How to avoid Medicare Part B penalty?

To avoid the Medicare Part B penalty, enroll during your Initial Enrollment Period (IEP) when first eligible (around age 65) or, if you have employer coverage, during the Special Enrollment Period (SEP) within 8 months of losing that coverage. The penalty is a permanent 10% increase for each full year you delay Part B after your IEP, so enrolling on time or using the SEP to delay with creditable group coverage is key, with help available through Medicare Savings Programs for low-income individuals.

How do I get rid of Medicare Part B penalty?

You can get a Medicare Part B penalty waived (or reduced) by applying for Equitable Relief, typically for errors like misinformation from government reps, confusion, or serious illness preventing timely enrollment, requiring you to file an appeal with Social Security, prove your case with documentation, and often pay the penalty during review. A penalty is usually avoided by enrolling during a Special Enrollment Period (SEP), often within 8 months of losing job-based coverage. 

How to avoid paying Medicare Part B?

You can avoid paying Medicare Part B premiums without penalty if you have creditable employer health coverage (from your or a spouse's current job with 20+ employees) past age 65, allowing you to delay enrollment until your employment ends, then sign up within 8 months. Otherwise, you'll face a lifetime penalty; to save money if you're a higher earner, you can try to lower your income (IRMAA) through tax strategies or appeal surcharges, but you generally can't avoid the premium if you don't have other qualifying coverage. 

How to avoid Medicare Part B excess charges?

The best way to avoid Part B excess charges is to only get care from Medicare-approved providers who accept assignment. Ask if they accept assignment before scheduling your service to be 100% sure.

Is there any way to avoid the donut hole in Medicare?

To avoid the Medicare donut hole (coverage gap), focus on reducing drug costs by choosing generics, comparing plans annually, using mail-order or discount cards (like GoodRx), asking your doctor for samples, and enrolling in assistance programs like Extra Help if you have low income; the goal is to keep your total spending below the coverage gap threshold, though the gap's impact lessens each year, especially for generics.
 

Beware of the Medicare Part B Penalty

Can I use GoodRx if I'm in the donut hole?

GoodRx can't be used in combination with Medicare, but it can be used in place of Medicare. You may want to consider using GoodRx instead of Medicare when Medicare doesn't cover your medication, when you won't reach your annual deductible, or when you're in the coverage gap phase (“donut hole”) of your Medicare plan.

What is the income limit to avoid Irmaa?

To avoid Medicare's Income-Related Monthly Adjustment Amount (IRMAA), your Modified Adjusted Gross Income (MAGI) must generally be below $109,000 for single filers and $218,000 for married couples filing jointly for 2026 costs, based on your 2024 tax return; crossing these thresholds triggers extra premiums for Medicare Parts B & D. Lower MAGI (e.g., under $106,000 single / $212,000 joint for 2025) means you pay standard premiums, but higher incomes fall into brackets with increasing surcharges. 

What if you can't afford to pay for Medicare Part B?

If you can't afford to pay your Medicare premiums and other medical costs, you may be able to get help from your state. States offer Medicare Savings Programs for people entitled to Medicare who have limited income. Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance.

How common is part B excess charge?

Medicare Part B excess charges are not very common because over 96-98% of doctors accept Medicare assignment (agreeing to the approved fee), but they can happen with nonparticipating providers who aren't bound by Medicare's fee limits and can add up to 15% extra, though some states (like CT, MA, MN, NY, OH, PA, RI, VT) prohibit them entirely. To avoid them, always check if your doctor accepts assignment before appointments, use the Medicare.gov tool, or get a Medigap Plan F or G that covers these charges.
 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

Is there a cheaper alternative to Medicare Part B?

Medicare Supplement Insurance (Medigap)

An insurance policy you can buy to help lower your share of certain costs for Part A and Part B services (Original Medicare).

How do you get Medicare Part B for free?

You can get Medicare Part B premiums paid for by qualifying for a Medicare Savings Program (MSP) through Medicaid if you have low income/assets, receive employer reimbursement via an HRA, or enroll in a Medicare Advantage Plan (Part C) with a "giveback" benefit. While not truly free, these methods can cover or significantly reduce the monthly premium for those who can't afford it, especially those on Social Security Disability (SSDI) or Railroad Retirement Board (RRB) benefits. 

How can I reduce Medicare Part B cost?

You can reduce your Medicare Part B premium by reporting a qualifying life event (like retirement or divorce) to Social Security using Form SSA-44, applying for Medicare Savings Programs (MSPs) if you have low income, or enrolling in a Medicare Advantage (Part C) plan that offers a Part B premium giveback benefit. Other methods include using a Health Savings Account (HSA) or deferring income if you have credible coverage elsewhere, like through a working spouse's plan, to avoid penalties. 

Why do people opt out of Medicare Part B?

Income too high – Higher earners pay a higher standard Part B monthly premium amount due to Income Related Monthly Adjustment Amounts (IRMAA). Some opt out due to premium costs. Failure to pay premiums – Part B coverage can be terminated if premium payments are delinquent for 12 continuous months.

How much will Medicare Part B cost in 2025?

For 2025, the standard Medicare Part B premium is $185 per month, but this can be higher based on your income (Income-Related Monthly Adjustment Amount - IRMAA) or lower due to the "hold harmless" rule for some. The actual amount depends on your 2023 income and you might pay the standard $185, more if higher income, or potentially less if your Social Security benefit increase (COLA) was small and you're held harmless. 

How is the Part B penalty calculated?

If you failed to sign up for Medicare when you were first eligible, and you didn't have any creditable coverage, you will be subject to the Medicare Part B late enrollment penalty. This penalty is equal to 10% for every year (12 full months) that you waited to enroll, and is added to your monthly premium.

Which states prohibit part B excess charges?

Eight states prohibit or limit Medicare Part B excess charges, protecting beneficiaries from doctors charging more than Medicare allows: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont, though specifics vary (e.g., NY caps charges, not fully bans). In these states, healthcare providers must accept Medicare's approved amount, preventing the extra 15% fee (Part B Excess Charge) that non-participating doctors can levy elsewhere, say Humana and Healthline. 

Why is Social Security no longer paying Medicare Part B?

If Social Security (SSA) stops paying your Medicare Part B premium (meaning they stop deducting it from your check), it's usually because you enrolled in a Medicare Advantage plan with a "giveback," qualified for Medicaid/Medicare Savings Program, your income changed, or there was an error; you'll get a notice, and your check will increase, but you become responsible for direct payment to avoid coverage loss. 

Does everyone pay $170 for Medicare Part B?

Costs for Part B (Medical Insurance)

$185 each month ($202.90 in 2026) (or higher depending on your income). The amount can change each year. You'll pay the premium each month, even if you don't get any Part B-covered services.

At what age do you stop paying Medicare premiums after?

Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. See Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.

Who qualifies for $800 Medicare reimbursement?

All you have to do is provide proof that you pay Medicare Part B premiums. Each eligible active or retired member on a contract with Medicare Part A and Part B, including covered spouses, can get their own $800 reimbursement. Download our Medicare Reimbursement Account QuickStart Guide to learn more.

How much money can you have in the bank when you are on Medicare?

Medicare itself doesn't have a bank account limit, but if you need help paying costs through Medicare Savings Programs (MSPs), asset limits apply (around $9,660 for individuals, $14,470 for couples in 2025) for programs like QMB, SLMB, and QI, though California eliminated asset tests for its state-run MSPs. These limits cover countable assets like savings, but your primary home and one car usually don't count. 

How to beat Irmaa?

How to Avoid IRMAA: 9 (Simple) Ways to Reduce Medicare Costs

1. 1.) Charitable Giving.
2. 2.) Tax Deductible Retirement Account Contributions.
3. 3.) Tax-Free Retirement Income.
4. 4.) Tax-Efficient Investments.
5. 5.) Tax-Efficient Withdrawal Strategies.
6. 6.) Medicare Savings Accounts (MSAs)
7. 7.) Roth Conversions.
8. 8.) Tax Gain Harvesting.

Do 401k withdrawals count as income for Medicare?

Yes, withdrawals from traditional 401(k)s count as taxable income, increasing your Modified Adjusted Gross Income (MAGI) and potentially triggering higher Medicare Part B and Part D premiums through the Income-Related Monthly Adjustment Amount (IRMAA) surcharge, which is based on your tax return from two years prior. Large one-time withdrawals or higher-than-usual distributions can push you into a higher income bracket, increasing costs, so strategic planning with a financial advisor is key.