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What Happens if You Fail to Pay Your Medicare Premiums

If you fail to pay your Medicare premium, you get reminders and a grace period to make the payment. Know all about defaulting on your Medicare premium.
A couple analyzing Medicare papers to avoid default
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Though you should regularly pay your Medicare premiums, it may happen at times that you fail or forget to do so. What happen in such cases and what do you do? You get reminders and a grace period to make the payment. But what if you still can’t make the payment and you get disenrolled from your Medicare plan? Know all about what happens if you fail to pay your Medicare premiums. ~ Ed.

What Happens if You Fail to Pay Your Medicare Premiums

If you rely on Medicare and forget to pay your Medicare premium, you may start to panic.

For example, you may wonder if you will lose your Medicare coverage due to an oversight.

Luckily, the Center for Medicare and Medicaid Services (CMS) have guidelines for what happens in the event you forget to pay your Medicare premium.

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Steps Plans Follow if You Fail to Pay Your Medicare Premiums

Generally, CMS requires plans to take the following steps if you do not pay your Medicare premium:

  • Send you a written bill: This bill must include both the amount due and the due date
  • Send you a written notice of the missed payment: The notice must state the consequences for non-payment, such as plan disenrollment.
  • Give you a grace period to make payment: Plans are required to give you at least a two-month grace period to make payment before disenrolling you. Although plans are encouraged to mail you multiple notices, they are only required to mail you one. 

If you do not make payment after the plan’s grace period, the plan can disenroll you. This may occur on the first day of the month following the end of the grace period. For example, if you miss your February payment, your plan may send you both a written bill and a written notice of missed payment in February. Your grace period would then be the months of February and March. If your grace period ends on March 30, you can be disenrolled on April 1. 

It is important to remember that some situations protect you from automatic disenrollment. For example, plans cannot disenroll you if your monthly premiums are paid directly from your Social Security payment.

What Happens After You Are Disenrolled From Your Medicare Plan?

After you have been disenrolled, the next steps depend on the Medicare plan that has disenrolled you:

  • If you have been disenrolled from a Medicare Advantage plan, you will be automatically enrolled in Original Medicare. You can sign up for another Medicare Advantage plan during the Open Enrollment period. It occurs annually from October 15 through December 7.
  • If you have been disenrolled from a Medicare Part D drug plan, you can sign up again during Open Enrollment. However, you may still be required to pay for outstanding premiums you still owe before you are allowed to re-enroll in Medicare Part D.
  • You can request an additional chance to keep your coverage and pay your premiums. Medicare recognizes a “Good Cause” policy. It allows you to get your coverage reinstated if you can show a good reason that you did not make your payment. To take advantage of the Good Cause policy, you should contact your plan no later than 60 days after you have been disenrolled.

Final Words

If you think you have forgotten to pay your Medicare premium, the most important thing that you can do is to reach out to your plan as soon as possible. Your plan will help you determine the best way to get up to date with your payments.

Over to you

Have you ever defaulted on your Medicare premium? If yes, then what did you do? Let us know in the comments.

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Disclaimer: We're not offering any medical advice here. These ideas are for educational and entertainment purposes only. Always seek a professional medical opinion from a physician of your choosing before making any medical decision. The information provided here is not intended to be a substitute to the advice given by your physician or another healthcare professional.

Disclaimer: Though the views expressed are of the author’s own, this article has been checked for its authenticity of information and resource links provided for a better and deeper understanding of the subject matter. However, you're suggested to make your diligent research and consult subject experts to decide what is best for you. If you spot any factual errors, spelling, or grammatical mistakes in the article, please report at [email protected] Thanks.

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