What is creditable coverage for Medicare Part B?


Editorial team Published on

Creditable coverage for Medicare Part B is health insurance from an active employer or a spouse's active employer with 20 or more employees that pays at least as much as standard Medicare.

What Counts as Creditable Part B Coverage

  • Large employer group plans: Coverage from a current job where the company has 20 or more employees.
  • Active spouse's employer plan: Group health coverage through a spouse who is actively working at a company with 20+ employees.
  • Union health plans: Active group coverage provided through a union.

What Does NOT Count as Creditable Part B Coverage

  • Small employer plans: Businesses with fewer than 20 employees.
  • Retiree insurance: Plans from a former employer after you or your spouse retire.
  • COBRA: Continuation coverage after leaving a job.
  • Individual market plans: Private health insurance bought on your own or through the ACA.
  • VA health benefits: Department of Veterans Affairs healthcare does not count for Part B (though VA drug benefits do count for Part D).

Why It Matters

  • Delay without penalty: Having creditable Part B coverage lets you postpone signing up for Medicare Part B past age 65 without facing lifetime late fees.
  • Late penalty cost: If you delay Part B without creditable coverage, your monthly premium increases by 10% for every 12-month period you waited, and you pay this penalty for life.
  • Special Enrollment Period: When you finally stop working or lose your large group coverage, you get an 8-month window to sign up for Part B penalty-free.