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 How To Avoid the Medicare Part D Penalty!!

by | Jan 19, 2024 | Medicare, Medicare Part D

How To Avoid the Medicare Part D Penalty!!

Hello Toni:

I read your article about how ignoring Medicare rules is Costing Americans millions and I believe I have made a mistake because I have not enrolled in a Medicare Part D prescription drug plan. I need your help!

I retired in August and had a telemarketing agent help me find a Medicare Supplement which began Sept. 1. No one told me that I had a specific amount of time to enroll in my Medicare Part D plan. Currently, my prescriptions are generic, and I use GoodRx to receive the discount.

When I enrolled on December 15 for a new Medicare Part D plan, I was denied because I did not apply on time.

I am 70 and my Part D will begin next year when I’m 71. Medicare informed me that the Part D penalty will be $.3470 X 72 months since my Medicare Part A began 6 years ago at 65. I cannot believe that I must pay an extra $25 per month as a Part D “penalty”.

Please explain this ridiculous Medicare Part D rule and when I can begin my plan. Thank You, Samuel from Chattanooga, TN

Samuel:

You will have to wait until the next Medicare Annual Enrollment period from Oct.15-Dec. 7 to enroll in a Medicare Part D plan. Your effective date will be Jan. 1, 2025. The good news is that you are currently taking generics and can use GoodRx (which is not what Medicare deems as a “creditable” prescription drug plan) until you enroll in Medicare Part D during that time. (Chapter 5 of the Toni Says® Medicare Survival Guide Advanced edition, explains Medicare Part D, how to avoid Part D penalties, and the famous “Donut Hole.”)

Once you are past 65 and leaving creditable employer’s group coverage with a prescription drug plan, Medicare gives you only 63 days, not 90 days, not 8 months, but less than 63 days to enroll in Medicare Part D or a Medicare Advantage plan with prescription drug coverage.

Your late enrollment period (LEP) did not begin from the day you left your company health plan, nor from your Medicare Part B start date. It began from the month your Medicare Part A began.

The LEP (Late Enrollment Period) penalty for Medicare Part D can be charged to you because:

  • You waited past 63 days without creditable prescription drug coverage upon leaving company benefits and you are older than 65 years and 90 days. Readers: Do not wait past 63 days to get Medicare Part D upon leaving company health insurance! (Samuel, this is your situation.)
  • Your company prescription drug benefits (not health insurance) were not “creditable” as Medicare declares.
  • You never enrolled in Medicare Part D at the time you enrolled in Medicare Part A and Part B when you turned 65, and now want to enroll.

Samuel, you were denied Medicare Part D prescription coverage because you met Medicare’s LEP (late enrollment penalty) rule and will receive the Part D penalty when you enroll during Medicare’s Annual Enrollment period–a penalty which lasts a lifetime.

Americans retiring after 65, who are leaving employer’s health plans and applying for Medicare Parts A and B, must also prove they have “creditable coverage” when applying for a Medicare Part D prescription drug plan. This is a Medicare rule. Don’t delay your Part D enrollment.

Is the maze of Medicare confusing you? Contact the Toni Says® Medicare team at 832-519-8664 or info@tonisays.com with your Medicare questions. Toni King’s Medicare Survival Guide® Advanced edition and the new “Confused about Medicare” video series is on sale at www.tonisays.com.

 

 

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