Part D Late-Enrollment Penalty

I got a call yesterday from a client who signed up for a Medicare Advantage plan three years ago.  He has had Part D as part of his Medicare Advantage plan for the last three years, but he just got a letter saying he must pay a premium from now on for his $0 premium Advantage plan.

It turns out that Jim did not sign up for Part D when he turned 65 and two years went by before he enrolled in Part D through a Medicare Advantage plan. Three years ago, I don’t think the Medicare Advantage plans enforced the late-enrollment penalty, but it looks like Medicare has been auditing the plans and finding people who had not been assessed a penalty.

Jim will have to pay around $7 per month for his Part D late-enrollment penalty.  He’s okay paying the penalty because his Medicare Advantage plan has no co-pay for the expensive drugs he takes to control his blood sugar.  Drugs like Byetta, Avandia, Januvia, Tradjenta, Metformin, Glumetza, Janumet, and Actoplus have a $0 co-pay on his plan.  Jim is in a plan for people with Diabetes and he gets two drugs each month for $0 this year. Last year he paid $45 per month for each prescription refill. The full retail cost of many anti-diabetic drugs can be $200 or more.

I have met with a number of people turning 65 (including a doctor) who decided not to enroll in a Part D plan because they took only one or two cheap generic drugs.  I told them about the late-enrollment penalty they would face if their prescription needs should change in the future. Diabetes is one of those illnesses that sneak up on people – and the drugs to treat it are expensive.

Luckily for Jim, his penalty is only around $7.  Last year I enrolled a woman in a plan for people with Diabetes and her late-enrollment penalty was $27.  I think she had gone 7 years without Part D.

Part D is voluntary, but there is a price to pay later on for not enrolling when you are first eligible.  If a person gets a Medicare supplement, they need to buy a “stand-alone” Part D plan and pay from $12 to $34 (or higher) per month. If a person enrolls in a Medicare Advantage plan, Part D is usually included at no additional charge – and most Advantage plans in Arizona have $0 premium.







2 comments for “Part D Late-Enrollment Penalty

  1. 05/20/2017 at 1:28 pm

    Please advise me on how to END the Medicare Late Enrollment Fee. Late fees should have ending time and not last forever. The law is unfair to the elderly and poor.
    Russell Earl Kelly
    316 Aonia Rd
    Washington, Ga 30673
    age 72

  2. Denise
    05/21/2017 at 9:51 am

    I am sorry to inform you that the Part D late-enrollment penalty does not end – – unless your income is below a certain level. If you qualify for help with your prescriptions, you do not pay the late-enrollment penalty. Otherwise it never ends.

    You qualify for help with your drug costs if your income is below $1,580 (single) or $2,050 (married). You can apply for this help at

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