Part D Late Enrollment Penalty and What You Can Do

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The Part D late enrollment penalty can actually be present on a Medicare Advantage (MAPD) plan, too, as it contains a Part D component. So, someone with a $0 premium "Advantage" plan may be getting a bill for the premiums that this late enrollment penalty can cause.

The problem is that when you start onto Medicare after the age of 65, Medicare expects that you will get a Part D plan. When you do not, they put the burden of proof onto you to show that you had creditable coverage the time since you were 65 until the time you have signed up for a drug plan with Medicare.
Important links to help:
https://www.medicare.gov/drug-coverag...

https://www.medicare.gov/drug-coverag...

Note:
If you get Extra Help, you don't pay the late enrollment penalty.

How Do I Ask for a Reconsideration?

The reconsideration request form should have been sent with the Late Enrollment Penalty Reconsideration Notice (if you cannot find the reconsideration request form, please call the member services department for your Medicare Part D plan). Complete the form. Mail it to the address or fax it to the number listed on the form within 60 days from the date on the letter you got stating you had to pay a late enrollment penalty. You should also send any proof that supports your case, like information about previous creditable prescription drug coverage -- send only copies of your original support documents.

If you wait more than 60 days, you must explain why your request is late.
Medicare will decide if you had cause to send a late request.

What Do I Need to Include with My Late Enrollment Penalty (LEP) Reconsideration Request?

A completed, signed Late Enrollment Penalty (LEP) reconsideration request (keep a copy).

Copies of information you believe may help your case.

If you’ve named someone to act for you, a copy of the proof the individual can represent you.
NOTE: Do not send original documents.

Your Medicare drug plan will give you a reconsideration request form when it sends you the letter telling you that you have to pay a late enrollment penalty. Mail the completed form to the address, or fax it to the number listed on the form within 60 days from the date on the letter. You should also send any proof that supports your case, like information about previous creditable prescription drug coverage.

Reconsideration of a Late Enrollment Penalty (LEP) is processed by an Independent Review Entity (IRE) which is also known as a Qualified Independent Contractor (QIC). The IRE/QIC handling Late Enrollment Penalty Reconsiderations is:

MAXIMUS Federal Services
Medicare Part D QIC
P.O. Box 991
Victor, NY 14564-0991

Fax numbers: (585) 869-3320
Toll free fax: (866) 589-5241
Customer Service: 585-425-5300
Toll Free Customer Service: 877-456-5302

If you need more information about requesting a reconsideration of your late enrollment penalty, call your Medicare drug plan. You also may visit www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) for help. TTY users should call 1-877-486-2048.