Medicare Part D Late Enrollment Penalty

1. [What is the Medicare Part D Late Enrollment Penalty?]()

2. [Is There a Medicare Part D Penalty Under 65?]()

3. [Medicare Part D Late Enrollment Penalty Calculator]()

The Medicare Part D late enrollment penalty is an additional cost on top of your monthly Medicare Part D premium. This extra charge is based on the current year’s national base Medicare Part D premium.

The Medicare Part D penalty amount is 1% of the national base premium for every month you went without creditable drug coverage when first eligible for Medicare. The penalty is in place to encourage beneficiaries to enroll in a Medicare Part D plan if they lack creditable coverage, meaning drug coverage at least as good as a Medicare drug plan.

When you first become eligible for Medicare, you receive an Initial Enrollment Period to sign up for Original Medicare. Once you have Original Medicare, you are eligible for Medicare Part D.

A Medicare Part D plan

Prescription coverage through Medicare Part C – a Medicare Advantage Prescription Drug (MAPD) plan

Another healthcare plan that includes prescription drug coverage that is at least as good as the coverage Medicare provides

If you do not enroll in Medicare Part D when you first become eligible, and you don’t have other creditable drug coverage, you may face a late enrollment penalty.

If you qualify for Medicare due to disability but delay Medicare Part D enrollment, you will incur the Medicare Part D penalty when you pick up the drug coverage before 65. To avoid the Medicare Part D penalty, you must be aware of your Medicare eligibility status, know your Medicare Part A effective date, and sign up for Medicare Part D as soon as possible.

Being under 65 will not protect you from Medicare’s late enrollment penalties. If you do not have creditable medical or drug coverage after reaching eligibility, you will need to pay the Medicare Part B and Part D penalties, respectively. So, do not delay your enrollment.

However, when you turn 65, any penalty you incur will be voided, so you will have a clean slate. You will also get a second opportunity to enroll in Medicare Part D to avoid future penalties.

The Medicare Part D penalty is based on the number of months you were eligible for Original Medicare without having creditable prescription drug coverage. For each month you go without Medicare Part D or other creditable coverage, you will pay an additional premium of 1% of the current national base Medicare Part D premium.

Additionally, the Medicare Part D penalty is not a one-time penalty. You will pay the penalty monthly for as long as you have Medicare prescription coverage. The Medicare Part D penalty is rounded to the nearest 10¢ and added to the premium you pay for your Medicare Part D plan.

Since the Medicare Part D penalty is always based on the current year’s national base premium, it is subject to change or increase each year. The Medicare Part D penalty calculation can be challenging to calculate. So, we provided an example to show how it works.