What is the Part D late enrollment penalty in 2026?
The Part D late enrollment penalty in 2026 is 1% of the $38.99 national base beneficiary premium for every full month you went without creditable drug coverage, about $4.70 a month for each year late, added to your premium for as long as you have Part D.
It applies if you went 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period ended. The base premium is reset each year, so the dollar amount can change even though your months do not.
| Months without coverage | Penalty rate | Added each month | Added per year |
|---|---|---|---|
| 12 months (1 year) | 12% | $4.70 | $56.40 |
| 24 months (2 years) | 24% | $9.40 | $112.80 |
| 36 months (3 years) | 36% | $14 | $168 |
| 60 months (5 years) | 60% | $23.40 | $280.80 |
How the penalty is calculated
Medicare counts the full months you were eligible but had no creditable drug coverage, multiplies by 1% of the national base beneficiary premium ($38.99 in 2026), and rounds to the nearest 10 cents. The result is added to whatever Part D or Medicare Advantage drug plan you join.
What avoids or reduces it
Creditable coverage: drug coverage from an employer, union, VA, TRICARE or similar that is expected to pay at least as much as standard Part D. Your employer or plan sends a yearly notice saying whether it is creditable; keep it. People who qualify for Extra Help do not pay the penalty.
If you think the penalty is wrong, you can ask your plan for a reconsideration within the deadline in your penalty letter.
What to do next
If you are past 65 without creditable coverage, enrolling during Annual Enrollment (October 15 to December 7, 2026) stops the months from adding up. Our Part D penalty calculator estimates the amount, and we can check your creditable coverage letters with you in Chandler.
Related questions
What is the Part D late enrollment penalty in 2026?
The Part D late enrollment penalty in 2026 is 1% of the $38.99 national base beneficiary premium for every full month you went without creditable drug coverage, about $4.70 a month for each year late, added to your premium for as long as you have Part D.
Does the Part D penalty ever go away?
Generally no. It lasts as long as you have Medicare drug coverage, except for people who qualify for Extra Help.
Does VA coverage count as creditable?
Yes. VA drug coverage is creditable, so you can delay Part D without a penalty while you have it.
What is the 2026 national base beneficiary premium?
$38.99 a month. CMS sets a new figure each year.
How long can I go without drug coverage before the penalty applies?
The penalty applies once you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period ends. A shorter gap does not count. If you are retiring or changing plans, start the new drug coverage before the old one ends.
How much is the Part D penalty after two years without coverage?
Twenty-four months adds 24% of the $38.99 base premium: about $9.40 a month in 2026, or $112.80 a year, on top of your plan premium. Because the base premium is reset each year, the dollar figure can change even though your 24 months do not.
Do I pay the penalty with a Medicare Advantage drug plan?
Yes. The penalty is added to the premium of whatever Part D plan or Medicare Advantage plan with drug coverage you join. Picking a plan with a $0 drug premium does not remove it; you pay the penalty amount each month instead of nothing.
Can I appeal a Part D late enrollment penalty?
Yes. You can ask your plan for a reconsideration within the deadline in your penalty letter. Include proof of any creditable drug coverage you had, such as the yearly notice from an employer, union, VA or TRICARE. We can help you find and organize those letters at our Chandler office.
Does employer drug coverage count as creditable?
Often, but not always. Coverage counts if it is expected to pay, on average, at least as much as standard Part D. Your employer or plan sends a yearly notice saying whether it is creditable; keep every one. If you are not sure, ask your benefits office before you delay Part D.
Sources
- Medicare.gov: Part D late enrollment penalty Centers for Medicare & Medicaid Services
Please note: We do not offer every plan available in your area. Currently we represent 34 organizations which offer 64 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.Rise Up Benefits Group is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.
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