MEDICARE PART D

Monthly premium:

The Part D monthly premium varies by plan (higher-income consumers may pay more). The charts below show your estimated prescription drug plan monthly premium based on your income as reported on your IRS tax return from 2 years ago and last year. If your income is above a certain limit, you’ll pay an income-related monthly adjustment amount in addition to your plan premium.

If your filing status and yearly income in 2014 was

File individual tax return File joint tax return File married & separate tax return You pay (in 2016)
$85,000 or less $170,000 or less $85,000 or less your plan premium
above $85,000 up to $107,000 above $170,000 up to $214,000 not applicable $12 + your plan premium
above $107,000 up to $160,000 above $214,000 up to $320,000 not applicable $31.10 + your plan premium
above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 up to $129,000 $50.10 + your plan premium
above $214,000 above $428,000 above $129,000 $69.10 + your plan premium

• Late enrollment penalty:
You may owe a late enrollment penalty if you go without a Medicare Prescription Drug Plan (Part D), or without a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, or without creditable prescription drug coverage for any continuous period of 63 days or more after your Initial Enrollment Period is over. In general, you’ll have to pay this penalty for as long as you have a Medicare drug plan. The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage.

Initial Enrollment Period
If you are enrolled in Medicare Part A and/or Part B and live in your plan’s service area, you can enroll in the Medicare drug benefit (Part D) during your Initial Enrollment Period (IEP).

Your IEP for Part D will usually be the same as for Part B: the seven-month period that includes the three months before the month you become eligible for Medicare, the month you are eligible, and three months after the month you become eligible. For example, if you become eligible for Medicare when you turn 65 on May 15, your IEP will be February 1 to August 31. Note: If you are disabled and are turning 65 you will qualify for a new Part D IEP. That IEP will last seven months including the three months before you turn 65, the month you turn 65, and the three months after you turn 65. If you were paying a Medicare drug benefit premium penalty because you signed up late for Part D before you turned 65, you will no longer have to pay this once your Part D IEP begins.

If you join a Medicare drug plan during the three months before you are eligible for Medicare, your coverage will start the month you become eligible. If you join a Medicare drug plan during the month you become eligible, or during the three months afterwards, your drug coverage will start the first of the month after you enroll. You should enroll early during your IEP to make sure that your coverage begins as soon as you are eligible.

If you do not join a Medicare drug plan during your Initial Enrollment Period, you may not be able to enroll until Fall Open Enrollment. Fall Open Enrollment begins October 15 and ends December 7. Changes and enrollments made during Fall Open Enrollment become effective January 1. You may also have to pay a premium penalty.

Part D Late Enrollment Penalty
If you do not enroll in the Medicare drug benefit (Part D) when you first become eligible and you choose to enroll at a later date, you may have to pay a premium penalty. The premium penalty will be 1 percent for every month you delay enrollment (1 percent of the national base beneficiary premium). For example, the national base beneficiary premium in 2016 is $34.10 a month. If you delayed enrollment for seven months, your monthly premium penalty would be $2.39 ($34.10 x 1 percent = $0.341 x 7 = $2.39), which will be added to your plan’s monthly premium.

If you have to pay the premium penalty, and you do not qualify for Extra Help, you will have to do so for as long as you are enrolled in the Medicare drug benefit. This penalty will increase every year, as the national base beneficiary premium increases.

In some specific circumstances you will not have to pay the premium penalty. You will not have to pay a premium penalty for late enrollment if:

– You already have prescription drug coverage at least as good as Medicare’s (creditable). In order to avoid a premium penalty, you cannot have been without creditable drug coverage for more than 63 days. Speak with your insurer or your company’s human resources department to find out if your current drug coverage is as good as Medicare’s or better.

– You qualify for Extra Help and enroll in a Medicare drug plan. you show that you received inadequate information about whether your drug coverage was creditable.

• Deductibles, copayments, & coinsurance:

The amount you pay for Part D deductibles, copayments, and/or coinsurance varies by plan. Look for specific Medicare drug plan costs, and then call the plans you’re interested in to get more details.

Compare Medicare D Plans