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How do I avoid a Medicare Part D late-enrollment penalty increase when I move to a new area and lose my Part D coverage?

Category: Late-Enrollment Penalty (LEP)
Updated: Jun, 12 2023


To avoid the Part D Late-Enrollment Penalty (LEP) simply enroll in a new Medicare Part D plan (PDP) or Medicare Advantage (MAPD) in your new area or region

You will not incur the premium penalty for being without creditable Medicare Part D coverage, if you join a Medicare drug plan within 63 days of the move -- and you automatically qualify for a Special Enrollment Period (SEP) to join the new Medicare prescription drug plan.

Special Enrollment Periods allow you to join or change or drop Medicare plans outside of the annual Open Enrollment Period (AEP) that starts October 15 and continues through December 7.  The Medicare Part D Special Enrollment Periods are explained here: Q1FAQ.com/514 and here: Q1FAQ.com/561

Please note that there are 34 Medicare Part D "regions" across the country (here is a link to a list of Medicare Part D Regions) and you will note that some of the larger states, such as California are a single Medicare Part D region (Region #32).  However, some states such as Pennsylvania and  West Virginia  are combined into one Medicare Part D region (Region #6) - so in this case, if you move from West Virginia to Pennsylvania, you will keep your same Medicare Part D coverage and not be granted a Special Enrollment Period since you are still in CMS Region #6.

In short:  When you move your primary residence to a new Medicare Part D Region, you are granted a Special Enrollment Period (SEP) that will allow you a certain amount of time to enroll into a new plan.  You can see all stand-alone Medicare Part D plans in a specific state using our Medicare Part D Plan Finder (PDP-Finder.com/CA) - just choose your state abbreviation to get started.


Moving with your Medicare Advantage plan?
If you are enrolled in a Medicare Advantage plan (with or without drug coverage - MA or MAPD) and move to another county or Zip Code, you will also be provided a Special Enrollment Period to join a Medicare Part D or Medicare Advantage plan in your new area.  You can see all Medicare Advantage plans in a specific Zip Code using our Medicare Advantage Plan Finder (MA-Finder.com/44319) - enter your Zip Code or choose a state abbreviation and then choose the county.

Contact Medicare to learn more about SEPs and Medicare plans in your new area.
You may wish to contact a Medicare representative and ask about the length of time before the SEP closes - you can reach a representative at 1-800-MEDICARE (1-800-633-4227) - other SEPs allow 63 days or different amounts of time to get into another Part D prescription drug plan.  A Medicare representative can also help you find the most economical Medicare drug coverage in your new area.

Can I just join the same Medicare plan in my new area?
Yes, if available.  Medicare plan availability varies across the country and you may find that your new area does not have the same Medicare plans as your previous residence.  But if available, you can enroll into the same Medicare Part D prescription drug plan (again, if available in your new Region) or you can choose a completely new Medicare Part D plan (that may be more affordable).  However, the monthly premiums of Medicare Part D plans may vary State to State (or Region to Region), but you will not be penalized unless you wait beyond the closing of your SEP - then you also probably will have no possibility of drug coverage until the start of the next calendar year.





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