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What is the Medicare Part D Late Enrollment Penalty?

  • Medicare with Melissa

When you first become eligible for Medicare, if you do not get a Part D plan, Medicare will charge you a penalty if you do not have creditable coverage through an employer or another group like the VA.  You have 63 days to get your Medicare Part D coverage. 

If you don’t get coverage, you will have to pay the late enrollment penalty for every full month you delay. 

How is the Part D penalty calculated?

The penalty amount is 1% of the national average premium. The national average premium is $33.06 in 2021. Multiply the national average plan premium by .01 and then multiply this by the number of months that you did not have any creditable coverage. This is then rounded to the nearest $.10 and added to the plan premium that you want to purchase. This penalty can increase or decrease every year based on the national average plan premium.

This penalty is for life, so try to avoid the Part D penalty by: 

  • Purchasing a Part D plan when you are first eligible
  • Don’t go more than within 63 days without creditable coverage
  • Keep good records of your creditable coverage because Medicare will ask for proof of coverage from an employer or other group like the VA.  You can always appeal the penalty and you will need to prove you had coverage. 

Learn More: What is Part D IRMAA?

People Also Read: What is Part B or Part D IRMAA charges?

Popular search: Medicare Enrollment Period

Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.


Oh my gosh!! I was so confused about the Medicare Supplement process. I am turning 65 soon and am retired and have always had insurance thru my former employer. I didn’t know a thing about going on Medicare and was struggling to sort it all out.

A friend of mine recommended contacting Senior HealthCare Solutions, so I did. Melissa was FANTASTIC!! She was professional, responsive, caring and friendly. She explained the steps I needed to take, gathered my information, helped me choose good plans for MY specific needs and took care of my applications over the phone. 1-2-3, eesy-peesy and I was done!! And it didn’t cost me a DIME!!! WOW!!! I HIGHLY recommend Senior Healthcare Solutions for anyone who’s overwhelmed with making the right choices with Medicare Supplemental Insurance and Rx coverage. It’ll take a load off your mind!

Janice W.

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