Many Medicare beneficiaries are attracted to zero-dollar premium plans that require no monthly financial commitment. In return, the beneficiaries are willing to accept the higher member cost sharing that generally accompanies these plans. Because these plans offer benefits richer than traditional Medicare and include Part D pharmacy coverage for no premium, zero-dollar premium plans routinely perform well during the annual enrollment period as it relates to member retention and growth. However, what happens to membership when the organization adds a premium to the zero-dollar premium plan?