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What is the Part D (prescription drug plan) Late Enrollment Penalty?


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?

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.


Senior Healthcare Solutions, you truly stand out from most other insurance agents. Thank you so much for all of your help and I know that you will have nothing but success with how you conduct business.

Joan B.

Montgomery, AL

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