Are You Eligible To Have Your Penalty Fee Waived?

Reviewed and Updated by Anastasia Iliou,

Are You Eligible To Have Your Penalty Fee Waived?

Did you miss your enrollment period? Are you living without health insurance?

Under Obamacare, also known as the Affordable Care Act, everyone is required to have health insurance. Your window to sign up is from three months before you turn 65 through three months after your birthday (unless you have a Special Enrollment Period). If you miss that period, you’ll be subject to a penalty fee. The fee will be added to your premium once you enroll. This means that the longer you wait to sign up for Medicare, the higher your premiums will be. Thankfully, you may be eligible for an exception.

CMS (the organization that oversees Medicare) decided that the ACA rules are not clear to many seniors, and most probably didn’t even know they were required to enroll when they turned 65. Many citizens with marketplace health care mistakenly assumed that they would automatically be enrolled.

If you did not receive the required information which tells you about the penalty fee, you can have your fee waived. You may qualify for the waiver until September 30th, 2017.

[clickToTweet tweet=”If you didn’t know about the penalty fee, you may qualify for a waiver until September 30th, 2017.” quote=”If you didn’t know about the penalty fee, you may qualify for a waiver until September 30th, 2017.”]

You can find the following instructions to file for your waiver with more information on your eligibility at

How To File A Waiver

  1. Gather appropriate documentation. You will need proof of your QHP enrollment. Bring a Part B enrollment form (Form CMS-40B) and your Medicare card. You can also fill out a Part B enrollment form at your Social Security office. Examples of proof of QHP can be:
    • Letter about your enrollment in both Medicare and a Marketplace plan
    • QHP premium bills and proof of payment
    • IRS form 1095-A that shows months of coverage and/or cost assistance amounts
    • A Marketplace eligibility determination notice
      • Access through your Marketplace account
    • Receipt from first premium payment you made to your QHP (also called a premium binder payment)
  2. Call the Social Security Administration (SSA) at 800-772-1213 or go to to find a local Social Security office that you can visit in person.
  3. Once at the office or on the phone with a representative, ask to use the time-limited equitable relief to enroll in Part B and/or eliminate your Part B LEP. Mention that you were enrolled in both premium-free Part A and a QHP. If you are calling to eliminate an LEP, you must specifically request that you want the LEP eliminated.

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