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continued eligibility, if applicable, or (2) a minimum of 30 days after providing the advance notice of disenrollment.

If the SNP fails to process the disenrollment timely: • The SNP should send the disenrollment notice (MA Exhibit 32) to the enrollee regarding the potential for involuntary disenrollment with a proposed disenrollment date and the full length of the deemed continued eligibility period; • The SNP should send the disenrollment notice (MA Exhibit 33) to the enrollee regarding the loss of special needs status with an explanation of the delay and the revised disenrollment date.

For information on premiums, benefits, and cost sharing during the period of deemed continued eligibility, see Chapter 16-B of the Medicare Managed Care Manual.

Individuals who lose special needs status are eligible for a Special Election Period to make a new election. See § 30.6.13 for more information.

60.2.5 – Failure to Pay a Part D-Income Related Monthly Adjustment Amount (Part D- IRMAA) 42 CFR §§ 423.44(e), 423.286(d)(4), and 423.293(d)

Section 1860D-13(a)(7) of the Social Security Act requires that individuals be assessed a Part D income related monthly adjustment amount (Part D-IRMAA) in certain circumstances. The Part D-IRMAA is: • A monthly amount that is added to the individual’s Part D premium; • Based on an individual’s modified adjusted gross income (MAGI).

Individuals with Part D-IRMAA must pay this additional premium directly to the government, not to the plan. CMS has established a three-month initial grace period before individuals who fail to pay their Part D-IRMAA will be disenrolled from their MA-PD or Part D plan. After the three-month grace period, individuals who fail to pay their Part D IRMAA will be disenrolled from their MA-PD or Part D plan by CMS. CMS will notify the individual’s plan of the disenrollment via the DTRR. The disenrollment effective date is the first day of the month after the initial grace period.

Example: Ms. Jones owes a Part D-IRMAA and has a three-month grace period for premium payment. CMS bills Ms. Jones her monthly Part D-IRMAA amount, which is due March 1. Ms. Jones does not pay all the Part D-IRMAA amounts owed by the due date of the March bill. On March 7, the plan sends a nonpayment notice to Ms. Jones. She ignores the notice and subsequent monthly bills. Ms. Jones does not make the required payments during the three- month grace period (March, April, May). CMS disenrolls Ms. Jones effective June 1 and sends the plan a specific TRC via the DTRR.