US · guidance
CMS Pub. 100-01, ch. 2, § 40.7.7
Late Enrollment Penalty (LEP) for Premium Part A
If an individual did not enroll in premium Part A when first eligible, they may have to pay
a higher monthly premium if they decide to enroll later. The monthly premium for Part A
may increase up to 10%. The individual will have to pay the higher premium for twice the
number of years the individual could have had Part A, but did not sign up.
For individuals enrolling using the SEP Related to Coverage Under Group Health
Plans, the premium Part A LEP is calculated by adding the months that have elapsed
between the close of the individual’s IEP and the end of the month in which the individual
enrolls. For enrollments after your IEP has ended, months where you had group health
plan coverage are excluded from the LEP calculation.
For individuals enrolling using an Exceptional Conditions SEP, the International
Volunteers SEP, or the SEP for Certain TRICARE Beneficiaries, no LEP will be applied.
History
(Rev. 12046, Issued:05-18-23, Effective:01-01-23, Implementation:06-21-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a2fa425b7adc1eaa8ec2784822369a7f91f53beabbff3a4c7757a42bdda3cf59
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