Medicare late enrollment penalties can be costly.
Calculate 2026 Medicare Late Enrollment Penalties (LEP) and learn how they can be avoided.
Missing Medicare enrollment periods can cost thousands over a lifetime
Part A LEP
Up to 10% higher premiums for twice the number of years they could have had coverage
Part B LEP
10% increase for each 12-month period enrollment was delayed, for as long as they have Medicare
Part D LEP
Additional 1% per month without coverage, added to their premium for as long as they have Medicare
Medicare is health insurance, too. And its enrollment windows exist for a reason: the program only works if people join before they need it. But missing a window doesn't always mean a penalty is unavoidable —it depends on the part, how long enrollment was delayed, and whether a qualifying exception applies. For Part B and Part D, an unexcused delay means a permanent monthly increase. For Part A, the penalty is temporary, but only applies to those who pay a premium to begin with.
Medicare Late Enrollment Penalty Calculator
Medicare Part A eligibility
You're eligible for Medicare Part A when you:
- Are 65 or older and a U.S. citizen or permanent legal resident who has lived in the United States for at least 5 continuous years
- Receive or are eligible for Social Security or Railroad Retirement benefits
- Are under 65 and have certain disabilities
Premium-free Part A
Most people don't pay a premium for Part A when:
- You (or your spouse) has worked and paid Medicare taxes for at least 40 quarters (10 years)
- You're eligible for or receiving retirement benefits from Social Security or the Railroad Retirement Board
Premium-required Part A
You'll need to pay a monthly premium for Part A if you (or your spouse) worked and paid Medicare taxes for less than 40 quarters
About Part A Late Enrollment Penalties
If you're not eligible for premium-free Part A and don't buy it when you're first eligible, your monthly premium may go up 10%. You'll have to pay the higher premium for twice the number of years you could have had Part A but didn't sign up.
The 2026 Part A premium rates are:
- $0 per month if you or your spouse worked and paid Medicare taxes for 40 or more quarters
- $311 per month if you paid Medicare taxes for 30-39 quarters
- $565 per month if you paid Medicare taxes for fewer than 30 quarters
These premium amounts are subject to change annually.
Medicare Part B eligibility
You're eligible for Medicare Part B when you:
- Are 65 or older and a U.S. citizen or permanent legal resident
- Are already enrolled in Medicare Part A
You may also qualify if you:
- Are under 65 and have received Social Security Disability Insurance (SSDI) for 24 months
- Have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)
About Part B Late Enrollment Penalties
If you don't sign up for Part B when you're first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. The penalty is a 10% increase in your monthly premium for each full 12-month period you could have had Part B but didn't sign up.
The standard Part B premium for 2026 is $202.90 per month. This amount is subject to change annually.
Medicare Part D eligibility
You're eligible for Medicare Part D when you:
- Are enrolled in Medicare Part A and/or Part B
- Live in the service area of a Medicare drug plan
About Part D Late Enrollment Penalties
If you go without Part D or other creditable prescription drug coverage for any continuous period of 63 days or more after your Initial Enrollment Period, you may have to pay a late enrollment penalty.
The penalty is calculated as 1% of the national base beneficiary premium for each month you were without coverage. This penalty is added to your monthly Part D premium and may increase each year as the national base beneficiary premium changes.
The 2026 national base beneficiary premium is $38.99 per month. This amount is subject to change annually.
How to avoid Late Enrollment Penalties
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Who is eligible for Medicare?
A beneficiary becomes eligible for Medicare Part A when:
- They are 65 or older
- They are disabled
- They have End-Stage Renal Disease
- They are eligible for premium-free Part A if they or their spouse have paid Medicare taxes for 40 quarters.
They become eligible for Medicare Part B when:- They are eligible for premium-free Part A
- If they must pay a premium for Part A, they must meet these requirements to enroll in Part B:
- They are 65 or older
- They are a resident of the United States AND
- They are a U.S. Citizen, OR
- They have been lawfully present in the US for five continuous years before applying for Medicare
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Can the Initial Enrollment Period help avoid penalties?
The Initial Enrollment Period for Medicare is when a beneficiary is first eligible to sign up for Medicare Parts A and B.
The seven-month period begins three months before the month they turn 65, and ends three months after that month.
During this time, they can also elect to join a Medicare Advantage (Part C) plan or a Medicare Part D prescription drug plan.
Enrolling during the Initial Enrollment Period is one way to avoid Late Enrollment Penalties. -
How might Special Enrollment Periods help avoid penalties for Medicare Part A and Part B?
Certain situations, like a loss of employer-sponsored coverage after retirement, may qualify beneficiaries for a Special Enrollment Period.
Be careful: they only have eight months from the date they lost employer-sponsored coverage to join Medicare without facing a Late Enrollment Penalty for Part A and/or B.
If they are eligible for premium-free Part A, they will not have a late enrollment penalty for that Part.
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How might Special Enrollment Periods help avoid a Late Enrollment Penalty for Part D?
When a beneficiary becomes eligible for Medicare, they must maintain drug coverage that is at least as good as what a Medicare plan offers.
If they lose that coverage, such as when leaving an employer-sponsored plan or other prescription drug coverage, they have 63 days to enroll in new coverage without facing a penalty.
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How does the Low-Income Subsidy (Extra Help) affect a Part D Late Enrollment Penalty?
When a beneficiary is receiving a Low-Income Subsidy (or Extra Help), their Part D Late Enrollment Penalty, if applicable, is suspended.
The penalty will be reinstated should the beneficiary lose eligibility for Extra Help.
Check this year's income and resource limits to see if your client qualifies.
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