Are There Any Penalties if I Miss the Enrollment Period?
Yes, late enrollment penalty will be assessed if you go more than 63 days beyond your initial enrollment period without drug coverage.
Note: If you qualify for an extra help program, you will not be charged a penalty.
How is the Late Enrollment Penalty Figured?
For each month you go without coverage after your enrollment period has ended, you are charged 1% of the National Base Beneficiary Premium. In 2023, that amount is $32.74 per month. Assume your enrollment period ended in January of this year and you did not enroll in a prescription drug plan. Now assume that you wait until the next open enrollment season for Medicare, which begins on October 15. You decide to enroll in Medicare Part D on November 1. You would have gone nine months without coverage. Therefore, you will be charged 9% of $32.74 – which is $2.9466. That amount will be rounded to the nearest $0.10 in either direction and added to your monthly premium. In this case, your penalty would be $2.90 per month.
Will I Always Have to Pay the Monthly Penalty?
Yes, you will continue to pay the penalty every month in most cases. Generally speaking, once Medicare has determined a late enrollment penalty for a Medicare Part D prescription drug plan, that penalty will apply to the monthly premium as long as the member is enrolled.