Medicare Late Enrollment Penalties

Can Late Enrollment Penalties Be Removed

All Medicare beneficiaries must prepare to face a late enrollment penalty if they miss enrollment for Part A, B, or D. However, late enrollment penalties cannot be removed.

Medicare beneficiaries need to follow certain rules and regulations regarding enrollment, and failure to comply can result in penalties. To give you a perspective, we have discussed the penalties below that an individual might incur due to negligence.

The Medicare Part A Penalty

A 10% charge will be added to the monthly premium. An individual will be required to pay this penalty for double the amount of time they went without Part A coverage. 

If an individual has worked and paid taxes into Medicare for ten years or more, they are entitled to Part A for free. However, if there is not enough employment history, then out of pocket or external premiums shall be applied.

The Medicare Part B Penalty

A 10% increase will be added to the current Part B premium as part of the penalty. This means for every 12-month period you went without Part B coverage, your premium can go up every 12 months. This is a lifelong penalty. However, if an individual is eligible for a Special Enrollment Period, they can avoid the penalty.

The Medicare Part D Penalty

The drug premium comes with a penalty of 1% of the average monthly prescription. The amount is rounded off to 10 cents depending upon the months missed. If the enrollment has not occurred within three months, the penalty applies right away. It is important to note that the penalty is permanent, and the beneficiary must pay it.

However, if you happen to have health insurance through your employer or as part of your spouse’s employment, you might not incur any penalty fees.

What if you disagree with the late enrollment penalty?

You are free to request a “reconsideration.” The drug plan you are part of will send all the required information about how you can request reconsideration when a need arises.

You will be required to complete a form and post it to the address or fax number mentioned on the form. It is important to mention that you must do all this within 60 days from the date you received a letter stating that you owe an LEP.

If you have any more questions regarding enrollment periods and avoiding late enrollment periods, reach out to one of our experts.

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