TONI SAYS: How to avoid the Medicare Part D penalty

By Toni King

Dear Readers: Last week’s Medicare article, “Ignoring Medicare rules costs Americans millions in penalties,” contained an error. The Medicare Part D Penalty is based on 1% for each month, not year, for which one could have but failed to enroll in Medicare Part D.

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


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:

1) 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.)

2) Your company prescription drug benefits (not health insurance) were not “creditable” as Medicare declares.

3) 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 [email protected] with your Medicare questions. Toni King’s Medicare Survival Guide Advanced edition and the new “Confused about Medicare” video series is on sale at