Medicare Part D Penalty

Why skipping drug coverage can cost you for life — and how the Part D penalty is calculated.

📞 Call 1-800-633-4427 — FreeAmerica's Trusted Toll-Free Number

Elderly man in patterned shirt reading and holding bills at a home table, appearing focused, illustrating Medicare Part D Penalty — 1-800-MEDIGAP, America's Trusted Toll-Free Number. — Photo: SHVETS production / Pexels

Quick answer

The Medicare Part D penalty is a permanent surcharge added to your drug plan premium if you go 63 or more days without creditable coverage after your Initial Enrollment Period. It equals 1% of the national base premium per uncovered month, per Medicare.gov.

The Part D penalty is small per month but adds up for life. Here is exactly how it works.

How is the Part D penalty calculated?

The Medicare Part D late enrollment penalty is calculated by multiplying 1% of the national base beneficiary premium by the number of full months you went without creditable drug coverage after your Initial Enrollment Period. That figure is rounded to the nearest 10 cents and added to your Part D premium. The penalty applies if you went 63 or more continuous days without creditable coverage. Because the national base premium changes each year, your penalty amount can rise over time — and it generally stays with you for as long as you have Part D.

How do you avoid the Part D penalty?

Avoid the Part D penalty by enrolling in a Medicare drug plan when you are first eligible, or by keeping creditable prescription coverage — coverage at least as good as standard Part D — through an employer, union, or VA plan. Keep the annual notice your plan sends confirming it is creditable, since you may need it later. If you lose creditable coverage, enroll in a Part D plan within 63 days to stay penalty-free. To check whether your current drug coverage is creditable, call 1-800-MEDIGAP (1-800-633-4427).

More on Medicare Costs & IRMAA

← Medicare Costs & IRMAA (overview)pillar guide Medicare Part B Premium 2026 How Much Does Medicare Cost?Medicare Part B Deductible 2026 IRMAA 2026 Medicare Income Limits 2026 Medicare Part A Deductible 2026 Medicare Late Enrollment Penalty

Frequently asked questions

How is the Medicare Part D penalty calculated?+

The Part D penalty equals 1% of the national base beneficiary premium multiplied by the number of full months you went without creditable drug coverage, rounded to the nearest 10 cents. It is added to your Part D premium and generally lasts as long as you have Part D.

How long does the Part D penalty last?+

The Medicare Part D late enrollment penalty generally lasts for as long as you have Medicare drug coverage. Because it is tied to the national base premium, which changes yearly, the dollar amount of your penalty can increase over time.

What counts as creditable drug coverage?+

Creditable coverage is prescription drug coverage expected to pay, on average, at least as much as standard Medicare Part D. Common sources include employer, union, or VA plans. Your plan sends an annual notice stating whether its coverage is creditable — keep it for your records.

Can I avoid the Part D penalty?+

Yes. Enroll in a Part D plan when first eligible, or keep creditable drug coverage and sign up within 63 days of losing it. To confirm whether your current coverage is creditable and avoid a lifelong surcharge, call 1-800-MEDIGAP (1-800-633-4427).

Talk to a licensed specialist — free.

America's Trusted Toll-Free Number. One call answers it all, at no cost and no obligation.

📞 Call 1-800-MEDIGAP