The Part D penalty is charged when you go 63 days or more in a row without creditable prescription drug coverage after your Initial Enrollment Period. It adds 1% of the national base beneficiary premium for each uncovered month, it is rounded to the nearest 10 cents, and it is permanent.
This tool applies officially published figures to the numbers you enter. It is not an insurance quote, it is not an eligibility determination, and it does not predict what a carrier will charge you. Only HealthCare.gov, Medicare.gov, Social Security or the carrier can determine your eligibility and your actual price.
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Medicare Part D Late Enrollment Penalty: how it works
Why the penalty is not a fixed dollar amount
The penalty is a percentage of a national figure CMS sets each year, not of your own plan’s premium. That means two people with the same number of uncovered months pay the same penalty even if one is in a $0 plan and the other is in a $70 plan — and it means the penalty changes a little every January.
The 63-day rule
A short gap is forgiven. The penalty only starts once you have gone 63 days or more in a row without creditable coverage. If you are changing plans, make sure the new one starts before that window closes.
Common questionsCommon questions
I take no medications. Do I still need Part D?
Many people in that position still take a low-cost plan purely to avoid the penalty, because the penalty is permanent and grows with every month you wait. Whether that is worth it depends on the cheapest plan available to you, which changes by county and by year.
Does coverage from the VA count?
Yes. VA drug coverage is creditable, so months covered by it do not count toward the penalty. Your plan or employer must tell you each year in writing whether your drug coverage is creditable — keep those letters.
Which year’s base premium does this use?
The 2027 national base beneficiary premium of $41.33, published by CMS. The penalty is recalculated against the base premium of whichever year you are paying it in.