Blog / Part D

Do I need Part D if I do not take any medications?

Almost always yes. The late enrollment penalty counts every month you go without drug coverage, and once it starts you pay it for life.

Updated September 3, 2026 · 3 min read · by Gerino Alejos

Yes, in almost every case you should still sign up. Part D is the part of Medicare that pays for prescriptions, and the late enrollment penalty counts the months you go without it, whether you fill a prescription or not. Once it starts, it never goes away.

How the penalty works

The penalty is a surcharge, an extra amount added to your premium, the monthly bill for the coverage. For every full month you go without creditable drug coverage after you are eligible, about 1 percent of a national base premium gets added on.

You pay it for as long as you have Part D. Two years with no coverage comes to about a 24 percent surcharge. Five years is about 60 percent.

The amount is worked out again each year against that national base number, so it grows over time instead of staying put.

The arithmetic: a small premium now versus a permanent penalty

Low cost drug plans exist for people who take nothing yet. Put a small monthly bill now next to a surcharge you pay for life, and signing up wins almost every time.

There is also the coverage itself. Being healthy at 65 tells you little about 70. One new diagnosis can mean a drug that costs hundreds a month, and with no plan you wait until January for coverage.

When you can safely skip Part D

Only if you already have other creditable drug coverage, meaning coverage at least as good as Part D. These count.

• VA prescription benefits.
• TRICARE.
• Most employer or union drug plans from a job you still hold.
• Some retiree drug plans.
• Certain Indian Health Service coverage.

Your plan has to tell you each year whether its coverage is creditable, usually in a notice that comes in the fall. Keep it. That letter is what you hand over if a penalty is charged by mistake. See what creditable coverage means.

What does not count as creditable coverage

• Prescription discount cards.
• Pharmacy savings programs.
• Drug company assistance programs.
• Marketplace coverage once you can have Medicare.

Any of these can lower what you pay at the counter. None of them stop the penalty clock.

What to do

1. If you have VA, TRICARE or work drug coverage, get it in writing that the coverage is creditable, and file the notice.
2. If you have none of that, sign up for a low cost plan that covers the basics during your enrollment window.
3. Look again each fall. If you start taking a drug, switch during Annual Enrollment, the fall window for changing drug plans, to one that covers it well.
4. If money is tight, check Extra Help first. It is a program that lowers what you pay for drug coverage, and it can bring the cost close to nothing. See Extra Help.

Start with the enrollment window you have now, because this penalty is easier to avoid than to undo. See the full detail on the penalty. If you want us to check whether your coverage counts, call our McAllen office at (956) 687 3334, or enter your ZIP code in the plan pricing box on this page.

Gerino Alejos

Licensed insurance agent · License 3128710 · NPN 18243381

Owner of McAllen Insurance Group, an independent agency on North 10th Street in McAllen. Works with clients across Hidalgo, Cameron and Starr counties on Medicare, Marketplace health, life and auto coverage. Se habla español.