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Can You Lose Your Medicare Benefits


As Medicare experts, we get many questions about losing Medicare benefits, how long Medicare benefits last, if you can put Medicare benefits on hold, and more. This article will answer all of these questions. Plus, you’ll learn how to handle real-life scenarios if you’re faced with losing your Medicare benefits.

Reasons You Can Lose Your Medicare Benefits

There are a number of reasons that can cause you to lose your Medicare benefits. First, let’s start with how your coverage can be terminated through Social Security Disability Insurance (SSDI).

SSDI Benefits Ending

SSDI is a federal program that assists Americans with disabilities. Individuals who stop receiving SSDI benefits can continue Medicare coverage for 93 months. However, they can only get 93 months of Medicare if they’ve completed their nine-month work period.

Additionally, they become eligible for premium-free Medicare Part A for eight and a half years if they finish the nine-month period and their trial work period. In the meantime, they can also continue paying for your Part B coverage.

With that said, if you return back to work before your Medicare benefits kick in, you’re responsible for sustaining your SSDI benefits if it pays more than your substantial gainful activity (SGA).

Not Paying Your Monthly Premiums

It’s important to pay your premiums on time to avoid losing your benefits. Beneficiaries get a 90-day grace period and two additional bills before their coverage is terminated. Your grace period starts the month you miss a payment.

Your coverage is terminated if you reach the end of your grace period and haven’t paid your outstanding balance after you receive a delinquent bill.

How You Can Lose Supplemental Medicare Coverage

Losing supplemental Medicare coverage is different from becoming dis-enrolled from Original Medicare. The following are reasons that can disqualify you from your current supplemental coverage.

Moving Outside Your Plan’s Coverage Area 

If you relocate to a new address with Medicare Advantage or Part D plan you could lose your coverage. Private insurance companies sell these plans, which are specific to certain areas.

Lying Or Omitting Information On Your Plan Medigap Application

When applying for a Medigap, you should never lie or attempt to leave out the truth. Doing so can lead to the cancelation of your coverage. You’ll need to answer health questions and undergo the medical underwriting process if you apply outside of your Medigap Open Enrollment Period. In this situation, it’s crucial to be as honest as possible about your health. 

How Long Do Medicare Benefits Last?

For those under 65 who are eligible due to disability, Medicare benefits last at least seven years and nine months, as long as your disability still meets certain requirements under Social Security. You’re responsible for reporting any changes to Social Security. This ensures that you’re payments are accurate. It also lets the agency know how long you’ll have Medicare once you return to work. 

FAQs

How do I check my Medicare benefits?
You can check your benefits by visiting SSA.gov, where you can create an online account. 
Will I lose Medicare if I get married?
You can only lose premium-free Part A if you were eligible through your ex-spouse and got remarried and your new partner did not pay enough quarters either.
Can I put Medicare on hold?
Yes, however, if you don’t have creditable coverage you are subject to paying a penalty.
What if I don't want Medicare?
By law, you don’t have to enroll in Medicare. However, you will face late enrollment penalties for Parts A, B, and D.
How long does it take for Medicare to kick in?
Medicare benefits start on the first day of the month of your 65th birthday if you’re getting Social Security. It could take up to three months if you apply yourself, or longer if you apply using the General Enrollment Period.
What happens when you lose Medicare?
If you lose your coverage, you could then be eligible for Medicaid.

How to Avoid Losing Your Medicare Benefits

While there are several ways you could lose your Medicare benefits, it’s usually preventable. We suggest staying on top of your payments and always being honest with your insurance providers. If you’re interested in a supplemental Medicare policy, give us a call at the phone number above. We also have an online rate form you can use to find plans near you.

Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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