Part D Late Enrollment Penalty Calculations

If you don’t buy Part D Rx when you are supposed to, there is a late enrollment  penalty of 12%/year when you finally do.  Part D became available in 1.2006 ^Wikipedia.   See Medicare & You,  Part D Rx Guide,  Medicare.Gov for more details.

The late enrollment penalty is an amount that’s added to your Part D premium. You may owe a late enrollment penalty if at any time after your initial enrollment period is over, there’s a period of 63 or more days in a row when you don’t have Part D or other creditable prescription drug coverage. See “Medicare and you #10050” for an introduction to the LEP, Late Enrollment Penalty. Currently, the late enrollment penalty is calculated by multiplying 1% of the national base beneficiary premium ($35.63 in 2017) times the number of full, uncovered months that you were eligible (Residence) but didn’t join a Medicare drug plan and went without other creditable prescription drug coverage.

Consumer Links

Part D Prescription Drug Guide #11109 84 pages pdf

Part D Late Enrollment Penalty Reconsideration Request Form

cms.gov Appeals-and-Grievances/  Part D Rx

42 USC §1395 Late Enrollment Penalty on Cornell Law Website

Penalty Calculator – Waugh Insurance Agency

 

Child pages in our Part D Rx Prescriptions Section

 

• Maximus Appeals

Q & A

Steve,

I am 75. When Part D became available I did not enroll because I found another supplier at a substantial discount.

If I understand the program, I am now subject to a 1% per month penalty from the date I became eligible to join Part D or in my case about a 50% penalty on the premium cost. Can this be so?

Of course when it comes to the U.S. government stupid is the norm.

Lately I have found that as Generics become available, I can switch back to purchasing them at Costco at substantial discount.

Thanks,

George P

So what happened to the $ 31.80 you quoted earlier?

***I did not quote that. It’s from the Official Medicare Manual.
“national base beneficiary premium” ($31.08 in 2012)
Or was that the low premium in 2006?It changes ($32.34 in 2011)
See the links below.

And on which the 1% is being calculated?

$31.08
Now it appears we are at $ 54.82 p/m or $657.84 per year for the “Standard” plan.  Math sounds close.

The answer to the annual income from regular taxable earnings is less than $ 170,000.00.

The good side is you do not have that “extra” tax.
Can this figure be relied upon and have premiums increased by 19% since 2006?The penalty is only for the period of time that you have not been covered. So, it’s $15 forever. On the other hand…
Since the “national base beneficiary premium” may increase each year, the penalty amount may also increase every year. You may have to pay this penalty for as long as you have a Medicare drug plan.

More Info. (Unfortunately, it says the exact same thing)
.medicare.gov
q1medicare.com
At 06:07 PM 4/30/2012,  Is that $ 31.08 X 50 months X 1% penalty per month = $ 15.52 for a total monthly premium of $ 47.34??????

***My numbers do not quite match, but the concept is correct.
It would be $15.52 on top of what ever premium you choose.

healthreformquotes.com/

Do you and your wife have more than $170k in income?
healthreformquotes.com/

If I understand the program, I am now subject to a 1% per month penalty from the date I became eligible to join Part D or in my case about a 50% penalty on the premium cost. Can this be so?

***2006 Effective Date = 50 months x ($31,08/1%) = $15/month penalty