Thousands lose Medicare drug coverage over tiny unpaid premiums

Thousands of Medicare beneficiaries lost prescription-drug coverage after falling behind on premiums as small as $8, a penalty that hit people who did not realize their zero-premium plans had quietly become billable. In many cases, the loss left them locked out of coverage until 2027, turning a small unpaid balance into a years-long gap in drug access.

Medicare Part D is the optional drug benefit for people in Medicare, sold through private insurers approved by the program. Under Medicare rules, beneficiaries can face a late-enrollment penalty if they go 63 days or more without Part D coverage or other creditable prescription coverage. Once a plan disenrolls someone for nonpayment, the clock keeps running.

Medicare has warned that stand-alone Part D premiums were expected to climb, including hikes of up to $50 a month. A plan that once cost nothing can therefore start generating bills without the beneficiary recognizing the change, especially if notices are overlooked or the payment amount is small.

Drug-plan open enrollment runs from October 15 through December 7, and changes made then take effect January 1 of the following year. Someone dropped for nonpayment can miss the window to rejoin quickly and may have to wait through another coverage cycle before getting back in.

A separate Social Security premium-withholding error previously jeopardized coverage for about 250,000 seniors. In the current Part D cases, small delinquent balances, often unnoticed, triggered cancellation, then a long period without drug coverage and the risk of an added late-enrollment penalty.