Thousands of Medicare beneficiaries lost prescription drug coverage in 2026 after small previously zero-dollar premiums rose, and most cannot reenroll until the fall open enrollment for coverage beginning in 2027.
Many of the affected people were enrolled in Wellcare's Value Script stand-alone prescription drug plan, which has nearly 6 million customers, and a person with knowledge of the matter said Wellcare terminated coverage for about 140,000 Value Script beneficiaries in April.
Jude Pare and his partner, Diane Tix, said they returned to their Minnesota home in April to find a letter from Wellcare saying Pare's coverage had been terminated after three months of unpaid premiums totaling $28.80; Pare takes Xarelto, and Tix said, "He could bleed to death without it."
Some members owed as little as $8.10 for three months, and Wayne Bennett said Wellcare canceled his Value Script plan after he hadn't paid a $3.60 monthly premium; Medicare drug plans can drop customers who don't pay after a two-month grace period, which Wellcare extended to three.
About 40,000 of the people who were dropped may be able to enroll in new coverage immediately because they have low incomes and receive financial assistance through Medicare's "Extra Help" program, and beneficiaries who go without coverage for at least 63 days could face a permanent late-enrollment penalty that increases every year.
Christopher Krepich, a Centers for Medicare & Medicaid Services spokesperson, said the agency does not publicly provide plan-specific disenrollment figures and noted legal requirements limit what CMS can do to help beneficiaries who lose coverage for not paying premiums; Sarah Baiocchi, senior vice president for specialty and prescription drug plans at Centene, said members received a CMS-required annual notice of changes in September and blamed the Social Security Administration as a "key driver of non-payment disenrollments," while Social Security spokespeople referred questions to CMS and officials said premiums and other changes for 2027 will be unveiled in September.