Why Medicare Penalties Matter
Medicare has enrollment windows. If you miss them without a qualifying reason, you may face permanent premium penalties that increase your costs for as long as you have Medicare. These penalties are not one-time fees — they are added to your monthly premium every month, for life.
Part B Penalty
10% of the standard Part B premium for each full 12-month period you were eligible but did not enroll (without a valid SEP).
Part D Penalty
1% of the national base beneficiary premium for each month without creditable drug coverage. Rounded to nearest $0.10 and added to your Part D premium permanently.
Part B Late Enrollment Penalty
The Part B penalty applies if you did not enroll in Part B when first eligible and did not have a valid Special Enrollment Period (SEP) reason — such as active employer coverage through your own or your spouse's current employer.
Part B Penalty Examples (2026)
| Years Delayed | Penalty % | Monthly Penalty Amount | Total Monthly Premium |
|---|---|---|---|
| 1 year | 10% | +$20.29/mo | $223.19/mo |
| 2 years | 20% | +$40.58/mo | $243.48/mo |
| 3 years | 30% | +$60.87/mo | $263.77/mo |
| 5 years | 50% | +$101.45/mo | $304.35/mo |
⚠️ VA Coverage Does NOT Protect You from Part B Penalties
VA health care is NOT considered creditable coverage for delaying Part B. If you rely only on VA health care and delay Part B, you may face this permanent penalty.
Part D Late Enrollment Penalty
The Part D penalty applies if you went without creditable prescription drug coverage for 63 or more days after first becoming eligible for Medicare Part D.
Part D Penalty Formula
Penalty = 1% × $38.99 × [uncovered months]
Rounded to the nearest $0.10. Added to your monthly Part D premium. Recalculated each year as the base premium changes.
Part D Penalty Examples (2026)
| Uncovered Months | Monthly Penalty | Annual Extra Cost |
|---|---|---|
| 12 months (1 year) | +$4.70/mo | $56.40/yr |
| 24 months (2 years) | +$9.40/mo | $112.80/yr |
| 36 months (3 years) | +$14.00/mo | $168.00/yr |
| 60 months (5 years) | +$23.40/mo | $280.80/yr |