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Medicare

Is It Possible To Lose Your Medicare Benefits?

Yes, it is possible to lose your Medicare benefits, but only if you fail to keep up with your payments.

How Medicare Works

To better understand how you could lose your Medicare benefits, you need to know how it works. Original Medicare, Medicare Advantage, Part D, and Medicare Supplements all function off of the same general payment structure.

When you enroll in a Medicare plan, you agree to make certain payments, while they agree to provide benefits and coverage in return. You must make three main types of payments towards your Medicare plan—premiums, deductibles, and cost-sharing fees.

Medicare premiums are paid once a month. For Original Medicare Part A, you likely won’t have to pay one. For Part B, the current premium for 2021 is $148.50. Premiums for other Medicare plans will vary.

A deductible is required once every calendar year you receive care. So, if you go a whole year without using any of your plan’s benefits, you won’t have to pay it. But, when you do use a benefit, you will pay the deductible. In 2021, the Part A deductible is $1,484 per benefit period. For Part B, the deductible is paid annually and is currently set at $203.

Cost-sharing is your contribution towards the total cost of a benefit. Say, for instance, that your Medicare plan covers 80% of the total cost of the item you need. You are required to cover the remaining 20% and thus “share the cost” with your plan.

When You Lose Benefits

What does all of this have to do with losing benefits? If you fail to make these payments, your plan will cancel your coverage.

You will have a few warnings before they cancel. If you miss a premium payment for one month, you will receive a notice in the mail. In the second month you miss your payment, you will receive a few more. In the third month, you will receive one more warning. Then, your coverage will end. The same will apply to any other missed payments.

Can You Get it Back?

If you have a valid reason for missing your payments, Medicare has a “good cause” policy. You must prove your reason with the plan, and they will reinstate your coverage, but only after you repay the missing payments. Acceptable reasons may include house fires, the death of a spouse, serious illnesses, etc.

We’re Here to Help—Call Today

We want to make sure you’re able to keep up with your Medicare costs. For help and advice, call Cornerstone Senior Advisors at 316-260-3331.