Can a Medicare Advantage plan drop a member for not paying premiums?
Yes, an MA plan may disenroll a member for failure to pay premiums, but only after giving reasonable collection efforts, a grace period of at least two whole calendar months, and proper notice — this is optional for the plan, not automatic.
What the rule says
“Except as specified in paragraph (d)(1)(iv) of this section, an MA organization may disenroll an individual from the MA plan for failure to pay basic and supplementary premiums under the following circumstances:”
“The MA organization can demonstrate to CMS that it made reasonable efforts to collect the unpaid premium amount, including:”
“Providing the individual with a grace period, that is, an opportunity to pay past due premiums in full. The length of the grace period must—”
“Be at least 2 whole calendar months; and”
“The MA organization provides the enrollee with notice of disenrollment that meets the requirements set forth in paragraph (c) of this section.”
“An MA organization may not disenroll an individual who had monthly premiums withheld per § 422.262(f)(1) and (g) of this part, or who is in premium withhold status, as defined by CMS.”
Per CMS guidance (CY 2027), this is a plan-by-plan choice:
“Disenroll the member after a grace period and proper notice.”
“Disenrollment for failure to pay plan premiums is optional for each plan; however, plans must apply disenrollment policies consistently across all enrollees, including applying a consistent grace period of no less than two whole calendar months.”
This answer relies in part on the CY 2027 enrollment guidance, which applies to enrollment requests received on or after January 1, 2027 (and may apply to AEP enrollments effective that date).
Carrier and FMO rules are often stricter than CMS rules. This tool reports what CMS sources say and is not legal advice. Enrollment guidance shown is the CY 2027 version. Regulation text reflects the CY 2027 marketing rules, which apply to marketing beginning October 1, 2026.
This answer was generated by mapdbot from the sources listed below on October 2, 2026 and checked against them. Regulation text: eCFR as of 09/15/2026. It is for licensed insurance agents, is not legal advice, and does not cover carrier or FMO rules.