Can I Pause My Medicare Coverage?

Once you become eligible for Medicare at age 65, you have the option to enroll in or defer enrollment in Medicare Part B (medical insurance) and Part D (prescription drug coverage).

However, you cannot pause your Part A coverage if you are receiving it premium-free. You’d have to completely drop Part A and Part B, with some risks involved.

Below is an overview of whether and how you can pause your Medicare coverage:

Can You Pause Medicare Part A?

Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health services.

If you or your spouse paid Medicare taxes while working for at least 10 years (40 quarters), you receive premium-free Part A coverage at 65.

In this case, you cannot voluntarily pause or drop just Part A – it is an automatic entitlement once you turn 65. Your Part A coverage will remain active unless you proactively drop Parts A and B completely (more details below).

However, if you have to pay a premium for Part A because you didn’t pay enough Medicare taxes while working, you have the option to drop your Premium Part A coverage. You would need to follow the instructions below for dropping Part B.

Can You Pause Medicare Part B?

Medicare Part B covers physician services, outpatient care, preventive services, ambulance services, durable medical equipment, and more.

Most people pay a premium for Part B coverage. If you want to pause Part B coverage, you can drop it at any time by following these steps:

• Contact Social Security and request to withdraw your Part B enrollment. You can call 1-800-772-1213 or visit your local Social Security office.

• Submit a signed written request using Form CMS-1763.

• If you recently received your Medicare card, return the card to Social Security. Keeping it indicates you agree to Part B enrollment.

• Your Part B coverage will end the first of the month after your request is processed.

• You will have to pay back any premiums paid for the months you had Part B coverage.

Keep in mind that dropping Part B leaves you without outpatient and preventive coverage. You’d need to pay 100% of costs for Part B-covered services out of pocket until you re-enroll.

Can You Pause Medicare Part D?

Medicare Part D provides prescription drug coverage through private insurers. It has a monthly premium which varies based on the plan you select.

You can drop Medicare Part D coverage at any time by contacting your plan and requesting disenrollment. Your coverage will end the first of the following month after your request.

Without Part D coverage, you’d pay full price for prescription medications until you enroll again during a valid enrollment period.

What Are the Risks of Pausing Medicare Coverage?

Before dropping any part of your Medicare coverage, it’s important to understand the potential risks:

• Paying full health costs out-of-pocket: Without the dropped coverage, you’ll have to pay 100% of costs for services, drugs, or care normally covered. This can get very expensive.

• Gaps in coverage: If you want to re-enroll later, you may have to wait for the next valid Medicare enrollment period. This can leave you without important coverage.

• Lifetime late enrollment penalties: If you don’t have a special enrollment period, re-enrolling later can incur costly late penalties you pay for as long as you have that Medicare coverage.

• Declined Medigap coverage: In most states, dropping Medicare to enroll in employer coverage means you lose your federal protections for purchasing a Medigap policy when you retire.

Evaluate whether the risks are worth temporarily pausing coverage based on your situation. Get advice from a Medicare expert if unsure.

How Do You Completely Drop Medicare Parts A and B?

In certain cases, you may want to completely drop all Medicare coverage if you have other solid health insurance. For example, some people with employer coverage over 65 want to defer enrolling in any part of Medicare.

To fully drop Medicare Parts A and B:

• You’ll need to actively decline automatic enrollment in premium-free Part A when first eligible at 65 if you don’t want it.

• Follow the instructions above to disenroll from Part B by contacting Social Security.

• Return your Medicare card if you received one. This completely ends all Part A and Part B entitlement.

Without any Medicare coverage, you cannot enroll in Medicare Part D or a Medicare Advantage Plan either. You’d rely solely on your employer health plan.

Be sure to sign up for Medicare during a special enrollment period before your employment coverage ends to avoid coverage gaps and penalties.

When Can You Re-enroll in Medicare After Pausing?

If you want to restart any paused or dropped Medicare coverage, you’ll need to wait for an enrollment period:

Re-Enrolling in Part B

• January 1 – March 31 each year – This is Medicare’s general enrollment period for Part B. Your coverage starts July 1.

• Special enrollment period – If you have employer coverage, you get an 8-month special enrollment period after the employment coverage ends to enroll in Part B without penalty.

• General enrollment penalty – If you don’t have a special enrollment period, you may have to pay a 10% penalty for each 12-month period you delayed Part B.

Re-enrolling in Part D

You can enroll in Medicare Part D or a new prescription drug plan during the following periods:

• October 15 to December 7 – This is the annual open enrollment period for Medicare Part D and Medicare Advantage plans. Coverage begins January 1.

• Special enrollment period – If you lose other creditable prescription drug coverage like an employer plan, you have 2 months to enroll penalty-free.

• General enrollment penalty – If you don’t have a special enrollment period, you may have to pay a 1% penalty for every month you delayed Part D coverage.

Talk to a Medicare expert or your State Health Insurance Assistance Program (SHIP) to understand your specific enrollment options before dropping any part of Medicare.

Common Scenarios for Pausing Medicare

Some common situations where Medicare enrollees may temporarily pause their coverage include:

Returning to Work After 65

If you have the option for employer group health insurance after age 65, you may want to suspend Medicare Part B and D coverage to avoid paying double premiums. You cannot pause premium-free Part A.

Carefully review how the employer plan coordinates with Medicare before making any changes. Rules differ based on company size.

Becoming Eligible for Veterans or TRICARE Benefits

If you become eligible for Veterans Affairs (VA) benefits or military TRICARE coverage after age 65, you may want to drop Medicare Part B and D coverage to avoid paying extra premiums.

The VA and military coverage act as the primary payer while you have it. You can re-enroll in Medicare Part B and D later with a special enrollment period.

Leaving U.S. to Live Abroad

Once you are out of the U.S. for 6 months in a row, your Medicare Part B coverage ends automatically. Part A coverage will continue if you paid Medicare taxes for at least 30 quarters (7.5 years).

You can re-enroll in Part B with no penalty if you return to the U.S. within 12 months of losing eligibility. The general enrollment period applies if longer than 12 months.

Gaining Medicaid, QMB, or SLMB Eligibility

If you become retroactively eligible for Medicaid, QMB, or SLMB benefits after being enrolled in Medicare Part B, you can request to have your Part B premiums stopped for any months where the state paid on your behalf.

Contact Medicare to stop premium deductions going forward once the other coverage begins. Provide documentation showing your Medicaid/QMB/SLMB eligibility start date.

The Takeaway

While you cannot voluntarily pause premium-free Part A coverage, you can disenroll from Medicare Part B and Part D coverage if you want to defer enrollment due to other health insurance options.

However, this comes with some risks like coverage gaps and late penalties if you don’t re-enroll under a valid enrollment period. Seek expert guidance to understand the implications before dropping any part of Medicare.

Frequently Asked Questions

Can I just pause one part of Medicare?

No, you cannot selectively pause just Part A, Part B, or Part D. You must completely disenroll from Part B and/or Part D coverage if you wish to pause them.

What happens if I disenroll from Medicare but keep my card?

Simply keeping your Medicare card does not mean you have active coverage if you request to disenroll from Part B and/or Part D. You must return the card if you do not want the coverage.

Can I pause my Medigap policy along with Medicare?

If you completely drop Medicare Parts A and B, you will need to cancel any Med