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What happens if I am disenrolled from my Medicare Part D plan?

Category: Medicare Plan Disenrollment
Updated: Jul, 08 2023


If you lose your Medicare Part D coverage or are involuntarily disenrolled from your Medicare plan:
  • 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 limits (such as entering the Coverage Gap and receiving a Donut Hole discount or exiting the Coverage Gap 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).



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:






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  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
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  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
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  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.