The Medicare Part B late enrollment penalty adds 10% to your monthly Part B premium for every full 12 months you were eligible but didn't enroll. The penalty is permanent — it stays on your premium for the rest of your life. In 2026 the standard Part B premium is $202.90/month, so a 1-year delay adds $20.29/month forever ($243/year), a 2-year delay adds $40.58/month ($487/year), and a 5-year delay adds $101.45/month ($1,217/year, every year, no cap). You only avoid the penalty if you had creditable employer coverage from an employer with 20+ employees. COBRA, retiree plans, and ACA Marketplace coverage do NOT count. For your specific situation in Durham County, call Rob Simm at (828) 761-3326 — free, no obligation.

What Durham families ask

What does the Part B penalty actually cost you in real dollars?

The questions Durham residents are actually asking when they realize they may have missed their window.

Is the penalty really permanent — or does it eventually drop off?

Permanent. It stays on your $202.90 premium every month for life and goes up each year as the standard premium rises.

Does my COBRA or retiree plan protect me from the penalty?

No. Only active employer group coverage from a company with 20+ employees counts as creditable. COBRA and retiree do not.

What if Social Security gave me wrong information?

You can request equitable relief in writing — but it's rarely granted. Most appeals fail. On-time enrollment is the only reliable defense.

If I'm late, when can I actually enroll?

If you have a Special Enrollment Period from employer coverage ending, you have 8 months. Otherwise, the General Enrollment Period runs January 1 to March 31 each year.

⚠️ The penalty has no cap and never expires

If you delayed Part B by 10 years, your penalty is 100% — you pay $202.90 in standard premium PLUS $202.90 in penalty, every month, forever. That's $4,870 per year on top of your regular premium. The penalty also rises with the standard premium, so the dollar damage grows annually. There is no forgiveness program.

The difference

What does Medicare.gov tell you vs. what does a broker actually do?

What do you need to know?	Medicare.gov	Rob Simm — NC #10447418
Penalty calculation	States the 10% rule but doesn't run your exact numbers	I calculate your specific penalty in dollars based on your delay months and projected premium
Employer size check	Says "20+ employees" without explaining how to verify	I help you confirm employer headcount with HR and document creditable coverage
SEP eligibility	Lists Special Enrollment Periods generically	I map your exact 8-month SEP window from when employer coverage ends
Equitable relief appeals	Mentions the option but no guidance on success	I tell you honestly whether your case has merit and help you file Form CMS-1763
Avoiding the trap	Generic "enroll during IEP" advice	I check your IEP, employer coverage, COBRA timing, and Medigap window all at once
What it really costs	Shows current premium tables	I model your lifetime penalty cost so you can decide before it's too late

2026 Medicare numbers

What are the 2026 Part B numbers you actually need?

$202.90

Part B premium per month

2026 standard rate. Higher with IRMAA surcharge based on income above $106,000.

$283

Part B annual deductible

You pay this before Medicare covers 80% of outpatient care.

10%

Penalty per 12 months delayed

Added to your $202.90 premium, permanently. 24 months late = 20% = $40.58/mo for life.

7 mo

Initial Enrollment Period window

3 months before your 65th birthday month, your birthday month, and 3 months after.

💡 Broker Tip — Durham County

The single most common mistake I see in Durham is people assuming COBRA after leaving Duke, IBM, GSK, or any local employer protects them from the Part B penalty. It doesn't. The day your active employer coverage ends, your 8-month SEP starts — even if you stay on COBRA. If you're 65+ and leaving an employer with 20+ employees, enroll in Part B within 8 months of your last day of work, not your last day of COBRA. I've watched several Durham retirees lose this window and pay 30%+ penalties for life.

— Rob Simm, Licensed Medicare Broker, NC #10447418

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Rob Simm · Licensed NC Medicare Broker · NPN #10447418

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Real scenario · Durham County

What does a 2-year vs 5-year Part B delay actually cost?

2-year delay · for life

$40.58/mo

A Durham resident who delays Part B for 24 months without creditable coverage pays a 20% penalty — $40.58/month on top of $202.90 base. That's $487 per year, every year, forever — rising with each annual premium increase.

5-year delay · for life

$101.45/mo

A 5-year delay triggers a 50% penalty — $101.45/month for life. That's $1,217 per year, indefinitely. Over a 20-year retirement, the penalty alone exceeds $24,000 in 2026 dollars before annual increases.

It pays to talk to the right broker

Why doesn't it cost you anything to work with me?

It doesn’t — because I get paid by the insurance carrier to manage your plan. Most call centers get paid more to steer your business toward certain carriers based on volume and contracts. The only thing I’m optimizing for is making sure you’re covered correctly when you actually need it. That’s what keeps people coming back. And referring their neighbors.

Common questions

Frequently asked questions

How is the Medicare Part B late enrollment penalty calculated in 2026?

The Part B penalty is 10% of the standard Part B premium for every full 12 months you were eligible but didn't enroll. In 2026, the standard premium is $202.90/month. A 1-year delay adds $20.29/month for life. A 2-year delay adds $40.58/month. A 5-year delay adds $101.45/month — that's $1,217 per year, every year, with no cap.

Is the Part B penalty permanent or does it eventually go away?

The Part B penalty is permanent. Once it's added to your premium, you pay it every month for the rest of your life — even if you switch plans or carriers. The penalty also adjusts upward each year as the standard Part B premium rises, so the dollar cost grows over time.

Who is exempt from the Part B late enrollment penalty?

You're exempt if you had creditable employer group health coverage from an employer with 20 or more employees while you were eligible for Medicare. You then get an 8-month Special Enrollment Period after that coverage ends to enroll in Part B with no penalty. COBRA, retiree coverage, and individual ACA plans do NOT count as creditable for this purpose. Employer size matters — under 20 employees, Medicare is primary at 65 and you should enroll on time.

Can the Part B penalty be waived or appealed?

Equitable relief is possible if Social Security or a federal employee gave you incorrect information that caused you to miss enrollment. You file Form CMS-1763 or request equitable relief in writing. It's not automatic and it's not common — most penalty appeals fail. The reliable solution is to enroll on time during your 7-month Initial Enrollment Period.

What's the difference between the Part B penalty and the Part D penalty?

Part B penalty is 10% per 12 months delayed and is added to your $202.90 premium permanently. Part D penalty is 1% of the national base beneficiary premium ($37.20 in 2026) per month — so 24 months without creditable drug coverage adds about $8.93/month. Both penalties are permanent. Part D is calculated by the month, Part B by the full year.

Related Medicare guides

Medicare Enrollment in NC – 2026 Guide Working Past 65 – Medicare Enrollment Special Enrollment Periods in NC Extra Help/LIS Eligibility NC 2026 Compare Medicare Advantage Plans in NC Best Places to Buy Health Insurance Online Free Medicare Quotes Online Cheap Health Insurance Without Employer Coverage

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Robert Simm

Licensed Independent Medicare Broker

Helping NC families navigate Medicare since 2014. Independent — I work with all carriers and get paid the same regardless of which plan you choose. I verify provider networks with Duke Health directly and answer my own phone the next year when something changes.

📞 (828) 761-3326 📋 NC #10447418 🏥 AHIP Certified ⭐ 5.0 · 20+ reviews 📍 2731 Meridian Pkwy, Durham NC 27713 🕐 Mon–Fri 9am–7pm ET

Last Updated: 2026-05-03 | Reviewed By: Robert Simm, Licensed Medicare Broker, NC #10447418 | Next Review: October 2026

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