You take no medications. Here is why skipping the drug plan can cost you every month for the rest of your life.

Part four of Healthcare in Retirement, and back to the legal pad. I am not an advisor. I am an engineer. This one is pure arithmetic, so I will show every step, and the advisors at American Retirement Advisors can tell you what it means for you.

The situation

You are 66 and healthy. No prescriptions. A caller said it to us almost word for word: "I don't take any statins regularly or anything like that, so I don't have anything that I take." So why on earth would you pay for a Medicare drug plan?

Two reasons, and neither one is about the pills you take today.

Reason one: the penalty is permanent, and it grows while you wait

Part D is optional. But Medicare keeps score. If you go 63 days or more without drug coverage that counts as creditable, from the end of your Initial Enrollment Period on, a late enrollment penalty gets added to your premium when you finally join, and it stays there for as long as you have Medicare drug coverage, even if you switch plans.

The formula is simple enough to do on a napkin. One percent of the national base beneficiary premium, which is $38.99 for 2026, multiplied by the number of full months you went without coverage, rounded to the nearest ten cents. So:

• 12 months without coverage: $4.70 a month, every month, for life.
• 24 months: $9.40 a month.
• 30 months: $11.70 a month, about $140 a year.
• 60 months: $23.40 a month, about $281 a year.
• Skip it from 65 to 75, then need it: 120 months, $46.80 a month, about $560 a year, on top of whatever the plan costs, until the end.

And because the base premium is reset every year, the penalty is recalculated against the new number every year. It does not fade. It follows the base premium up.

We hear the other end of this on the phone. A man with a deduction on his Social Security statement he could not explain: "It says it's for late enrollment penalty, but what is a late enrollment penalty? Why?" By the time someone asks that question, the answer is usually "years ago," and there is nothing to be done about it.

Reason two: you cannot sign up when you need it

This is the one people do not see coming. Suppose you skip the plan, and in February a doctor hands you a prescription that costs real money. You cannot just enroll. You can join a drug plan only during your Initial Enrollment Period, during the Annual Enrollment Period from October 15 to December 7 with coverage starting January 1, or during a Special Enrollment Period for a specific life event like moving or losing other coverage. A new diagnosis is not on that list. So you pay full retail from February to January, and then the penalty starts.

Not taking medication is a fact about today. It is not a plan.

What the insurance actually costs

Here is the part that makes the decision easy. In 2026, Arizona has 10 stand-alone drug plans, and the lowest monthly premium is $0. Nevada is the same: 10 plans, lowest premium $0. And every Part D plan this year caps what you pay for covered drugs at $2,100 for the year.

So the comparison is this. A $0 or low-premium plan that you never use, which starts the clock on nothing and hands you a $2,100 ceiling the day a diagnosis shows up. Or no plan, a penalty that compounds monthly, and a year of retail prices before you can even fix it. I have done harder math than that. This is about as clean an answer as this kind of math gets.

One warning. A pharmacy discount card is not creditable coverage. It saves you money at the counter and does nothing to stop the penalty clock. We wrote about that here. Coverage that does count includes a current or former employer's plan, TRICARE, and the VA, which is why yesterday's veteran can breathe easy as long as he keeps his VA drug coverage.

What a Certified Medicare Planner® does differently

They make sure everyone on Original Medicare has some drug plan at the right price, even the healthy ones, and they say why. They match the plan to the pharmacy you actually use, not the cheapest sticker. They review it every fall, because plans change their prices and their drug lists every year, and a $0 plan this year is not automatically $0 next year. They keep the paperwork that proves creditable coverage from a job or the VA, so a penalty is never charged by mistake, and if one is, they know how to appeal it. And when a prescription finally arrives, they are the phone call that says, you are covered, here is your copay.

If you have no drug plan right now, October 15 is your next door, and it closes December 7. The advisors are at 602-281-3898.

Friday, October 2. Foothills Library, Glendale, 10:30 AM. Mustang Library, Scottsdale, 2:30 PM. No cost. Register at 123easymedicare.com/medicare-workshop or call (877) 220-1089.

Next in Healthcare in Retirement: the Medigap door that locks behind you. Why leaving a Medicare Advantage plan for a Supplement later can mean health questions, a denial, or a higher price, the 12-month trial right that protects you once, and the one thing Nevada has that Arizona does not.

This event is presented by 123EasyMedicare, a brand of American Retirement Advisors, an independent, private organization. It is not sponsored by, endorsed by, or affiliated with Medicare, the Centers for Medicare & Medicaid Services, the Social Security Administration, or any government agency. The libraries are not sponsors of, and are not affiliated with, this event. Educational only; not tax, legal, or insurance advice.

Disclaimer: This article is for educational purposes only. It is not sponsored, endorsed, or otherwise representative of Medicare or the federal Medicare program. American Retirement Advisors is not a government agency. For official Medicare information, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).