"Individuals with Part D-IRMAA [Part D-Income-Related Monthly Adjustment Amount] must pay this additional [IRMAA] premium directly to the government, not to their Part D plan sponsor. CMS has established a 3-month initial grace period before individuals who fail to pay their Part D-IRMAA will be disenrolled from their Part D plan.
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Example: Ms. Jones must pay a Part D-IRMAA. CMS bills Ms. Jones her monthly Part D-IRMAA amount in March, April and May. Ms. Jones does not pay all the Part D-IRMAA amounts owed by the due date of the May bill. CMS generates a disenrollment and sends the plan a specific TRC [Transaction Reply Code] via the daily TRR [Transaction Reply Report]. The effective date of the disenrollment will be June 1.
The Part D sponsor must send each affected individual a written notice of the disenrollment within ten (10) calendar days of receipt of the TRR indicating disenrollment for non-payment of the Part D-IRMAA.
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"If an individual does not have or no longer has Medicare prescription drug coverage, they shouldn’t be charged the Part D-IRMAA. However, if someone didn’t pay the Part D-IRMAA that was owed before disenrolling from their prescription drug coverage, they are responsible for the past due amount." [emphasis added]
"Individuals with Part D-IRMAA must pay this additional premium directly to the government, not to their plans. CMS has established a 3-month initial grace period before individuals in an MA plan with Part D coverage (MA-PD) who fail to pay their assessed Part D-IRMAA will be disenrolled from the MA-PD plan. CMS will report the disenrollments to the organization via the daily TRR [Transaction Reply Report] using a specific Transaction Reply Code (TRC). The effective date of the disenrollment is the first of the month following the end of the initial grace period. " [emphasis added](source: Medicare Managed Care Manual Chapter 2 - Medicare Advantage Enrollment and Disenrollment Updated: August 19, 2011 (Revised: November 16, 2011, August 7, 2012, August 30, 2013, August 14, 2014, July 6, 2015, September 1, 2015, September 14, 2015, December 30, 2015, May 27, 2016, August 25, 2016 & June 15, 2017))
"Individuals involuntarily disenrolled from their Medicare Part D [or Medicare Advantage] plan for failure to pay Part D-IRMAA have the opportunity to ask CMS for reinstatement into the plan from which they were disenrolled. CMS may reinstate enrollment, without interruption of coverage, if the individual demonstrates good cause and pays in full within three (3) calendar months of the disenrollment effective date:"Good Cause" generally means that you can show your failure to make timely IRMAA payments was due to unique, unusual, or unexpected circumstances over which you had no control and could not reasonably have been expected to foresee - and such an unusual event most likely will never occur again.
• The Part D-IRMAA amounts that caused the disenrollment for nonpayment of Part D-IRMAA, and/or
• Any plan premium amounts owed at the time they was disenrolled."