Is Your Medicare Plan Changing? Important Next Steps

The annual Medicare open enrollment period is here, and some enrollees will need to take action to avoid getting stuck in a plan that doesn’t meet their needs. By now, all enrollees should have received a notice about any Medicare plan changes going into effect in 2026. If you don’t like these changes, you have options.

Why Medicare Enrollees Should Pay Extra Attention This Year

In response to financial pressure, some Medicare insurance companies are dropping certain benefits. As a result, it’s possible that your Medicare plan will be discontinued in 2026. It’s also possible that your plan will continue to be offered, but some benefits may be cut.

For people who depend on Medicare, this can be stressful. However, there are still options. In fact, CMS says 97% of Medicare beneficiaries will have access to 10 or more Medicare Advantage plan choices for plan year 2026.

Will Your Medicare Plan Change Next Year?

To see if your Medicare Advantage or Medicare Part D plan is changing next year, check your Annual Notice of Change (ANOC). This is a letter that your plan should have sent out in September, detailing any plan changes. Any changes will go into effect starting January 1.

Possible changes could impact your:

• Your monthly premium may go up or down.
• Out-of-Pocket Costs. Look for changes to your copays (the amount you pay when you access care or buy a prescription) and your out-of-pocket maximum (the most you will be required to pay for covered care during a plan year).
• Many Medicare Advantage plans provide benefits that are not required under Medicare rules, and these benefits can change. For example, some plans offer gym memberships or dental benefits. Your plan may be adding or cutting benefits.
• Prescription Coverage. The amount you pay for certain prescriptions could be changing. There could also be changes to your deductible (the amount you pay out of pocket before your plan benefits apply).
• Watch for network changes. Most plans use networks of providers, medical facilities and pharmacies. If you don’t treat within these networks, you may have to pay more, and your care may not be covered.

If you have not received your Annual Notices of Change yet, contact your plan. You will need this information to make good decisions during open enrollment.

What if You Don’t Like Your Medicare Plan Changes?

When you receive your Medicare ANOC, review the plan changes to determine how they will impact you.

• Are you losing access to your doctor, pharmacy or hospital? If a primary care and specialty doctor you see is no longer in network, you may need to decide between switching to a plan that includes them or finding a new doctor. The same goes for the pharmacy or hospital you use.
• Are your costs increasing? If your premiums or out-of-pocket costs are increasing, you need to determine whether you can budget for the increase. If you can’t, you may be able to find a more affordable plan option. (If you’re really struggling with costs, you can also see if you qualify for the Medicare Savings or Extra Help programs.)
• Are your benefits being cut? If your plan is cutting benefits, consider whether you actually used these benefits or were planning to use them in the new year. If you want the benefits that are being cut, you can look for another plan that still offers them.
• Is your plan being discontinued? If your plan will no longer be offered in 2026, you should find a new plan.

Make the Most out of Your Medicare Enrollment Period

The annual Medicare enrollment period runs from October 15 to December 7. This is your opportunity to find the right plan for your needs, so don’t let it pass you by.

• If you are unhappy with your plan changes, explore your options to see if there’s another plan that suits your needs.
• Even if you are happy with your plan, consider exploring your options. It’s possible that there’s another plan that is an even better fit for you. You won’t know unless you look.

An independent agent can help you understand your plan changes and explore your plan options. Even if your plan hasn’t changed, it’s good to have a second opinion, and independent agents do not charge beneficiaries for guidance.

Do you need help with Medicare enrollment? Heffernan Insurance Brokers can guide you through the process and help you make an informed decision. Learn more.