The $9.40 Mistake That Follows You Forever: Understanding the Part D Penalty
“I Don’t Take Anything, Why Would I Need It?”
Frank didn’t take a single prescription when he turned 65. No blood pressure medication, no maintenance drugs, nothing. So when it came time to pick a Part D plan, he skipped it. Why pay for something he didn’t use?
Two years later, his doctor put him on a new medication, and that’s when he found out the truth: the penalty for skipping Part D doesn’t care whether you needed it at the time. It only cares whether you went without it, and now Frank pays extra, every single month, for the rest of his life.
Not taking any medications right now? That’s exactly when this penalty quietly starts. Find out if you’re at risk of this exact mistake
How the Penalty Actually Works
It’s 1% of the national base beneficiary premium ($38.99 in 2026) for every full month you went without creditable drug coverage, rounded to the nearest $0.10, recalculated annually. Frank went 24 months uncovered. 24% of $38.99 is about $9.40 extra every month, permanently, on top of his plan’s regular premium.
What Counts as Creditable Coverage?
Coverage expected to pay at least as much as standard Part D, usually employer/union plans, VA coverage, or TRICARE. Always confirm directly, not every employer plan automatically qualifies.
Already past 65 without Part D? The clock is already running. Avoid this penalty before it starts, not after
Is It Really Permanent?
Yes. It’s recalculated each year against the current base premium, but it never disappears once it’s attached to your bill.
How Do I Avoid It?
Enroll during your Initial Enrollment Period, or maintain verified creditable coverage without a gap of 63+ days. Qualify for Extra Help, and the penalty doesn’t apply at all.
Ready to Talk It Through?
Cole Insure is an independent Medicare brokerage. We work for you, not one insurance company. No fees, no bias toward any single carrier.
This is an advertisement for insurance. Not connected with or endorsed by the U.S. government or the federal Medicare program.
