A person may decide to disenroll from Medicare Part B for various reasons. Medicare allows people to reenroll in Part B if they want to, though they may face penalties.
Medicare may remove an individual from Part B due to nonpayment of premiums. A person may choose to disenroll themselves voluntarily if, for example, they found alternative health coverage.
It is possible for the individual to reenroll in Medicare Part B. However, they will generally need to pay late penalties.
This article looks at Medicare Part B and the reasons a person might no longer be enrolled. It also discusses the process an individual should follow to reenroll. Finally, it explains enrollment periods, penalties, and premiums.
Glossary of Medicare terms
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
An individual who wants to reenroll in Medicare Part B may have to pay a late enrollment penalty. Generally, the cost of the penalty relates to the length of time a person experienced a gap in coverage.
The monthly premium also increases by 10% for each 12-month period that an individual was eligible for Medicare Part B for but did not enroll.
The State Health Insurance Assistance Program (SHIP) offers advice about reenrolling in Part B and penalties.
To reenroll in Medicare Part B, individuals need to complete an application form on the Social Security Administration website.
The application process requires supporting documentation. The exact documents a person will need depend on their circumstances, such as whether the individual is enrolled in an employer’s healthcare insurance plan.
Besides the initial enrollment period, Medicare provides two standard opportunities each year for people with Medicare to reenroll in Part B or change their coverage.
In some cases, a person may not have to pay late enrollment fees. This may occur if they enroll during a special enrollment period (SEP).
Medicare general enrollment period
January 1 to March 31 is the Medicare general enrollment period.
People can join or reenroll in Original Medicare (parts A and B) for coverage to begin on July 1.
People with a Medicare Advantage plan can switch plans or join Original Medicare.
Medicare annual open enrollment period
October 15 to December 7 is the Medicare open enrollment period.
During this time, people can switch from a Medicare Advantage plan back to Original Medicare or vice versa.
People can also change Medicare Advantage plans and add, drop, or switch Medicare Part D (prescription drug) plans. Coverage starts January 1 of the following year.
Exceptions
Medicare allows exceptions for significant life events, such as moving to a new house, and offers SEPs.
Qualifying individuals can reenroll in Original Medicare or change their Medicare coverage during an SEP.
Learn more about Medicare enrollment periods.
Medicare may disenroll a person if they have not paid their premiums. A person may also disenroll themselves by leaving the plan voluntarily.
Because adequate healthcare coverage is important, the SHIP program can help a person make informed decisions about Medicare coverage, including looking at different options they may choose instead of Part B.
Missed premiums
Medicare can disenroll an individual from Part B if they do not pay the monthly premiums. However, Medicare provides up to a 3-month grace period to allow someone to pay the overdue premiums.
Grace period
Medicare beneficiaries must pay Part B premiums on or before the 25th day of the month after the date of the initial bill.
For example, if a person gets an initial bill on July 28, payment is due by August 25. If a person does not pay by that date, they will receive a second bill from Medicare, requesting payment by the 25th day of the following month. In this example, that would be September 25.
If Medicare does not receive payment after the second bill, the beneficiary receives a delinquency notice. This notice demands the total by the 25th day of the following month. In this example, that would be October 25.
If a person does not pay during the 3-month grace period, they will receive a termination notice stating they no longer have Medicare coverage.
However, if a person pays their missed premiums within 30 days of the termination notice, they will continue to receive Part B coverage. Otherwise, Medicare discontinues their coverage.
If a person’s coverage is discontinued, they must reenroll in Part B during the Medicare general enrollment period from January 1 to March 31.
Medicare good cause policy
If a person feels they have a good reason or cause for not paying their premiums, they can ask Medicare for reinstatement under the Medicare good cause policy.
The individual must be able to prove the reason for missing payments. Acceptable reasons typically include hospitalization, serious illness, the recent death of a spouse or close family member, or a house fire.
People will still need to pay the full amount for the premiums they owe within a specific time limit for Medicare to resume their coverage.
Alternative healthcare coverage
An employer may provide an alternative healthcare insurance plan for their employee. The coverage may also extend to their spouses.
If the employer insurance ends, Medicare provides a special enrollment period (SEP) to allow people to enroll in Part B. A person can sign up at several different times, such as:
- while they are still in the group health plan
- during the first month after they are no longer covered by the plan
- when the person stops working, whichever event happens first
Coverage will begin either on the first day of the month a person enrolls or any time within the following 3 months, as the person chooses. In this case, coverage will begin on the first day of the month of their choice.
However, if a person chooses to enroll at any other time during the 8-month SEP, their coverage will start the month after they enrolled.
Read about Medicare vs. private health insurance.
Medicare Part B is part of Original Medicare. Generally, people are first eligible for Medicare Part B when they turn 65 years old, unless they have other qualifying conditions.
Part B covers medically necessary services and supplies, such as:
- outpatient care and emergency room visits
- preventive services, including tests and screenings
- ambulance transport
- durable medical equipment, such as crutches and wheelchairs
- mental health services
Medicare extends both Medicare Part A and Part B benefits to people who:
- are age 65 years or older
- have a disability and receive Social Security income or Railroad Retirement Board benefits
- have received a diagnosis of end stage renal disease
- have received a diagnosis of amyotrophic lateral sclerosis
A person can use this online tool to find out whether Medicare covers a service, item, or test.
Learn more about Medicare Part B.
The Social Security Act sets out the Medicare premiums, deductibles, and copays each year.
An individual’s income determines what they will pay for their Medicare Part B monthly premium. For individuals with an income below $103,000, the standard monthly premium is $174.70 in 2024, with an annual deductible of $240.
A person will generally pay 20% of the cost for Medicare-covered services after they have paid the deductible.
Learn more about Medicare costs.
People who receive Medicare benefits can decide to disenroll from their Medicare Part B plan or may be disenrolled for not paying their premiums.
Medicare allows a person to reenroll in a plan, but they may have to pay a late enrollment penalty fee and provide proof of other coverage.
Since it is essential to have adequate healthcare coverage, people should fully understand the risks and benefits of changing their health insurance. Medicare provides a free, unbiased advisory service through the SHIP program to help people make informed decisions about Medicare coverage.