Ven. Feb 7th, 2025

07/02/2025

12:16
CSTMedicare provides essential health coverage for millions, but certain circumstances can lead to a loss of eligibility. With February 2025 approaching, it’s important to understand who might be at risk and why.1. Non-Payment of PremiumsMedicare isn’t always free-some beneficiaries must pay premiums, particularly for Part B (medical insurance) and Part D (prescription drug coverage). Failure to pay premiums can result in coverage termination. However, there is usually a grace period, and reinstatement may be possible during the Annual Enrollment Period (AEP) or a Special Enrollment Period (SEP).2. Moving out of the U.S.Medicare generally does not cover healthcare services outside the U.S. If a beneficiary moves abroad, their coverage can become inactive. While they can continue paying for Part B, their benefits won’t be usable until they return to the U.S.3. IncarcerationMedicare benefits are suspended if a beneficiary is incarcerated in a federal prison. While coverage resumes upon release, during incarceration, the facility is responsible for medical care costs.4. End of Coverage for Specific Health ConditionsSome beneficiaries qualify for Medicare due to severe medical conditions, but coverage isn’t always permanent.End-Stage Renal Disease (ESRD): Medicare coverage typically ends 12 months after stopping dialysis or 36 months after a kidney transplant.Disability Before Age 65: If someone qualified for Medicare due to a disability but later returns to work, they may receive up to 93 months of continued Medicare coverage. After that period, they must requalify based on their disability status.5. Switching to a Medicare Advantage PlanEnrolling in a Medicare Advantage plan means most Part A and Part B benefits are handled by the private insurer instead of Original Medicare. While coverage continues, benefits may change, and failure to understand plan details could lead to unintended gaps in coverage.6. Changes in Medicare Savings Programs (MSP) EligibilityMSPs help low-income individuals pay for Medicare costs, including premiums and co-pays. However, income thresholds vary by state, and an increase in income or assets could result in loss of MSP benefits, making Medicare more expensive but not eliminating eligibility.Most people who qualify for Medicare keep their coverage for life, especially if they qualify by age. However, staying informed about requirements and changes is crucial. If you’re concerned about your Medicare eligibility, check with the Social Security Administration or Medicare to ensure uninterrupted coverage.