What is the Part D late enrollment penalty in 2026?
The Part D late enrollment penalty in 2026 is 1% of the $38.99 national base beneficiary premium for every full month you went without creditable drug coverage, about $4.70 a month for each year late, added to your premium for as long as you have Part D.
It applies in New Jersey as everywhere if you went 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period ended. The base premium is reset each year, so the dollar amount can change even though your months do not.
| Months without coverage | Penalty rate | Added each month | Added per year |
|---|---|---|---|
| 12 months (1 year) | 12% | $4.70 | $56.40 |
| 24 months (2 years) | 24% | $9.40 | $112.80 |
| 36 months (3 years) | 36% | $14 | $168 |
| 60 months (5 years) | 60% | $23.40 | $280.80 |
Illustration, not a quote: a hypothetical example using figures from CMS: Creditable coverage and Part D late enrollment penalty guidance, CY 2025 (chapter 4).
How the penalty is calculated
Medicare counts the full months you were eligible but had no creditable drug coverage, multiplies by 1% of the national base beneficiary premium ($38.99 in 2026), and rounds to the nearest 10 cents. The result is added to whatever Part D or Medicare Advantage drug plan you join.
What avoids or reduces it
Creditable coverage: drug coverage from an employer, union, VA, TRICARE or similar that is expected to pay at least as much as standard Part D. Your employer or plan sends a yearly notice saying whether it is creditable; keep it. People who qualify for Extra Help do not pay the penalty.
If you think the penalty is wrong, you can ask for a reconsideration within the deadline in your penalty letter.
Worked example: thirty months without drug coverage
Say your Initial Enrollment Period ended June 30, 2024, you had no creditable drug coverage, and you join a plan that starts January 1, 2027. Medicare counts July 2024 through December 2026: 30 full months. At the 2026 base premium that is 30% of $38.99, or $11.70 a month and $140.40 a year, recalculated each January as CMS resets the base.
For 2027 CMS has set the base premium at $41.33 (CMS Part D announcement, July 28, 2026). The same 30 months then add $12.40 a month, or $148.80 a year. The months never change; the dollars follow the base premium.
On Medicare before 65? The penalty can reset
If you got Medicare early because of a disability and have been paying a Part D penalty, it does not have to follow you for life. CMS guidance says that when you turn 65 you get a new Initial Enrollment Period, your penalty ends the day before that period begins (three months before your 65th birthday month), and your record of months without coverage resets to zero (CMS Part D creditable coverage and late enrollment penalty guidance, CY2025, chapter 4). A new penalty can start only if you go 63 days or more without creditable drug coverage after that.
Choosing drug coverage in New Jersey for 2027
If you stay on Original Medicare, a stand-alone plan stops the count. New Jersey has 11 of them for 2027, with monthly premiums from $5.30 (Wellcare Value Script (PDP)) to $217.90 and drug deductibles from $300 to $700. If you prefer Medicare Advantage, 34 of the 41 Camden County plans include drug coverage. The other 7 do not, which only suits people with VA or other creditable coverage.
What to do next
If you are past 65 without creditable coverage, enrolling during Annual Enrollment (October 15 to December 7, 2026) stops the months from adding up. Our Part D penalty calculator estimates the amount, and Jackie can check your creditable coverage letters with you by phone or Zoom.
Related questions
What is the Part D late enrollment penalty in 2026?
The Part D late enrollment penalty in 2026 is 1% of the $38.99 national base beneficiary premium for every full month you went without creditable drug coverage, about $4.70 a month for each year late, added to your premium for as long as you have Part D.
Does the Part D penalty ever go away?
Generally no. It lasts as long as you have Medicare drug coverage, except for people who qualify for Extra Help.
Does VA coverage count as creditable?
Yes. VA drug coverage is creditable, so you can delay Part D without a penalty while you have it.
What is the 2026 national base beneficiary premium?
$38.99 a month. CMS sets a new figure each year.
Which New Jersey drug plans cost nothing with full Extra Help in 2027?
2 of the 11 New Jersey stand-alone plans are at or below the low-income benchmark for 2027 (Wellcare Classic (PDP) and Humana Basic Rx Plan (PDP)), so people with full Extra Help pay no monthly premium on them, per the CMS 2027 landscape.
Sources
- Medicare.gov: Part D late enrollment penalty Centers for Medicare & Medicaid Services
- CMS CY2027 landscape, New Jersey stand-alone Part D plans (PDP region 04) Centers for Medicare & Medicaid Services
- CMS: CY 2027 Part D base beneficiary premium announcement (July 28, 2026) Centers for Medicare & Medicaid Services
- CMS: Creditable coverage and Part D late enrollment penalty guidance, CY 2025 (chapter 4) Centers for Medicare & Medicaid Services
Please note: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.Garden State Medicare Solutions is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.