Late Enrollment Penalty

Contest a Late Enrollment Penalty for PART D (Prescription Drugs)

It’s not uncommon to contest a Late Enrollment Penalty (LEP) for Part D (prescription drug coverage). Many individuals who qualify for Part D when they turn 65 or who qualify for Medicare through disability don’t realize that when you are first eligible for Medicare, you MUST either have a prescription drug plan with creditable prescription drug coverage through an employer-sponsored plan or something else that is considered as good as Medicare.  If you don’t have an employer or retiree plan, you MUST enroll into a Medicare plan that offers prescription drug coverage through either a Medicare Advantage Prescription Drug Plan, or a stand-alone Prescription Drug Plan (Medicare Part D).

If you don’t have Part D coverage within the first 63 days of being eligible for Medicare, you will likely be assessed a “Medicare Part D Late Enrollment Penalty”.  This penalty is NOT a one time charge.  Instead, it is billed EVERY SINGLE MONTH as long as you have prescription drug coverage.  The longer someone goes without Medicare Part D coverage, the greater the monthly LEP will be. The LEP is calculated based upon the average national prescription drug plan premium.  Currently that amount is roughly $35.00/month.

How a Late Enrollment Penalty [LEP] is calculated:
$35 x 1% x the number of months you were eligible but chose to not have a creditable drug plan.

The LEP can add up over time.  Give us a call.  There are several ways to contest the LEP and have it removed permanently.  We’ll be happy to help you better understand the process and what your options are.

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