Medicare Part D late enrollment penalty appeal fax

Where to fax a Part D Late Enrollment Penalty (LEP) Reconsideration Request Form to the Part D Independent Review Entity (C2C).

Verified October 22, 2026Checked against Part D Late Enrollment Penalty (LEP) Reconsideration Request Form (CMS.gov).

Medicare Part D late enrollment penalty appeal fax: which number to use
Who uses it	Office	Fax
Enrollees appealing a Part D late enrollment penalty	Part D IRE (C2C), LEP reconsiderations	(833) 946-1912

Before you fax

The form says to send it within 60 days of the date on the letter that says you have to pay a late enrollment penalty, and that the enrollee's signature is required.
Use one form for each enrollee.

Last verified October 22, 2026

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