Sometimes Medicare plan premiums inadvertently do not make it to the plan and unfortunately, even if you unintentionally did not pay
your Medicare plan premiums, your Medicare plan has the option of involuntarily disenrolling
you from the Medicare plan.
So what should you do if you learn that your Medicare plan premium payments have not been made over the past months?
Contact your Medicare plan immediately.
The good news is Medicare has implemented safe-guards
to protect Medicare beneficiaries who inadvertently missed a premium
payment and requires your Medicare plan to contact you about unpaid
premiums during the “grace period
you receive a notification that your Medicare plan premium is unpaid,
telephone the Medicare plan’s Member Services department immediately and
arrange to make the payments (the toll-free number is on your Member ID
card and most printed plan materials).
If you find that you have
already been disenrolled from your Medicare plan, you can still contact
your plan’s Member Services department and, if you have “good cause
” for why your Medicare plan premiums were not paid, ask to pay the unpaid premiums and be reinstated in the plan. Please click here for more
questions and answers related to Medicare plan disenrollment.
Question: If I pay just a part of my overdue premium, will my partial payment be enough to stop the disenrollment process?
Your partial payment of unpaid plan premiums may not be enough to stop the disenrollment process. The Medicare manual notes
: "While the sponsor may accept partial payments, it has the right to ask for full payment within the grace period
If the member does not pay the required amount within the grace period,
the effective date of disenrollment is the first day of the month after
the grace period ends."
Question: If I pay all of
my unpaid Medicare plan premiums after being disenrolled, will the plan
then reinstate my Medicare Part D plan coverage?
As noted above, without showing good cause
after disenrollment, just paying your unpaid premiums
will not be enough to get you reinstated back into your Medicare plan.
Instead, you will need to use a valid enrollment period to rejoin your
Medicare plan – such as a Special Enrollment Period (SEP
) (see "Changing Medicare plans to lower drug costs or increase coverage
") or the annual Open Enrollment Period (AEP
) that begins on October 15th.
Question: Can I be disenrolled from my Medicare prescription drug plan if I don’t pay my Part D IRMAA?
If you are a higher-earning Medicare beneficiary, you can be assessed an Income-Related Monthly Adjustment Amount (IRMAA
) that must be paid in addition to your Medicare Part D premium.
to your monthly premium payments, if you do not pay your Part D IRMAA, your
Medicare plan can “involuntarily” disenroll you from your plan and you
could be without prescription drug coverage for the remainder of the
year. You can click here to read more
about failing to pay Medicare Part D IRMAA.
You are responsible for Medicare Part D IRMAA payments if you are
enrolled in a Medicare prescription drug plan (PDP), a Medicare
Advantage plan that includes prescription coverage (MAPD), or if you
receive Medicare drug coverage through an employer or union health plan.