The late enrollment penalty is calculated by multiplying 1% of the “national base beneficiary premium” ($32.74 in 2020) times the number of full, uncovered months the beneficiary didn’t have Part D or other creditable coverage (but were eligible). The penalty amount is rounded to the nearest $0.10 and added to their monthly Part D premium.
Who is affected?
The beneficiary may owe a late enrollment penalty if, for any continuous period of 63 days or more after the Initial Enrollment Period is over, they go without one of these:
- A Medicare Prescription Drug Plan (Part D)
- A Medicare Advantage Plan (Part C) like an HMO or PPO with drug coverage
- Creditable prescription drug coverage through an employer or union
- Dual Eligible/ Extra Help recipients are exempt from paying the penalty
When does the beneficiary find out their penalty amount?
When they enroll in a Medicare Part D plan, the plan will tell them if they owe a penalty and what the total premium, including the penalty, will be. Click here for additional details on the Part D Late Enrollment Penalty, including the process for “reconsideration”.
How much is the Part D late enrollment fee?
In addition to the monthly premium
Ask your Pharmacist about Navigate
Navigate is an enrollment portal with an optimized digital consumer experience for Medicare consumers who are newly eligible or current beneficiaries looking to shop for or switch plans.
Navigate is designed to simplify the Medicare enrollment process and guide consumers to an informed decision that results with a cost effective outcome. The consumer is provided login access by their pharmacist who is part of Amplicare’s pharmacy network. Upon login, the user will be able to compare Medicare Part D and / or stand alone Prescription Drug Plans powered by their personalized data and historical script costs.
Your community pharmacist can provide information that unlocks access to the best Medicare plan for your health and wellness in your service area.
- Compare affordable, quality Medicare plans offered
- Estimate your prescription drug costs associated with the plan
- Check if your doctor is in the network and review the plan formulary
- Explore additional benefit offerings; Dental and Vision benefits