Should I Sign Up for Medicare Part B?

I've seen retirees miss this window because they retired in June but didn't realize they had until February of the next year. Circle it on your calendar. When you stop working, mark 8 months ahead on your calendar and enroll then. If you miss it by even one day, the penalty clock starts.

This is one of the most common and costly mistakes I see veterans make. They assume TRICARE will keep covering them if they skip Part B. It won't. TRICARE For Life requires both Part A and Part B — no exceptions. If you're a military retiree turning 65, enroll in Part B during your IEP. Don't risk a gap in your TRICARE coverage.

CHAMPVA beneficiaries who become Medicare-eligible face a strict choice: enroll in Part B and keep CHAMPVA, or skip Part B and lose CHAMPVA. There is no middle ground. If you're a veteran's spouse or dependent on CHAMPVA and approaching 65, enroll in Part B during your IEP — it's the only way to protect your coverage.

Online enrollment is the safest option — you get immediate confirmation and a record in your my Social Security account. Remember: Part B enrollment is handled by Social Security (ssa.gov), not Medicare.gov. Medicare.gov is where you shop for Part C and Part D plans later.

I've seen people add $60,000+ to their lifetime Medicare costs because they missed a 7-month window. It's one of the most avoidable mistakes in the benefits system. The penalty is the reason to enroll on time — not someday, not next year, during the IEP.

IRMAA is the cliff effect in action. Cross a threshold by $1, and you jump to a higher tier. A $200k MAGI at Standard costs $202.90/mo. A $205k MAGI at 3.2× costs $649.20/mo — a $446/month jump on $5k more income. That's why planning matters.

IRMAA is one of the few Medicare decisions where a good tax advisor pays for themselves in the first year. If you're in a high IRMAA tier, spend 2 hours with a CPA who understands IRMAA. The strategies they find can save you thousands.

I've seen people accidentally trigger a $4,000+ per year IRMAA surcharge because they took a large IRA distribution or sold a property without thinking about the Medicare impact two years later. The fix is simple but requires planning: know your MAGI thresholds, and plan major financial moves around them. A good tax advisor who understands IRMAA can save you more than their fee in the first year alone.

Filing status is one of the most overlooked IRMAA levers. I've seen couples paying $6,000+ per year in extra premiums simply because they filed separately by habit or on bad advice. One amended return — switching from MFS to joint — dropped them from the 3.2× tier to Standard. That's a 10-minute fix on Form 1040-X that saves thousands every year. If you're married and filing separately, run the numbers both ways before you file.

Many people don't realize they qualify for a Medicare Savings Program. Even those who think their income is too high may want to check — many states have higher limits than expected. And here's the bonus: QMB also eliminates Medicare deductibles and copays. That can be significant financial relief.

Part B is the foundation of Medicare coverage. Almost every Medicare Supplement plan and every Medicare Advantage plan requires Part B. Without it, options shrink dramatically. The $202.90 can be viewed as the price of keeping healthcare options open — and there are programs that may bring that cost down.