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Medicare Part D Late Enrollment Penalty
The Part D late enrollment penalty is an amount added to your monthly drug plan premium if you went too long without drug coverage after you first became eligible for Medicare. It usually lasts as long as you have Medicare drug coverage.
When the penalty applies
You may owe a penalty if, at any time after your Initial Enrollment Period ends, you go 63 days or more in a row without Part D or other creditable prescription drug coverage.
How the penalty is calculated in 2026
1% × the national base beneficiary premium ($38.99 in 2026) × the number of full months you went without coverage, rounded to the nearest $0.10.
| Months without coverage | Penalty % | Monthly penalty in 2026 |
|---|---|---|
| 12 | 12% | $4.68, rounded to $4.70 |
| 14 | 14% | $5.46, rounded to $5.50 |
| 24 | 24% | $9.36, rounded to $9.40 |
| 36 | 36% | $14.04, rounded to $14.00 |
The base premium can change each year, so the penalty amount can change too. It is added even if you choose a plan with a $0 premium.
What counts as creditable coverage
Coverage expected to pay at least as much as standard Medicare drug coverage, such as some employer or union plans, TRICARE, VA coverage and the Federal Employees Health Benefits Program. Your plan must send you a yearly notice saying whether it is creditable. Keep those notices.
Ways to avoid or remove the penalty
- Join a Part D plan or a Medicare Advantage Plan with drug coverage when you are first eligible.
- Keep creditable coverage and do not go 63 days or more without it.
- If you qualify for Extra Help, you do not pay the penalty.
- If you disagree, you can ask for a reconsideration within 60 days of the letter telling you about the penalty.
Source: Medicare.gov: Part D costs and late enrollment penalty (2026 national base beneficiary premium $38.99).
Frequently asked questions
How much is the Part D late enrollment penalty in 2026?
It is 1% of $38.99 for each full month you went without creditable drug coverage. For example, 14 months equals a $5.50 monthly penalty in 2026.
How long do you pay the Part D penalty?
Generally for as long as you have Medicare drug coverage, even if you switch plans.
How can I avoid the Part D penalty?
Join a drug plan when you first get Medicare, or keep creditable drug coverage and never go 63 days or more in a row without it.
Does Extra Help remove the Part D penalty?
Yes. If you qualify for Extra Help, you do not pay the Part D late enrollment penalty.
Talk with a licensed agent
Questions about your Medicare options? Call 1-844-438-6284 (TTY 711) or request a free, no-obligation quote. We do not offer every plan available in your area.
Sources for 2026 figures: CMS 2026 Medicare Parts A & B Premiums and Deductibles; Medicare.gov: Medicare costs; Medicare.gov: Part D costs. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).