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Costly Penalties for Failing to Enroll in Medicare Part D Highlighted in New Medicare Rights Brief

This week, the Medicare Rights Center released a new brief on the complexities of knowing when to enroll in Medicare Part D and the consequences of making mistakes. The brief, Medicare Snapshot: Stories from the Helpline, Part D Enrollment: Penalty Pitfallsreports on a recurring issue heard on the Medicare Rights national helpline.

Since 2006, people with Medicare have benefited from access to coverage for prescription medications by enrolling in private insurance plans through Medicare Part D. People eligible for Medicare who fail to enroll in Part D face a late enrollment penalty unless they have other creditable coverage, meaning a prescription drug plan that provides equal or greater value than the standard Part D benefit.

Many such penalties can be avoided. Yet, for various reasons, people new to Medicare miss key information they need to make informed decisions about their health care coverage. Oftentimes there is simply inadequate information or insufficient assistance for people with Medicare when it comes to the Part D late enrollment penalty.

To address these Part D enrollment pitfalls, Medicare Snapshot outlines needed improvements to the Medicare enrollment process, including:

  • Ensuring that Part D plans are not erroneously assessing penalties for their members;
  • Examining the effectiveness of creditable coverage notices; and
  • Enhancing beneficiary education and outreach.

For those eligible for Part D, Medicare Snapshot offers important advice, including:

  • When you become eligible for Medicare, you should enroll in a Part D plan unless you have other creditable prescription drug coverage. Creditable prescription drug coverage is coverage that is considered to be as good as or better than Part D. Your employer (or other entity providing prescription drug coverage) should inform you whether or not your coverage is creditable. If you do not receive this information, you should ask for it.
  • Hold onto any notice of creditable coverage that you may receive. Keep this in a safe place just in case you have to prove your creditable coverage.
  • If you have been without creditable drug coverage for more than 63 days while eligible for Medicare, you may face a lifetime Part D late enrollment penalty that must be paid or you will likely lose your coverage.
  • Everyone has the right to appeal their penalty.

Find more information here on the Part D late enrollment penalty and appeals:

For additional help, visit Medicare Interactive, the Medicare Rights Center’s educational website at, or call 800-333-4114.

Read the brief.

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