I want to drop my Medicare plan and cannot find a Special Enrollment Period (SEP), what happens if I just stop paying my Medicare prescription drug plan premiums?

You may be disenrolled from your plan - and we do not recommend this action.  If you stop paying your Medicare plan premiums, your Medicare plan can:

• Involuntarily-disenroll you from the plan (after proper notice of non-payment and a grace-period) - and you may be without prescription drug (or healthcare) coverage for the remainder of the year (even if you agree to pay your unpaid premiums after disenrollment, your Medicare plan coverage will not be reinstated without showing "good cause" why you failed to pay your premiums,
  
  
• Send your unpaid premium balance to a collection agency (Medicare notes, "The [Medicare] plan has the right to take action to collect the unpaid premiums from the individual at any point during or after this [disenrollment] process."), and
  
  
• Require that you pay back-premiums should you ever try to re-enroll with the same Medicare plan carrier.  Medicare states, "[o]nce an individual is disenrolled for failure to pay premiums: [the] Plan can decline re-enrollment in the plan until payment of any outstanding past due premiums is received."  Also, your re-enrollment or enrollment in another plan must be requested during a valid election period.
  
  
• Plus, you may incur a permanent late-enrollment penalty if you ever choose to re-enroll in another Medicare Part D plan in the future (and this means you will pay a higher premium).

Suggestion #1: The Extra Help Program

If you are having trouble affording your monthly premiums, consider applying for the Medicare Part D Extra Help program and ask your local state Medicaid office about other programs that may provide you with assistance.  You can find a local Medicaid office at:  www.medicare.gov/talk-to-someone


Suggestion #2: Keep your plan and avoid the penalty

If you do not have any other creditable prescription drug coverage, then keep your Medicare plan this year and during the next annual Open Enrollment Period (AEP) that starts October 15th and continues through December 7th, work with a Medicare representative to find a more affordable Medicare plan (perhaps a Medicare Advantage plan that includes drug coverage and has a $0 premium).  A Medicare representative can be reached at: 1-800-633-4227.


Suggestion #3: Learn more before you stop paying your premiums

Please read our FAQ “I wish to drop my Medicare Part D prescription drug plan coverage. What should I do?” to learn more about dropping your Medicare plan during the AEP (October 15th through December 7th) or outside of the AEP using a Special Enrollment Period (SEP) or the Medicare Advantage Open Enrollment Period (MA-OEP).


For more information, please see:
2024 and prior years:
Medicare Prescription Drug Benefit Manual, Chapter 3 - Eligibility, Enrollment and Disenrollment, Updated: August 19, 2011, (Revised: November 16, 2011, August 7, 2012, August 30, 2013, August 30, 2014, July 6, 2015, September 1, 2015, September 14, 2015, December 30, 2015, May 27, 2016, August 25, 2016, June 15, 2017, July 31, 2018, August 12, 2020, & August 15, 2023)