What will the Part D late enrollment penalty cost you?
The Part D penalty is 1% of the national base beneficiary premium for every uncovered month after you became Part D-eligible — added to your Part D premium for life.
Enter the months without creditable coverage to see your estimated penalty.
Estimates use the plan year 2025 national base beneficiary premium ($36.78). The penalty formula is 1% × uncovered months × base premium, rounded to the nearest $0.10. Because the base premium adjusts each year, your actual monthly penalty also adjusts annually. If you qualify for Extra Help (LIS) the penalty is typically waived.
What counts as creditable coverage?
Creditable prescription drug coverage is coverage that pays at least as much on average as standard Medicare Part D. Plans that typically qualify include:
- Employer or union group health plan drug coverage
- Veterans Affairs (VA) prescription drug coverage
- TRICARE / FEHB prescription drug coverage
- Indian Health Service coverage
- Some retiree health plans
Your plan sends you an annual Notice of Creditable Coverage. Keep these notices — they’re how you prove to Medicare you weren’t uncovered.
Extra Help may waive the penalty
If you qualify for Extra Help (Low Income Subsidy), the Part D late enrollment penalty is typically waived. A licensed agent can help you determine likely Extra Help eligibility.
Need to enroll in Part D now?