Can seniors avoid paying for Medicare Part B?

Many seniors wonder if they can skip Medicare Part B to save money, but there are some things to know first. Designer491/Getty Images

Medicare is a lifeline for millions of Americans over 65, helping to cover hospital visits, doctor appointments and preventive care. But while Medicare Part A is generally free for those who qualify, Part B comes with a monthly premium that has steadily increased over the years. In 2025, the standard Part B premium is $185 per month, up from just over $174 per month in 2024. That may seem like a negligible amount, but for seniors on fixed incomes, that extra cost can feel significant, 

Given the financial challenges that seniors can face, many wonder if there's a way to avoid paying for Part B coverage. What's important to understand, though, is that this part of Medicare interacts with other insurance coverage, affects eligibility for supplemental coverage and can trigger penalties if you delay enrollment. So, it's important that seniors truly understand the rules around Part B — and whether you can actually avoid paying for it — before making any decisions.

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Can seniors avoid paying for Medicare Part B?

The short answer is no, most seniors cannot completely avoid Medicare Part B premiums. However, there are several scenarios where you might be able to delay enrollment or get help paying for it. 

One option you have for delaying enrollment in Medicare Part B is if you're still working and have creditable employer health insurance. This is the most common way people avoid Part B premiums: by staying on their employer's group health plan past age 65. As long as your employer has 20 or more employees, their insurance typically serves as primary coverage, and Medicare becomes secondary. You can delay Part B enrollment without penalty during this period — and for up to eight months after your employment or group coverage ends.

However, this strategy only works if you're actually employed, and it's also important to note that your spouse's employer coverage may also count for this purpose if you're the Medicare-eligible person. Once you retire or lose that employer coverage, you'll need to enroll in Part B or face late enrollment penalties that last for as long as you have Medicare.

For those with limited income, several programs can help pay your Part B premiums. The Medicare Savings Programs (MSP) are state-run programs that help cover premiums for people with incomes up to 135% of the federal poverty level. The Qualified Medicare Beneficiary (QMB) program, for example, covers all Part B premiums for seniors earning less than about $1,325 monthly (for 2025), while other MSP programs provide partial assistance.

And, if you're a senior who qualifies for both Medicare and Medicaid (known as "dual eligible"), Medicaid typically covers your Part B premiums entirely. Extra Help programs can also offer assistance with prescription drug costs, though these don't directly impact Part B premiums.

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What about other Medicare supplemental coverage?

Even if you find a way to reduce or delay your Medicare Part B premiums, it's important to consider how doing so affects your other supplemental coverage options. Many seniors rely on Medicare supplemental plans, like Medigap policies, Medicare Advantage plans or prescription drug plans, to help pay for costs that Medicare doesn't cover, such as copays, deductibles and certain medical services.

Most of these supplemental plans require that you are enrolled in both Medicare Part A and Part B, though. So, if you skip Part B, you may not be able to get a Medigap policy, join a Medicare Advantage plan or maintain your prescription drug coverage. That means what seems like a small monthly saving could end up costing a lot more if unexpected medical needs arise. In other words, skipping Part B can limit your options and leave you exposed to higher out-of-pocket costs.

The bottom line

While it is technically possible for some seniors to avoid paying for Medicare Part B, it's rarely the best long-term strategy for most seniors. The narrow window for penalty-free delayed enrollment, combined with the complexities of maintaining creditable coverage, makes this approach risky for anyone without rock-solid alternative insurance.

Still, if you're still working past 65 with excellent employer coverage, delaying Part B might make financial sense temporarily. You'll need to have a clear exit strategy and understand exactly when your eight-month enrollment window begins, though. For everyone else, the peace of mind and comprehensive coverage that comes with Medicare Part B typically outweighs the monthly premium costs.