Medicare Part D Penalty Calculator Please fill in the dates below to get an estimated penalty amount. Medicare Eligibility DateIf your eligibility date is prior to June 2006 you will use June 2006 as the starting valueEligible MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberEligible YearPlease enter a value between 2006 and 2025.ELIGIBLE TOTALMedicare Enrollment DateEnroll MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberEnroll YearPlease enter a value between 2006 and 2025.ENROLL TOTALTOTAL DIFFERENCEYEAR WARNINGPENALTY CALCPENALTY CALC 2The Eligibility Date must come before your Enroll Dates. Monthly PenaltyThis is only an estimate. Your actual penalty cost may vary. NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.