- You may no longer have any prescription drug coverage until you join another Medicare plan - this means that you will pay full retail price for your medications and the cost of your prescriptions will not count toward meeting your Medicare plan's coverage limit (exiting the Initial Coverage phase and receiving Catastrophic Coverage). However, if you have other drug coverage, such as VA coverage, you will still be able to use your VA drug coverage, even if you lose your Medicare Part D coverage.
- You may incur a permanent late-enrollment penalty that you will begin paying each month when you re-enroll in a Medicare Part D plan (you can read more below). You will not incur a late-enrollment penalty if you are eligible for the Medicare Part D Extra Help program or if you have some other form of creditable prescription drug coverage (such as VA, employer, or union drug coverage).
Your Medicare Part D plan or Medicare Advantage plan has the right, in certain situations, to involuntarily disenroll you from the Medicare plan and these situations include:
- Moving out of your plan's geographic Service Area
- for example, if you live in California and permanently move to
Florida, you would no long live in your Medicare plan's Service Area and
your Medicare plan can disenroll you from coverage - the good news is
that you are granted a Special Enrollment Period (SEP) when you move to a new Service Area that allows you the opportunity to join a new Medicare plan.
- Not paying your monthly premiums, IRMAA,
or late-enrollment penalties - you are naturally required to pay you
monthly premiums and other costs - but, Medicare plans will usually work
with someone who has missed a single payment or provides a "grace period" for you to pay any back or missing plan costs.
- Acting in a disruptive or abusive way toward your Medicare plan.
Once an individual is disenrolled from their Medicare Part D plan, they must wait until the next available enrollment period to join another Medicare plan. Unless the individual has a Special Enrollment Period, their next opportunity to enroll would be during the Annual Election Period (AEP) which runs from October 15th through December 7th of each year. As a note to Medicare Advantage plan Members who lose their plan coverage...
If you are enrolled in a Medicare Advantage plan and you are involuntarily disenrolled from your Medicare Advantage plan, you will automatically be enrolled back into your Original Medicare Part A and Medicare Part B coverage - but will not have access to any of your Medicare plan's additional coverage benefits (like dental or vision coverage).
The possibility of a permanent monthly penalty for people losing their Medicare prescription drug coverage
If there is a period of 63 continuous days or more when you are not enrolled in a Medicare Part D plan - and you do not have any other form of creditable prescription drug coverage (such as VA or employer coverage), you may have to pay a late-enrollment penalty when you later join a new Medicare drug plan. The late-enrollment penalty can change each year and is an additional fee you will pay each month along with your monthly Medicare plan premiums. You can read more about late-enrollment penalties in our FAQ section.
Also see:
- Can an individual re-enroll in their Medicare Part D plan if they re-pay their premium?
- How does the premium grace period work on Medicare Part D plans?
- What are Medicare Part D plans required to do before an individual is disenrolled from the plan?
- Can a plan disenroll a person with Medicare if they didn't pay their monthly premium?