or Marketplace insurance do not count as active employment exemptions to avoid penalties.
  • 🏥 Out-of-Pocket Liability: Without Part B, you shoulder 100% of outpatient costs, doctor fees, and ER visits if Medicare was supposed to be your primary payer.

💡 Valid Exceptions to Delay Part B

  • 🏢 Large Employer Plan: Active work coverage at a company with 20+ workers allows an 8-month Special Enrollment Period (SEP) to sign up later without penalty.
  • 🤝 Spousal Coverage: Active group coverage through a spouse's employer (20+ employees) where you are a dependent.

📊 When Part B is Mandatory at Age 65

  • 📉 Small Employers: Companies with fewer than 20 employees make Medicare primary, requiring Part B enrollment.
  • 📋 COBRA / Retiree Plans: Relying on COBRA or retiree health insurance means you must enroll in Part B on time to avoid lifelong penalties.