Medicare coverage is a lifelong benefit for individuals who meet eligibility criteria. However, there are certain situations where a person may have their coverage canceled.

To be eligible for Medicare, the federal health insurance program for older adults in the United States, you need to be 65 years of age or older.

If you’re younger than 65 years old, you may qualify for Medicare if you:

  • have disability and collect Social Security Disability Insurance
  • have end stage renal disease (ESRD)
  • have amyotrophic lateral sclerosis (ALS)

If you meet the eligibility requirements for Medicare, you have a right to coverage for the rest of your life.

However, it’s possible for your coverage to be canceled or discontinued. In this article, we discuss when this might occur and how to reenroll.

A person may lose their Medicare coverage if they:

  • stop paying their plan’s premiums
  • move out of their plan’s service area
  • no longer meet the eligibility criteria for the plan

Nonpayment of Medicare premiums

If you stop paying your monthly premiums, Medicare may terminate your coverage. Individuals enrolled in Original Medicare may have premium payments for Part A and Part B.

Generally, there is a grace period of a couple of months after a person stops paying their premium. During this time, you can get caught up on your payments. However, if you don’t resume them, Medicare will disenroll you from your coverage.

If you’re enrolled in a Medicare Advantage (Part C) or Part D plan, you’ll also need to continue paying your monthly premiums or risk termination of your coverage.

Moving out of a plan’s service area

If you move your permanent residence outside of your plan’s service area, it may affect your coverage.

Original Medicare coverage works anywhere in the United States. If you move abroad, you can stay enrolled in Medicare, but it won’t cover any healthcare services you receive. Likewise, if you’re incarcerated, you can keep your Original Medicare coverage, but it won’t be applied toward any of your healthcare costs, which will be covered by the penal institution.

Medicare Advantage plans work a bit differently. These plans have regional service areas, and your home address determines which plans you’re eligible for. If you move out of your county or state, it’s possible that you’ll no longer be in your plan’s service area.

If you have a Medicare Advantage plan and become incarcerated, the plan will consider you outside its service area and disenroll you.

If this happens, you may be disenrolled from the plan.

No longer meeting eligibility criteria

If you’re eligible for Social Security Disability Insurance (SSDI), you’re also eligible for Medicare. Eligibility involves having a condition that:

If you no longer meet the eligibility requirements for disability with the Social Security Administration, and you’re younger than 65 years old, your Medicare coverage may be discontinued.

However, if you have a qualifying disability but end up returning to work, you won’t automatically lose your Medicare coverage, provided your disability persists.

If you qualify for Medicare due to ESRD, your Medicare coverage will end 12 months after you stop receiving dialysis and 36 months after a successful kidney transplant.

Depending on why you lost Medicare coverage, you can likely reinstate it.

If you are disenrolled from Original Medicare, a Medicare Advantage plan, or a Part D plan due to nonpayment of the plan’s premium, you’ll have to wait until the Medicare open enrollment period to sign back up.

However, if you go without Medicare coverage for an extended time, you may be responsible for paying late enrollment penalties after you do enroll.

People who lost coverage due to leaving their plan’s service area may be able to avoid late enrollment penalties by qualifying for a special enrollment period (SEP). SEPs allow people to enroll in coverage outside of traditional enrollment periods.

If you have questions about reenrolling in Medicare after losing coverage, consider speaking with a Medicare representative about your situation or contacting your local State Health Insurance Assistance Program (SHIP).

For eligible individuals, Medicare coverage is a benefit that lasts a lifetime.

However, to maintain coverage, you’ll need to keep up with any necessary premium payments. Otherwise, your coverage may be discontinued.

There are other situations in which a person could lose their coverage, including moving out of their plan’s service area and no longer meeting eligibility criteria.