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What Happens If You Lose Your Medicare Coverage?

If you’re nearing 65, you may have questions about Medicare. People often want to know, “Can Medicare coverage be terminated?

Yes, if you don’t pay your Medicare premiums, your coverage will be dropped. What are your options then?

Why You Could Potentially Lose Medicare Benefits

First, there are multiple reasons why you might lose Medicare coverage, most of which are your responsibility. 

  • You fail to pay plan premiums.
  • You no longer have a qualifying disability.
  • You move outside of the plan’s coverage area.
  • Your plan is discontinued — the insurer may go out of business, or they choose to drop a specific program from their offerings (this is out of your hands). 
  • You lie about something on your plan application.
  • You engage in “disruptive behavior” or Medicare fraud.

Termination for Nonpayment

Most plans allow a grace period, which they’ll specify before payment is deemed outstanding. This period usually happens around two months after the due date. If you haven’t paid your premiums by the end of the grace period, your plan could be terminated. If you think your plan was wrongly removed, you may appeal the decision. 

Nonpayment can affect your eligibility for future Medicare enrollment. Plans may require you to pay any past-due premiums from the last year of coverage. You’ll also need to pay the first month’s premium at the time you enroll. 

Related Post: Should My Employer Pay My Medicare Premiums?

Medicare Advantage (Part C) Termination

If you get dropped from a Medicare Advantage plan, you’re automatically re-enrolled in Original Medicare (Parts A and B). If you want to buy a new Advantage plan, you’ll have to wait until the next enrollment period. 

Medicare Part D Termination

If you get “Extra Help,” and your prescription drug coverage plan is cut off, Medicare will send you a Reassignment Notice. You should receive this via mail in October. The notice says that you’ll be reassigned to a new Part D plan for the following year. You can decide to join a new program on your own after comparing your insurance options.   

Also, you can be disenrolled from Part D if you move out of the plan’s service area, lose Part A coverage, or stop getting Part B. If you don’t pay the Part D late enrollment fee, you may also be dropped. You’ll need to pay any outstanding premiums if you want to re-enroll. 

Related Post: How Do Prescription Drug Plans Work? 

Medigap Termination

Medicare Supplement (Medigap) plans can drop you if you don’t pay premiums, provide false info on your application, and if the carrier goes bankrupt. What’s unique about Medigap policies is that they’re guaranteed renewable.  

If your plan is terminated for a reason out of your control, you have guaranteed-issue rights. These rights allow you to purchase a new policy without medical underwriting. Six out of ten Medigap plans are available under guaranteed-issue, and you have 63 days to enroll in one after yours is stopped. 

Has Your Plan Been Terminated? We Can Help

If your Medicare coverage has been terminated and you’re not sure how to regain it, don’t fear. We want to answer any questions and help you find a new plan. Contact Trusted Senior Specialists today.