How could I be involuntarily disenrolled from my Medicare Part D or Medicare Advantage plan?
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.
If I lose my Medicare plan coverage, when can I re-enroll into my 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.
For example, dual-eligible individuals (Medicare / Medicaid) or
Extra
Help recipients have a quarterly Special Enrollment Period to join,
switch, or disenroll from a Medicare Advantage Plan or Medicare drug
plan once during the first nine months the year. So if you receive Medicare Part D
Extra Help and lose your Medicare plan coverage, you are allowed to
re-join your Medicare plan starting the first day of the next month
after enrollment.
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: