Medicare Part B provides essential medical insurance, covering outpatient care and preventive services. But while paying the monthly premium—$185 in 2025—is crucial, far too many beneficiaries miss this step. The consequences can be severe, yet the issue often goes unnoticed until coverage is suddenly gone.
These five Q&As will help clarify this issue.
Who Is At Risk For Nonpayment Of The Part B Premium?
Here are groups that could end up missing a payment. (Note: I have encountered at least one from every group on this list.)
- Medicare beneficiaries born after 1959.
- Part B premiums are deducted automatically from Social Security retirement benefits.
- However, those born after 1959 will not reach full retirement age until 67. If they apply for Medicare only at age 65, and not Social Security, they must take responsibility for payment.
- Those who are delaying Social Security until age 70. Like the first group, because they are not receiving benefits, they must make other payment arrangements.
- Anyone who has moved and did not notify Social Security. Their premium invoices could be going to the previous address.
- A couple on an around-the-world cruise or anyone away from home for an extended period. Their mail is stacking up in the box back home.
- Some who just plain forget to pay bills.
What Happens If A Part B Premium Payment Is Missed?
A client told me that she forgot to pay one bill and, suddenly, Medicare just canceled her Part B. Social Security has a very well established and documented procedure and there is nothing sudden about it.
- Medicare mails a Part B invoice quarterly. Beneficiaries should receive that around the 10th of the month and payment is due by the 25th day.
- If payment is not received by the due date, Medicare sends a “Second Notice,” around the 60th day, a reminder that payment is overdue.
- When payment is past due by at least one billing period (90 days after the initial bill), Medicare sends a “delinquent bill.” This bill identifies the current premium and past premium amounts that are due and the due date. (Find a sample delinquent bill here.)
- Unless the full balance is paid by the “due in full date,” Medicare will terminate coverage.
What Are The Repercussions Of Not Paying The Premiums?
Part B is canceled which means there is no coverage for outpatient services, including doctors’ visits, diagnostic services and procedures, therapy visits, day surgery, Part B drugs and vaccinations, along with preventive services. And cancelation causes a ripple effect.
How Does Someone Who Lost Medicare Part B For Nonpayment Of Premiums Get It Back?
The next chance to sign up for Part B is during the annual General Enrollment Period, January 1-March 31.There are two ways to enroll.
- During the GEP, complete one form, the Application for Enrollment in Medicare Part B (CMS-40B), and get it to the local Social Security office.
- Make a video, phone or in-person appointment by calling (800) 772-1213. Not all offices schedule appointments and dates can be two to three months in the future.
Medicare will require full payment of the back premiums. Coverage should begin the month after enrolling.
After Part B is reinstated, there is an opportunity to reapply for a Medicare Advantage plan or a Medigap policy. However, getting a Medigap plan again could involve medical underwriting.
What If There Is A Reason That Explains Why The Payments Were Missed?
Social Security does grant an extension of the grace period if there is a good reason for what happened, generally for circumstances that were beyond the individual’s control. This is called good cause. The Social Security website notes the example of a person who was physically unable to make the payment on time and there was no one to act on his or her behalf. A second example: A former client lost Part B after his bank merged with another one. The monthly payments he had arranged got lost in the transition shuffle.
If there is good cause, it is best to contact Social Security to initiate the process. A valid reason for missing payments and supporting documentation is a must.
Social Security does not recognize insufficient funds or a bad memory as good cause reasons.
Any Final Words?
- The best advice is to avoid this situation and that means paying Part B premiums on time. Set up an Easy Pay account directly with Medicare. If you do not choose this option, make sure to pay the invoices. You can do this through your Medicare.gov account or just send in the payment. (Allow adequate time for the Postal Service to deliver.)
- Remember to update Social Security if you move.
- Promptly open mail that comes from the Centers for Medicare and Medicare Services. If somehow a payment was missed, CMS will send a delinquent bill. You need to respond quickly to that.
Once you are receiving Social Security retirement benefits, the invoices and risk for nonpayment disappear. Until then, do what it takes to pay the bills on time.
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