Medicare Part D Late Enrollment Penalty (LEP)
The Medicare Part D Late Enrollment Penalty (LEP) is a fee added to your monthly premium if you don’t enroll in a Medicare Part D plan when you’re first eligible and go without creditable prescription drug coverage for 63 or more consecutive days.
How Is the Late Enrollment Penalty Calculated?
The penalty is calculated based on the number of months you were without creditable drug coverage and is added to your Part D premium permanently.
Formula for the Late Enrollment Penalty (2024)
1% of the national base beneficiary premium ($34.70 in 2024) × Number of full months without coverage
�� Example:
- You went 15 months without creditable drug coverage.
- 1% of $34.70 = $0.35 per month
- $0.35 × 15 months = $5.25 per month
- You’ll pay an extra $5.25 on top of your monthly Part D premium for life.
Note: The national base premium changes every year, so your penalty amount may increase annually.
How to Avoid the Late Enrollment Penalty
✅ Enroll in Medicare Part D when first eligible (during your Initial Enrollment Period).
✅ Ensure you have “creditable” drug coverage through an employer, VA, TRICARE, or other plan.
✅ Keep proof of creditable coverage to avoid penalties if you enroll later.
Appealing the Late Enrollment Penalty
If you believe the penalty was applied in error, you can request a reconsideration by following the instructions in your penalty notice from Medicare.
