Part D late enrollment penalty | Medicare

The late registration penalty is an come that ‘s permanently added to your Medicare drug coverage ( Part D ) premium. You may owe a recently registration penalty if at any clock after your initial Enrollment Period is over, there ‘s a period of 63 or more days in a quarrel when you do n’t have Medicare drug coverage or other

creditable prescription drug coverage

. You ’ ll generally have to pay the penalty for ampere long as you have Medicare drug coverage .
Learn how to avoid the deep registration penalty .

If you get

Extra Help

, you do n’t pay the late registration penalty .

How much is the Part D penalty?

The price of the recently registration penalty depends on how long you went without Part D or creditable prescription drug coverage .
Medicare calculates the penalty by multiplying 1 % of the “ national nucleotide beneficiary premium ” ( $ 33.37 in 2022 ) times the count of fully, exposed months you did n’t have Part D or creditable coverage. The monthly agio is rounded to the nearest $ .10 and added to your monthly Part D premium .
The national base benefactive role premium may change each year, so your penalty measure may besides change each year.

Mrs. Martinez has Medicare, and her first find to get Medicare drug coverage ( during her initial Enrollment Period ) ended on July 31, 2018. She doesn ’ t have prescription drug coverage from any other reference. She didn ’ deoxythymidine monophosphate join a Medicare drug plan by July 31, 2018, and alternatively joined during the overt Enrollment Period that ended December 7, 2020. Her Medicare drug coverage started January 1, 2021 .
Since Mrs. Martinez was without creditable prescription drug coverage from August 2018–December 2020, her penalty in 2022 is 29 % ( 1 % for each of the 29 months ) of $ 33.37 ( the national floor benefactive role premium for 2022 ) or $ 9.68 each calendar month. Since the monthly penalty is constantly rounded to the nearest $ 0.10, she will pay $ 9.70 each calendar month in addition to her plan ’ s monthly premium .
Here’s the math:
.29 ( 29 % penalty ) × $33.37 ( 2022 base benefactive role agio ) = $9.68
$9.68 rounded to the nearest $ 0.10 = $9.70
$9.70 = Mrs. Martinez’s monthly late enrollment penalty for 2022

How do I know if I owe a penalty?

After you join a Medicare drug plan, the plan will tell you if you owe a punishment and what your agio will be. In general, you ‘ll have to pay this penalty for arsenic long as you have a Medicare drug plan .

What if I don’t agree with the late enrollment penalty?

You may be able to ask for a “ reconsideration. ” Your drug design will send data about how to request a reconsideration .
Complete the form, and return it to the address or facsimile act listed on the form. You must do this within 60 days from the go steady on the letter telling you that you owe a late registration penalty. besides send any proofread that supports your case, like a copy of your detect of creditable prescription drug coverage from an employer or union design .

Do I have to pay the penalty even if I don’t agree with it?

By law, the late registration punishment is partially of the premium, so you must pay the punishment with the premium. You must besides pay the penalty evening if you ‘ve asked for a reconsideration. Medicare drug plans can disenroll members who do n’t pay their premiums, including the late registration penalty fortune of the premium.

How soon will I get a reconsideration decision?

In cosmopolitan, Medicare ’ s contractile organ makes reconsideration decisions within 90 days. The contractor will try to make a decisiveness american samoa promptly as possible. however, you may request an extension. Or, for good cause, Medicare ’ s contractor may take an extra 14 days to resolve your case .

What happens if Medicare’s contractor decides the penalty is wrong?

If Medicare ’ s contractor decides that all or separate of your late registration penalty is incorrect, the Medicare contractor will send you and your drug plan a letter explaining its decisiveness. Your medicare drug plan will remove or reduce your late registration penalty. The plan will send you a letter that shows the compensate premium amount and explains whether you ‘ll get a refund .

What happens if Medicare’s contractor decides the penalty is correct?

If Medicare ’ s contractor decides that your late registration penalty is adjust, the Medicare contractor will send you a letter explaining the decision, and you must pay the penalty .

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