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Additional Costs of the Premium Penalty

Let us focus on two factors that (based on the annual Open Enrollment period information) could be theoretically effected by late enrollment:

1. The total Amount of the Medicare Part D Premium Penalty
2. When Your Medicare Part D Coverage Begins - if you do decide to join a Medicare Part D plan outside of the Open Enrollment period


For purposes of explanation, let us use an example / fictitious Medicare Part D beneficiary: "Thomas" who is newly eligible for the Medicare Part D plans (his seven month window is November 2016 through May 2017) and does not have any other creditable prescription drug coverage.

- The Amount of the Premium Penalty. It appears that if our Medicare beneficiary Thomas (who does not fall within one of several special classes of exceptions defined by CMS) waits until after the close of his initial Open Enrollment deadline (May of 2017), he may be subject to a minimum of a 6% premium penalty because the next annual Open Enrollment period (or Annual Coordinated Election Period) does not begin until October 15, 2017 and runs until December 7, 2017.

- When Your Medicare Part D Coverage Begins. In addition to the increased premium penalty, it is possible that if Thomas waits until after May 2017, not only will he be subject to several months of the 1% monthly premium penalty, but Thomas also will not receive any Medicare Part D coverage before January 1, 2018. In other words, after his May 2017 deadline, Thomas cannot enroll in a Medicare Part D program until the next Open Enrollment that begins again on October 15 and coverage first starts in January of the next year.

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