Medicare Advantage Plans and Prescription Drug Plans can disenroll members if they fail to pay their premiums. All policies have grace periods of at least two months before the member is officially removed from the plan. When a member is disenrolled from a Medicare Advantage plan, they are automatically enrolled in Original Medicare. They can then wait until the next available enrollment period, generally between October 15 and December 7, to make any changes to their plan.
Part D Plans also disenroll members who move out of the plan’s service area, lose Medicare Part A benefits, or stop having Part B. Misrepresenting expected reimbursement from third-party coverage for Medicare-covered drugs will also lead to disenrollment. You can also be disenrolled for not paying the Part D late enrollment penalty, which accounts for the time you go without creditable prescription drug coverage. If you want to re-enroll in a Prescription Drug Plan, you may be asked to pay any outstanding premiums.
Plan Termination
If your plan is terminated due to you moving out of state, you may qualify for a Special Enrollment Period. This will then allow you to enroll in a new Medicare Advantage plan or prescription drug coverage plan. Plans are often region-specific, and Part D plans operate within a pharmacy network that can be local, regional, or national.
Medicare has a “Good Cause” policy, allowing people to ask for reinstatement of their coverage if they can show “good cause” for not having paid the premiums before the grace period ended. You can contact your policy within 60 days of disenrollment to request reinstatement with Good Cause. Good reasons may be emergencies or unexpected circumstances that prevented you from paying the premiums on time. If the request is accepted, you will have to pay the outstanding premiums within three months of the disenrollment.
Medicare Supplements
For Medicare Supplement Plans, there are only three reasons your plan can drop you:
- You fail to pay your premiums
- You gave false information on your application
- The insurance company goes bankrupt or insolvent
Medicare Supplement Plans are guaranteed renewable and give you guaranteed-issue rights. This means that if your plan is discontinued by no fault of your own, you can buy a new Medigap Plan without medical underwriting. Regardless of your current medical condition, you can still buy a plan. Plans A, B, C, F, K, and L are available under the guaranteed-issue. You have 63 days to find a new plan once yours is discontinued.
Cancelling Plans
If you choose to cancel your Medicare Advantage plan, you can do so during the Medicare Advantage Open Enrollment Period from January 1 to March 31, during the fall Open Enrollment Period from October 15 to December 7, or during a Special Enrollment Period particular to your circumstances. You can switch from Medicare Advantage back to Original Medicare and add a Part D plan to keep your prescription drug coverage.
