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Your 2015 Late-Enrollment Premium Penalties Will Increase by 2%

Category: Late Enrollment Penalty
Published: Aug, 17 2014 11:08:19

If you have accrued a Medicare Part D late-enrollment premium penalty (LEP), you can expect to see a 2% increase in your 2015 penalty payment.

How high of a late-enrollment penalty could someone pay in 2015?
It is possible to have a penalty that reaches as high as an additional $34.13 per month or $408 per year - that must be paid in addition to your 2015 Medicare Part D or Medicare Advantage plan premium.

The late-enrollment premium penalty is an additional monthly cost paid by Medicare Part D beneficiaries who did not enroll in a Medicare Part D prescription drug plan when they were first eligible or who were without creditable prescription drug coverage for more than 63 days.

If you are subject to a late-enrollment penalty, you will pay your plan’s monthly Medicare Part D premium along with an additional penalty calculated as one percent (1%) of the national base Medicare Part D monthly premium for each month you were without creditable prescription drug coverage.

As a reminder, the CMS estimated weighted average Medicare Part D premium ($32 in 2015) is not used for purposes of calculating the late-enrollment penalty.  Instead, the actual (non-weighted) Part D base beneficiary premium (or national base monthly Medicare Part D premium) is used to determine the amount of your late-enrollment penalty.

In 2015, the average monthly premium used to calculate the late-enrollment penalty will be $33.13, a 2% increase over the 2014 figure of $32.42.

As reference, here are the premium values used to calculate the late-enrollment penalties from past years:

  • 2015: $33.13
  • 2014: $32.42
  • 2013: $31.17
  • 2012: $31.08
  • 2011: $32.34
  • 2010: $31.94
  • 2009: $30.36
  • 2008: $27.93
  • 2007: $27.35
  • 2006: $32.20

Need an example of how to estimate your 2015 late-enrollment penalty
If you were previously without creditable prescription drug coverage for five years (60 months), you would pay, in addition to your monthly premium, a monthly penalty of $20.00 (60% of $33.13) or around $240 per year.  Using this same example, you would have paid a 2013 monthly penalty of $18.70 or about $224 per year.

Click here if you would like to read more on the Medicare Part D late-enrollment penalty.

Also, you can learn more in our Late-Enrollment Penalty (LEP) FAQ section.

Another example:  What would be your penalty if you were eligible for Medicare back in 2005, never enrolled, and now decide to join a Medicare Part D plan in 2015?

Around $34 a month or $408 per year. If you were eligible for Medicare back in 2005 and never joined a Medicare Part D plan and have been without any other creditable prescription drug coverage since the start of the Medicare Part D program (103 months), you would have a monthly late-enrollment penalty of around $34 in 2015 – paid in addition to your monthly Medicare Part D plan premium (103 months * 1% of $33.13 = $34 rounded to nearest $1).

late enrollment penalty

Please note:  In certain situations, you can appeal your late-enrollment penalty.

Also, no late-enrollment penalties are assessed on people who qualify for the Medicare Part D financial Extra-Help program.

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