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Senior Resources » Medicare Part D Penalty Costs WHAT?

Medicare Part D Penalty Costs WHAT?

Medicare Part D Penalty Costs WHAT?

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Hello Toni,

I made a terrible mistake last April when I was no longer covered by my employer’s group health plan due to retiring. I had a telemarketing agent help me find a Medicare Supplement which began on April 1. No one told me that I had a specific amount of time to enroll in my Medicare Part D plan. I have a serious health issue with Crohn’s disease and should have enrolled at that time for my Medicare Part D.

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When I enrolled in July for a new Medicare Part D plan, I was denied because did I not apply on time. I take Stelara which is over $2,000 a month that I now must pay on my own.

I now am 70 years old and was informed that my Part D penalty for not enrolling in a Medicare Part D prescription drug plan will be $.3337 X 60 months since my Part A began 5 years ago. I cannot believe that I must pay an extra $20.02 per month as a Part D penalty.

Please explain this ridiculous Medicare Part D penalty and please tell me I can enroll during this Medicare Annual Enrollment period. I have not purchased my Stelara in the last few months.

Thank You,

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Sydney from Atlanta, GA


Sydney,

Good News!! You can enroll in your Medicare Part D plan that covers your expensive Stelara and other prescriptions that you are currently taking during Medicare’s Annual Enrollment period from October 15-December 7. Your effective date will be January 1, and you can go purchase your Stelara on New Year’s Day if your pharmacy is open. If not, then January 2nd.

Chapter 5 of the Toni Says® Medicare Survival Guide Advanced edition, explains Medicare Part D, how to avoid Part D penalties, and the famous “Donut Hole.”

You are aware that you waited too long to apply for a Medicare Part D plan. Once you are past 65 and/or leaving creditable coverage, Medicare gives you 63 days to apply for a Medicare Part D or Medicare Advantage plan with prescription drug coverage.

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Your late enrollment period (LEP) did not begin from the day you left your company health plan, BUT from the month your Medicare Part A began not when your Medicare Part B began.

woman with a shocked face

The LEP penalty for Medicare Part D can be because:

  • You waited past 63 days without creditable prescription drug coverage when you are leaving company benefits and you are older than 65 years old and 90 days. Don’t wait past 63 days to get Part D when leaving company health plans!
  • Your company’s prescription drug benefits (not health benefits) are not creditable as Medicare declares.
  • You simply never enrolled in Medicare Part D when you were first eligible and want to enroll.

Sydney, you were denied Medicare Part D prescription coverage because you did not follow Medicare’s LEP rule and will receive a Part D penalty when you enroll during Medicare’s Annual Enrollment period.

Related: Can I Delay Medicare Enrollment?

Americans retiring after 65, that are leaving company health plans and applying for Medicare Parts A and B, must also prove they have “creditable coverage” when applying for a Medicare Part D prescription drug plan.

Have a Medicare concern or question? Please email the Toni Says® office at info@tonisays.com.

Join the Confused About Medicare Webinar on Wednesday, November 16th, 4:00 pm-6:00 pm CST. Click here to sign up!



Medicare Survival Guide Advanced Edition

Order Medicare Survival Guide Advanced

Medicare Survival Guide Advanced

What You Don’t Know Will Hurt You!

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Turning 65 in America is a milestone and one of the markers is enrolling in Medicare. But the system is so complicated, and there is a lot of false information out there.

In Toni King’s Medicare Survival Guide Advanced: Basics and Beyond, Toni gives you the critical steps you need to enroll in Medicare properly. Toni shares various situations that she has experienced with her many clients during Medicare consultations, and gives you the information and tools you need to enroll on time to avoid the “famous” Medicare Part B and D penalties.

Medicare Survival Guide Advanced helps you understand Medicare step by step…

Learn How to Enroll the Correct Way
• Still Working Past 65
• Turning 65
• VA Benefits
• Laid-off or Retiring

What Medicare Option Is Best for You
• Medicare Supplement vs. Advantage
• Losing Retirement Benefits

How to Avoid
• The Donut Hole
• Part B Penalties
• Part D IRMAA Penalties

If you are enrolling in Medicare and are confused by the commercials and telemarketers, or from the information that well-meaning friends or family members give, let Toni guide you through the maze of Medicare. Order TODAY!



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Originally published October 19, 2022

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