Who could lose Medicare coverage in February 2025
Medicare provides essential health coverage to millions of Americans, but eligibility can end in certain circumstances. If you are receiving Medicare benefits, it’s important to understand why your coverage could end and how to prevent it.
Not paying Medicare premiums
Medicare isn’t completely loose—many beneficiaries must pay premiums each month for Part B (medical health insurance) and Part D (prescription drug coverage).
- If a person doesn’t pay their Medicare rates on time, their coverage can quit.
- There’s typically a grace period all through which coverage may be reinstated by way of paying the stability owed.
- If coverage ends, it can be restarted at some stage in the Annual Enrollment Period (AEP) or Special Enrollment Period (SEP).
Coverage may end if you live outside the U.S.
If a person moves out of the U.S., his or her Medicare coverage may be affected.
- Medicare does not cover health services internationally. If you live outside the U.S., your coverage may become inactive.
- However, you can continue to pay for Part B if you wish, but you will receive benefits only if you return to the U.S.
Medicare coverage may be suspended if you are incarcerated
If a beneficiary is incarcerated in a federal or state prison, his or her Medicare coverage is automatically suspended.
- While in prison, medical care is the responsibility of the prison administration**.
- Medicare coverage is automatically reinstated after release from prison.
- However, beneficiaries should contact the Medicare office to update their information so that their coverage is not delayed.
Mediciary coverage may end for certain health reasons
Some people receive Medicare for certain medical conditions, but this coverage is not always permanent.
- End-Stage Renal Disease (ESRD): If a person stops dialysis, Medicare coverage ends after 12 months. Similarly, if a person has a kidney transplant, coverage may end after 36 months, unless the person is otherwise eligible for Medicare. – Disability-based eligibility under age 65: If a person was receiving Medicare because of a disability but later returned to work, he or she receives Medicare coverage for 93 months. After that, he or she must prove eligibility based on his or her disability status again.
Medicare Advantage (Part C) may change
Many Medicare beneficiaries leave Original Medicare for Medicare Advantage (Part C) plans, which are administered by private insurance companies.
- Although this plan continues coverage, its benefits and services may change.
- If a person does not understand the plan’s rules and benefits, there may be a sudden decrease or change in access to health care.
Medicare Savings Program (MSP) eligibility may end
Medicare Savings Programs (MSPs) help people who have low income to afford Medicare premiums and co-payments.
- These programs work based on income limits, and these limits can vary by state.
- If a beneficiary’s profits or property growth, she or he may end up ineligible for this assistance application.
- While this doesn’t mean Medicare coverage will quit, it could growth the fee of health care because the character will now should undergo the complete value himself or herself.
Conclusion
For most people, Medicare coverage lasts a lifetime, especially when they are age-eligible. But changes in eligibility rules, payment requirements, and financial situation can create a risk of terminating coverage.
If you are concerned that your Medicare coverage may stop, contact your Social Security or Medicare office in a timely manner and ensure your uninterrupted access to health services.