How the Part B penalty works
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 (including PEBB retiree coverage), COBRA, plans bought through Washington Healthplanfinder and VA health care. For how employer coverage works with Medicare, see working past 65 and do I need Part B if I'm still working? Veterans and TRICARE users should read veterans and VA care and TRICARE For Life.
How the Part D penalty works
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, PEBB or other plan sends a notice each year saying whether yours is. Keep those notices: they are your proof if Medicare later asks.
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 is on late enrollment penalties in Washington and Medicare Part D in Washington.
Penalty relief through Apple Health and Extra Help
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. In Washington, the Medicare Savings Programs (QMB, SLMB and QI-1) are part of Washington Apple Health. They have no asset test, and Washington's income limits are higher than the federal minimum.
- Medicare Savings Programs. Apple Health pays your Part B premium, and with QMB also your Part A premium if you owe one and your Medicare deductibles and coinsurance. Check your income with the savings programs screener and read Medicare Savings Programs in Washington.
- Extra Help. If you are in a Medicare Savings Program or have Apple Health, you get Extra Help automatically. Otherwise you can apply with Social Security.
- Special Enrollment Periods. If you had job-based coverage, you generally have eight months after that job or coverage ends to sign up for Part B without a penalty. See Medicare enrollment in Washington for this and other situations.
Sources
- Medicare.gov — Avoid late enrollment penalties
- Medicare.gov — Part D costs and the late enrollment penalty
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- WAC 182-517-0100 — Federal Medicare savings programs
- Washington State Health Care Authority — Medicare Savings Program
- WAC 182-12-171 — PEBB retiree insurance coverage (Medicare Parts A and B requirement)
Frequently asked questions
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 job-based 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.
How is the Part D penalty figured?
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.
Can Apple Health make my Part B penalty go away?
Yes, through a Medicare Savings Program. Medicare says you won't pay a Part B late penalty if you enroll in one. In Washington those are QMB, SLMB and QI-1, run by Washington Apple Health, with no asset test and income limits up to 138% of the federal poverty level.
Does Extra Help remove the Part D penalty?
Yes. If you get Extra Help, you don't pay a Part D late enrollment penalty.
I retired from a Washington public employer. Can PEBB coverage help me avoid a penalty?
PEBB retiree coverage doesn't stop the Part B penalty, because it isn't coverage from current work, and PEBB requires Medicare-eligible retirees to enroll in Part A and Part B. For Part D, HCA says PEBB retiree medical plans include Part D or creditable drug coverage, except the PEBB Medicare supplement plan; if you choose that one, you need a separate Part D plan to avoid the Part D penalty.
Medicare in your Washington county
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