Medicare Penalty Calculator - Part B & Part D Late Enrollment Penalties

🏥 Official Medicare Penalty Calculations

📋 Part B Enrollment Information

Date First Eligible for Part B

Usually when you turned 65 or became eligible for Medicare

Actual Part B Enrollment Date

When you actually enrolled in Part B

Did you have creditable coverage from an employer?

Yes No

Employer or union coverage can waive the penalty

⚠️ Important: Part B penalty is 10% for each full 12-month period you delayed enrollment without creditable coverage.

💊 Part D Enrollment Information

Date First Eligible for Part D

Usually when you first became eligible for Medicare

Actual Part D Enrollment Date

When you enrolled in Part D or creditable drug coverage

Did you have creditable drug coverage?

Yes No

Coverage as good as Medicare's standard drug coverage

⚠️ Important: Part D penalty is 1% of the national base premium for each month without coverage. This penalty is permanent.

📋 Part B Information

Date First Eligible for Part B

Usually when you turned 65

Actual Part B Enrollment Date

When you enrolled in Part B

Creditable coverage from employer (Part B)?

Yes No

💊 Part D Information

Date First Eligible for Part D

Usually same as Part B eligibility

Actual Part D Enrollment Date

When you enrolled in Part D

Creditable drug coverage?

Yes No

Monthly Penalty Amount

Months Without Coverage

Annual Penalty

Lifetime Cost (20 years)

Penalty Percentage

Penalty Calculation Details

Component	Value

Total Medicare Costs with Penalty

Medicare Part	Standard Premium	Penalty	Total Monthly

Understanding Medicare Penalties

Part B Late Enrollment Penalty

If you didn't sign up for Part B when you were first eligible and didn't have creditable coverage from an employer or union:

Penalty Amount: 10% of the standard Part B premium for each full 12-month period you delayed
Duration: You pay this penalty for as long as you have Part B
Example: If you delayed 24 months, you pay 20% more forever
2025 Standard Premium: $185.00/month (most people)

Part D Late Enrollment Penalty

If you go without Part D or creditable prescription drug coverage for 63 days or more:

Penalty Amount: 1% of the national base beneficiary premium for each month without coverage
Duration: You pay this penalty for as long as you have Part D
2025 National Base Premium: $36.78/month
Example: 24 months late = 24% × $36.78 = $8.83/month penalty

💡 Important: Medicare rounds Part D penalties to the nearest $0.10. The penalty amount can increase each year as the national base premium changes.

Creditable Coverage

You can avoid penalties if you had creditable coverage:

Part B: Coverage from current employment (you or spouse)
Part D: Drug coverage at least as good as Medicare's standard coverage
COBRA, retiree coverage, TRICARE, VA benefits may qualify
Marketplace plans do NOT count as creditable coverage

Special Enrollment Period (SEP)

You can enroll without penalty during a SEP if you:

Have coverage through current employment
Lose employer coverage (8-month window)
Move out of your plan's service area
Qualify for Extra Help with drug costs

How to Avoid Penalties

Enroll on time: During your Initial Enrollment Period (3 months before, month of, and 3 months after turning 65)
Keep creditable coverage: Don't let coverage lapse for more than 63 days
Document everything: Keep proof of creditable coverage
Consider Part D even if healthy: The penalty is permanent

Appeal Rights

You can appeal a penalty decision if you believe it's incorrect:

Request reconsideration within 60 days
Provide proof of creditable coverage
Show good cause for late enrollment
Get help from SHIP (State Health Insurance Assistance Program)