Medicare Part D Late Enrollment Penalty: Assessed and Appealed

Some people are surprised to find themselves fined with a Medicare part D late enrollment penalty. Many don’t know why they have been fined and they don’t know what they should do about the fine. Nobody likes having a penalty against them and they don’t like the idea of having to pay this increasing penalty for the rest of the time they have a Medicare part D plan. When a Medicare part D late enrollment penalty is issued, there are a few things people should remember.

When people are told of their late enrollment penalty, they don’t always understand why they are getting it. A Medicare part D late enrollment penalty is given to people that may not have had credible coverage when they should have had it. Credible coverage for Medicare part d means insurance coverage that had prescription drug coverage as good as or better than Medicare part d. If no insurance is on file with Medicare when a person becomes eligible then a fine is assessed and attached to their Medicare part D plan.

The Penalty is Wrong…. Now What?

Every year thousands of people are told they have to pay a Medicare part D late enrollment penalty and they actually shouldn’t have to pay one. When this happens, many are frustrated and upset because they weren’t expecting to pay any additional money. While it is frustrating, it’s something that can be fixed very easily.

When people are told they have to pay a Medicare part D late enrollment penalty the first thing they should do is look at the dates that are supposed to be without credible coverage. If during those times a Medicare member had credible coverage, there are three things that can be done to fight the penalty: call the Medicare part D insurance provider, call Centers of Medicare and Medicaid Services or mail in a letter with the information about having credible coverage for that time. By doing any of those three things, the penalty can be examined and the information can be updated. Most people that choose to do one of those three things have the penalties lifted from their Medicare part D plans.

The Penalty is Right…. What Happens Next?

There are times that a Medicare part D late enrollment penalty is correctly assessed and given to someone to pay. Those that have that fine will have to pay that penalty until they no longer have a Medicare part D plan. It’s a penalty that is normally sent in with the monthly premium payment to make it easier for the members to pay.

Unfortunately some people don’t realize they should have enrolled into a Medicare part D plan until it’s too late. When they do enroll into a plan, they have gone months, sometimes years without the proper coverage. As Centers for Medicare and Medicaid Services begin to look at the coverage a member had before, they use their own formula to calculate how much the penalty is for that year. As the prices of Medicare part D plans change, so does the monthly penalty paid.

Those that have to pay a Medicare part D late enrollment penalty don’t have a choice but pay it each month unless they can prove they had credible coverage.

Dec. 2 14'
Most employers have piicloes that allow for you to add spouses and children to your plan but will most likley ask you to contribute to the premium.These piicloes are usually outlined in your employee handbook and if you don't have one, the HR department or your boss should be able to easily answer your questions. It's a home human resources issue that comes up frequently.References : personal experience.
Jul. 7 15'


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